Hypertension Clinical Trial
Official title:
Bridging the Evidence-to-practice Gap: Evaluating Practice Facilitation as a Strategy to Accelerate Translation of a Systems-level Adherence Intervention Into Safety Net Practices
The proposed project will address this evidence-to-practice gap by evaluating the effect of practice facilitation (PF) of the intervention implementation fidelity (primary outcome) and clinical measures at 12 months (secondary outcomes).
Status | Recruiting |
Enrollment | 700 |
Est. completion date | December 30, 2024 |
Est. primary completion date | July 1, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 90 Years |
Eligibility | Inclusion Criteria: - Self-identify as Latino - Be fluent in English or Spanish - Be age 18 years or older - Receiving care in a safety-net primary care practice - Have uncontrolled HTN documented in the electronic health record (EHR) on at least two visits in the past year (defined as an average BP = 140/90 mmHg) - Have been prescribed at least one anti-hypertensive medication and be non- adherent to their medications, defined as adherence <80% in the preceding 12 months, as determined by prescription orders obtained from the clinic EHR. Clinic and nonclinical staff inclusion criteria: • Primary care provider (MD/DO, NP), Nurse, Medical Assistant, or administrative staff employed at the participating practices and (b) interacts with at least five patients with a diagnosis of hypertension. Exclusion Criteria: - Being deemed unable to comply with the study protocol (either self-selected or by indicating during screening that s/he could not complete all requested tasks) - Participation in other hypertension-related clinical trials - Have significant psychiatric comorbidity or reports of substance abuse (as documented in the EHR) - Plan to discontinue care at their practice within the next 12 months Clinic and nonclinical staff exclusion criteria: • Refuse to participate |
Country | Name | City | State |
---|---|---|---|
United States | NYUMC Langone | New York | New York |
Lead Sponsor | Collaborator |
---|---|
NYU Langone Health |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Level of implementation fidelity | Implementation fidelity will be defined as the degree to which ALTA was delivered, as intended. A mixed methods approach will be used to assess the five core domains of implementation fidelity: (1) adherence to the program protocol; (2) dose of the program delivered; (3) quality of program delivery; (4) participant responsiveness; and (5) program differentiation. | 12 months | |
Secondary | Blood Pressure (BP) control | First, BP control, will be defined as SBP <140 and DBP <90 mmHg.121 BP control will be assessed using the mean of the last two measurements recorded in the electronic health record (EHR) during each of the pre-intervention and post-intervention study periods (baseline and 12 months). We will also examine the proportion of patients with BP control <130/80 mmHg in exploratory analyses to provide preliminary data on BP control rates of hypertensive Latino patients when considering the new guidelines. We will also explore mean change in systolic and diastolic BP based on the mean of the last two recorded BP readings in the EHR during the pre- and post-intervention periods. | Baseline and 12 months | |
Secondary | Medication adherence | Will be assessed via pharmacy refills obtained from prescription orders in the clinic EHR using the proportion of days covered (PDC) metric, calculated as the total number of days covered by the medication. | 12 months |
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