Strategies to Manage High Blood Pressure

Overseen By Arleen F Brown, MD, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Los Angeles

Disqualifiers: No hypertension, Outside care, Under 18

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to improve high blood pressure management in Los Angeles County clinics by testing different strategies. It will evaluate three approaches: training doctors, educating patients, and maintaining usual methods. The goal is to enhance blood pressure management for everyone, with a focus on cultural differences. Titled "Multi-ethnic Multi-level Strategies and Behavioral Economics," the trial seeks to address these issues. Suitable participants have been diagnosed with high blood pressure and receive care at specific LA clinics. As an unphased trial, it offers participants the chance to contribute to innovative strategies that could enhance healthcare for diverse communities.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on managing blood pressure through outreach and education, so you may not need to change your current medication routine.

What prior data suggests that these strategies are safe for managing high blood pressure?

Research has shown that the treatment methods being tested, known as Multi-ethnic Multi-level Strategies and Behavioral Economics, aim to improve blood pressure management in clinics across Los Angeles County. The goal is to ensure everyone, regardless of background, receives the right support for managing high blood pressure.

These methods do not involve new drugs or risky procedures, focusing instead on education and support for both patients and healthcare providers. This approach generally poses little risk of side effects. The emphasis is on teaching individuals how to better manage their health and ensuring doctors have the necessary resources.

From a safety perspective, there is little cause for concern. The aim is to enhance health outcomes through supportive and educational means, rather than new medications or invasive treatments. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these strategies for managing high blood pressure because they focus on both healthcare providers and patients, which is different from the usual treatment methods like medication and lifestyle changes. The trial explores multi-level strategies that incorporate behavioral economics to potentially enhance adherence and effectiveness. By tailoring approaches specifically to providers and patients over different phases, these strategies aim to create sustainable improvements in blood pressure management that could outperform traditional methods.

What evidence suggests that this trial's strategies could be effective for managing high blood pressure?

This trial evaluates various strategies to manage high blood pressure, focusing on healthcare providers and patients. Research has shown that tailoring strategies to different ethnic groups can improve blood pressure management by considering cultural and economic factors. The trial includes provider-focused strategies, patient-focused strategies, and usual strategies, each implemented in different phases. Approaches targeting healthcare providers can raise awareness about the challenges of controlling blood pressure and improve access to medications. Strategies aimed at patients often include educational materials that respect cultural differences, boosting patient involvement and resource use. Although results vary, these methods aim to enhance overall blood pressure management, especially in diverse communities. ^{1 4 6 7 8}

Who Is on the Research Team?

Arleen F Brown, MD, PhD

Principal Investigator

University of California, Los Angeles

Are You a Good Fit for This Trial?

This trial is for diverse patients with high blood pressure in Los Angeles County Department of Health Services clinics. It's not specified who can't join, but it seems aimed at understanding and improving how patients manage their condition with the help of healthcare providers.

Inclusion Criteria

Accessing primary care at participating clinic in LAC DHS

Hypertension code in EHR (ICD-9 codes: 401, 402, 403, 404, 405, 437.2 and ICD-10 codes: I10, I11.0, I11.9. I12.0, I12.9, I13.0, I13.10, I13.11, I13.2, I15.0, I15.8, I67.4)

Exclusion Criteria

No hypertension codes in EHR

Primary care outside of participating clinic or LAC DHS

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention Implementation

Provider-focused and patient-focused outreach strategies are implemented to improve blood pressure management practices

2 years

Routine meetings and outreach activities

Sustainment

Observation of clinic use of patient- and provider-focused outreach practices without study-initiated interventions

1 year

Follow-up

Participants are monitored for safety and effectiveness after intervention

1 year

What Are the Treatments Tested in This Trial?

Interventions

• Multi-ethnic Multi-level Strategies and Behavioral Economics

Trial Overview The study tests three strategies to manage high blood pressure: one focused on educating providers, another on educating patients, and a third as usual care without special education. Clinics will be randomly assigned to these approaches to see which works best over three years.

How Is the Trial Designed?

Group I: Usual Strategies - Year1 Experimental Treatment 1 Intervention

Usual strategies implemented in year 1, patient-focused and provider-focused strategies implemented in year 2, and sustainment in year 3.

Group II: Provider-Focused Strategies - Year1 Experimental Treatment 2 Interventions

Provider-focused strategies implemented in year 1, patient-focused strategies implemented in year 2, and sustainment in year 3.

Group III: Patient-Focused Strategies - Year1 Experimental Treatment 2 Interventions

Patient-focused strategies implemented in year 1, provider-focused strategies implemented in year 2, and sustainment in year 3.

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials

1,594

Recruited

10,430,000+

National Heart, Lung, and Blood Institute (NHLBI)

Collaborator

Trials

3,987

Recruited

47,860,000+

Published Research Related to This Trial

The Achieve BP study assessed the willingness to accept (WTA) and willingness to pay (WTP) for blood pressure management among 38 patients with uncontrolled blood pressure, highlighting the importance of considering patient time and costs in evaluating treatment adherence.

Results showed that WTP was about twice as responsive as WTA, indicating that patients may value their willingness to pay for interventions more than their willingness to accept them, which can inform future health services research and cost-effectiveness evaluations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Willingness to pay and willingness to accept in a patient-centered blood pressure control study. Gleason-Comstock, J., Streater, A., Goodman, A., et al.[2022]

A unified community-based approach to prevent high blood pressure is essential, emphasizing lifestyle changes that are safe and culturally appropriate, which can lead to significant health benefits.

Combining medical strategies with community programs can enhance the effectiveness of hypertension prevention efforts, highlighting the importance of collaboration between health professionals and community leaders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The primary prevention of high blood pressure: a population approach. Blackburn, H., Grimm, R., Luepker, RV., et al.[2019]

The BETTER-BP trial is testing a digitally-enabled incentive lottery to improve adherence to antihypertensive medications among 435 patients with poorly controlled hypertension over a 6-month period.

If effective, this innovative approach could significantly enhance medication adherence and lower systolic blood pressure in vulnerable populations, potentially leading to broader implementation in healthcare settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Study design of BETTER-BP: Behavioral economics trial to enhance regulation of blood pressure. Dodson, JA., Schoenthaler, A., Fonceva, A., et al.[2023]

Citations

1. ucla.clinicaltrials.researcherprofiles.org ucla.clinicaltrials.researcherprofiles.org/trial/NCT06359691

Multi-ethnic Multi-level Strategies and Behavioral Economics ... Of the 43% of LAC DHS patients with hypertension, 60% are uncontrolled. ... The intervention partners with LAC DHS to randomize clinics to one of three strategies ...

2. implementationscience.biomedcentral.com implementationscience.biomedcentral.com/articles/10.1186/s13012-025-01452-5

Protocol for a Type 3 hybrid effectiveness-implementation ... In the U.S., racial and ethnic disparities in hypertension control contribute to disparities in cardiovascular mortality.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12192770/

Multilevel Interventions Demonstrate Mixed Effectiveness for ... There was mixed evidence that multilevel interventions targeting cardiovascular health improved blood pressure among US-based adults.

4. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/10.1111/1475-6773.13983

The National Heart Lung and Blood Institute Disparities ... Multi-ethnic multi-level strategies and behavioral economics to eliminate hypertension disparities in LA County, Reducing asthma attacks in ...

5. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2838314

Behavioral Economic Framing for Enrollment and ... In this trial, we evaluated whether opt-out framing after providing remote BP monitoring cuffs to patients with hypertension preenrollment ...

6. withpower.com withpower.com/trial/phase-hypertension-5-2024-43bc9

Strategies to Manage High Blood Pressure · Info for Participants This N/A medical study run by University of California, Los Angeles needs participants to evaluate whether Multi-ethnic Multi-level Strategies and ...

7. reporter.nih.gov reporter.nih.gov/project-details/10144853

Predicting and Reducing Future Health Disparities for U.S. ... We aim to develop a multi-ethnic simulation model of diabetes outcomes and to use this model to forecast the long-term implications of efforts to reduce ...

8. clinicaltrials.ucbraid.org clinicaltrials.ucbraid.org/high-blood-pressure

High Blood Pressure clinical trials at University of California ... Multi-ethnic Multi-level Strategies and Behavioral Economics to Eliminate Hypertension Disparities in Los Angeles County. Sorry, in progress ...