| At-Home Blood Pressure Monitors to Overcome Clinical Inertia and Improve Self-Management
Who is the intervention targeting?
African Americans and Latinos with hypertension (a cardiovascular disease risk factor)
What intervention is being evaluated?
Patients will discuss their blood pressure goal, monitoring regimen and action plan with their doctor and receive a blood pressure monitor for use at home. Patients will be asked to transmit their readings once a month for 9 months. They will receive monthly reminders to transmit their data. The blood pressure monitors will transmit the readings via modem and phone line to a secure database. The blood pressure readings will be also be recorded by patients on a tracking card and brought to follow-up visits with their provider. This will allow physicians to get a more complete picture of their patient's health and hopefully influence treatment decisions.
Where is this intervention taking place?
In 7 federally qualified health centers (FQHC) that provide primary care and related services to the residents of southwest Brooklyn
Partnering Organizations
The Fund for Public Health in New York (Lead Organization)
New York City Department of Health and Mental Hygiene
Lutheran Family Health Centers
Why might this approach work?
This project aims to address both patient and provider level mechanisms that will lead to reductions in blood pressure and improved hypertension control in a real world setting. Blood pressure monitors can help physcians overcome clinical inertia by providing more accurate readings and inform clinical decision making. Also, it make an asymptomatic condtion “real” for patients and may stimulate behavioral change.
How will this intervention be evaluated?
One thousand patients will participate in a randomized control trial to determine the effectiveness of the intervention versus treatment as usual. Clinical outcome measures include:
-
Absolute values of systolic and diastolic blood pressure
-
Change in systolic and diastolic blood pressure from baseline to follow-up at 9 months
-
Blood pressure control
-
Trajectory of blood pressure readings over time
-
Frequency and patterns of blood pressure monitor use
Some participants will be selected to participate in a focus group to gain insight on:
-
How the the blood pressure monitor were used
-
How self-monitoring affected their relationship with their provider
-
How using the monitor helped them to understand their disease and their lifestyle
-
How the education materials were used
Additionally, a clinic process evaluation will examine:
-
Clinic staff resource allocation
-
Time required to implement the intervention
-
Clinic staff satisfaction
-
Efficacy of clinic tools and support provided
Principal Investigators:
Thomas Farley, MD, MPH
Commissioner, New York City Department of Health and Mental Hygiene
Sonia Y. Angell, MD, MPH, DTMH
Director of Cardiovascular Disease Prevention, New York City Department of Health and Mentail Hygiene
|
