540 Participants Needed

Strategies to Manage High Blood Pressure

AW
AF
Overseen ByArleen F Brown, MD, PhD
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: University of California, Los Angeles
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

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 data supports the effectiveness of the treatment Multi-ethnic Multi-level Strategies and Behavioral Economics for managing high blood pressure?

Research shows that using behavioral economics strategies, like incentive programs, can help people stick to their blood pressure medication, which in turn can lower blood pressure, especially in disadvantaged groups.12345

Is the treatment generally safe for humans?

The research articles do not provide specific safety data for the treatment, but they focus on improving medication adherence and blood pressure control, which are generally safe strategies.12567

How does the Multi-ethnic Multi-level Strategies and Behavioral Economics treatment for high blood pressure differ from other treatments?

This treatment is unique because it combines behavioral economics (using psychological insights to influence behavior) with community-based strategies to improve blood pressure control, especially in disadvantaged minority populations. It focuses on patient-centered interventions and culturally appropriate education, rather than just medication, to address high blood pressure.128910

What is the purpose of this trial?

The goal of the study is to promote equitable hypertension (HTN) management across the diverse patient population found in Los Angeles County Department of Health Services (LAC DHS) clinics.To achieve this goal, the study team will conduct provider- and patient-focused outreach strategies to understand how to best support adoption of blood pressure management practices already available within LAC DHS.LAC DHS clinics will be randomly assigned to one of three study conditions: 1) provider-focused outreach, 2) patient-focused outreach, and 3) usual outreach. The study will occur across 3 years with patient- and provider-focused outreach occurring in Year 1 and 2. In Year 3, study initiated patient- and provider-focused outreach will stop, and clinic use of patient- and provider-focused outreach practices will be observed by the study team.Provider-focused outreach includes increasing cultural awareness of factors that hinder and support blood pressure control, increasing access to blood pressure medications, and providing blood pressure management education. Patient-focused outreach includes using culturally sensitive educational materials and reminders to improve patient understanding of blood pressure, education on how to manage the condition, and increasing awareness of available blood pressure management resources. Clinics assigned to the usual outreach condition will operate as per usual in Year 1 but will receive patient- and provider-focused outreach in Year 2.

Research Team

AF

Arleen F Brown, MD, PhD

Principal Investigator

University of California, Los Angeles

Eligibility Criteria

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

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

Treatment Details

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.
Participant Groups
3Treatment groups
Experimental Treatment
Group I: Usual Strategies - Year1Experimental Treatment1 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 - Year1Experimental Treatment2 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 - Year1Experimental Treatment2 Interventions
Patient-focused strategies implemented in year 1, provider-focused strategies implemented in year 2, and sustainment in year 3.

Find a Clinic Near You

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+

Findings from Research

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.
Study design of BETTER-BP: Behavioral economics trial to enhance regulation of blood pressure.Dodson, JA., Schoenthaler, A., Fonceva, A., et al.[2023]
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.
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.
The primary prevention of high blood pressure: a population approach.Blackburn, H., Grimm, R., Luepker, RV., et al.[2019]

References

Study design of BETTER-BP: Behavioral economics trial to enhance regulation of blood pressure. [2023]
Impact of a Patient-Centered Behavioral Economics Intervention on Hypertension Control in a Highly Disadvantaged Population: a Randomized Trial. [2022]
Blood pressure kiosks for medication therapy management programs: business opportunity for pharmacists. [2022]
Can we reduce the cost of illness with more compliant patients? An estimation of the effect of 100% compliance with hypertension treatment. [2022]
'Decision support system (DSS) for prevention of cardiovascular disease (CVD) among hypertensive (HTN) patients in Andhra Pradesh, India'--a cluster randomised community intervention trial. [2022]
Cost-Utility of an Objective Biochemical Measure to Improve Adherence to Antihypertensive Treatment. [2019]
Willingness to pay and willingness to accept in a patient-centered blood pressure control study. [2022]
Community panel discussions: from research to community action. [2008]
The primary prevention of high blood pressure: a population approach. [2019]
10.United Statespubmed.ncbi.nlm.nih.gov
Factors that appear as obstacles to the control of high blood pressure. [2005]
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