Machine Learning to Reduce Hypertension Treatment Clinical Inertia

Hypertension Clinical Trial

Official title:

Machine Learning to Reduce Hypertension Treatment Clinical Inertia

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05406336
• Other study ID #: K01HL151974
• Status: Not yet recruiting
• Phase: N/A
• Start date: October 1, 2024
• Est. completion date: July 31, 2025

Study information

• Verified date: June 2024
• Source: Temple University
• Contact: Gabriel Tajeu, DrPH
• Phone: 2055312258
• Email: gabriel.tajeu[@]temple.edu
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Among individuals with an uncontrolled BP at the current visit, the objective of this study is to compare clinical management of hypertension with and without information from a machine learning algorithm on whether a patient will have uncontrolled blood pressure at their next follow up visit through a case-vignette study.

Description:

Among adults with uncontrolled blood pressure (BP) at a clinic visit, clinical inertia is common. Clinical inertia is defined as a failure of providers to initiate or intensify treatment (i.e., adding medication or increasing dosage) when guidelines indicate doing so. Prior studies report that clinicians intensify antihypertensive medication treatment in less than 20% of visits where intensification would have been clinically recommended. Thus, patients who have uncontrolled BP may not receive timely therapy to control their BP. To address this issue, the investigators will use a randomized design to test the hypothesis that clinicians will be more likely to intensify the hypertensive regimen and/or assess nonadherence for patients with uncontrolled BP at the current visit when presented with information that a patient is predicted to have uncontrolled BP at the next visit by a machine learning algorithm.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 100
• Est. completion date: July 31, 2025
• Est. primary completion date: May 31, 2025
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 20 Years and older

Eligibility

Inclusion Criteria: practicing Temple University Health System primary care clinicians who see patients (i.e., internal medicine, family medicine, attending physicians, nurse practitioners) will be eligible to participate -

Exclusion Criteria:

-

Related Conditions & MeSH terms

• Hypertension

Intervention

Other:
• Predicted uncontrolled BP status (yes/no) at follow up visit, derived using a machine learning algorithm
The investigators have created a machine learning algorithm to predict uncontrolled blood pressure (BP) status (yes/no) at a follow up visit among adults with uncontrolled BP at their current visit. The investigators will determine whether adding this information to a vignette describing a patient will increase the likelihood that a clinician will intensify antihypertensive medication treatment.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Temple University

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Vignette #1 - antihypertensive medication treatment intensification	A clinical vignette of a patient with uncontrolled blood pressure will be presented to clinicians. They will then be asked to assess wether they would intensify antihypertensive medication treatment. This will be assessed using a 5-point Likert scale with scores ranging from 1 ("Strongly disagree") to 5 ("Strongly agree"). Likert scale scores will be compared between clinicians in the control and intervention group.	Immediately after clinical vignette
Primary	Vignette #2 - antihypertensive medication treatment intensification	A second clinical vignette of a patient with uncontrolled blood pressure will be presented to clinicians. They will then be asked to assess wether they would intensify antihypertensive medication treatment. This will be assessed using a 5-point Likert scale with scores ranging from 1 ("Strongly disagree") to 5 ("Strongly agree"). Likert scale scores will be compared between clinicians in the control and intervention group.	Immediately after clinical vignette
Primary	Vignette #3 - antihypertensive medication treatment intensification	A third clinical vignette of a patient with uncontrolled blood pressure will be presented to clinicians. They will then be asked to assess wether they would intensify antihypertensive medication treatment. This will be assessed using a 5-point Likert scale with scores ranging from 1 ("Strongly disagree") to 5 ("Strongly agree"). Likert scale scores will be compared between clinicians in the control and intervention group.	Immediately after clinical vignette