NCT01578577

Brief Summary

Many patients have difficulty performing routine medication management tasks. Individuals with limited literacy are at high risk for these problems. The overall study objective is to rigorously evaluate two primary care-based medication therapy management strategies that leverage an electronic health record (EHR) to promote patient understanding, medication reconciliation, medication adherence and disease control among hypertensive patients at safety net clinics.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
920

participants targeted

Target at P75+ for not_applicable hypertension

Timeline
Completed

Started Apr 2012

Longer than P75 for not_applicable hypertension

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

April 1, 2012

Completed
11 days until next milestone

First Submitted

Initial submission to the registry

April 12, 2012

Completed
5 days until next milestone

First Posted

Study publicly available on registry

April 17, 2012

Completed
4.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2016

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2016

Completed
3.1 years until next milestone

Results Posted

Study results publicly available

June 28, 2019

Completed
Last Updated

June 28, 2019

Status Verified

June 1, 2019

Enrollment Period

4.2 years

First QC Date

April 12, 2012

Results QC Date

June 4, 2019

Last Update Submit

June 4, 2019

Conditions

Keywords

Medication Therapy ManagementHypertensionHealth LiteracyMedication ReconciliationMedication Adherence

Outcome Measures

Primary Outcomes (1)

  • Systolic Blood Pressure

    The primary outcome is the systolic blood pressure measured approximately one year after the baseline interview is conducted.

    one year

Secondary Outcomes (2)

  • Effectiveness of the Electronic Health Record-based Health Literacy Medication Therapy Management Strategy (EHMI), With and Without a Nurse Educator, Compared to Standard Care.

    Baseline, 3 months, 6 months, 12 months

  • Effects of These Strategies by Patients' Literacy Skills

    Baseline, 3 months, 6 months,12 months

Study Arms (3)

Standard Care

NO INTERVENTION

This arm will serve as a control group and will not receive any intervention.

EHMI

EXPERIMENTAL

Electronic Health Record-based Health Literacy Medication Therapy Management Intervention (EHMI)arm consists of multiple components, all leveraged by the Epic EHR platform (Verona, WI). The EHMI intervention 1) activates patients to review their medication list and identify any adherence-related concerns, 2) automates a process for providing plain language, patient-centered print medication information for new and refilled prescriptions, and 3) provides additional print tools to help patients more effectively engage their providers, consolidate their regimen, and generally promote safe use and adherence.

Behavioral: EHMI

Nurse Educator + EHMI

EXPERIMENTAL
Behavioral: Nurse Educator + EHMI

Interventions

EHMIBEHAVIORAL

The EHMI intervention consists of multiple components, all leveraged by the Epic EHR platform (Verona, WI). The EHMI intervention 1) activates patients to review their medication list and identify any adherence-related concerns, 2) automates a process for providing plain language, patient-centered print medication information for new and refilled prescriptions, and 3) provides additional print tools to help patients more effectively engage their providers, consolidate their regimen, and generally promote safe use and adherence.

EHMI

This intervention is a combination of the use of a nurse educator and the EHMI tools described in the EHMI intervention arm. A nurse educator perform the following: 1) perform medication and medical record review 2)assess adherence and medication problems 3) provide counseling to promote safe and effective medication use 4) follow-up with patients after their visit to confirm they have filled all prescriptions, and can accurately teach back their medicine regimen, 5) communicate with prescribing physician when problems are identified.

Nurse Educator + EHMI

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • age is 18 years or older
  • at least 3 medications are prescribed by their physician
  • standardized mean blood pressure measurement ≥130 mm Hg systolic or ≥ 80 mm Hg diastolic if they are diabetic or mean blood pressure measurement ≥ 135 mm Hg systolic or ≥ 85 mm Hg diastolic if they are not
  • a Mini-Cog Exam score of ≥ 3
  • the patient is the person primarily responsible for administering their medication
  • the patient does not intend to move or change their usual source of medical care during the next year.

You may not qualify if:

  • the patient's usual source of medical care is not a participating ACCESS Community Health Center
  • is non-English language speaking
  • does not meet mean blood pressure criteria
  • has a Mini-Cog Exam score of \< 3
  • is not the person primarily responsible for administering medication
  • intends to move or change their usual source of medical care during the next year.
  • Is not prescribed at least 3 medications

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

ACCESS Community Health Network

Chicago, Illinois, 60661, United States

Location

Related Publications (2)

  • Persell SD, Karmali KN, Lazar D, Friesema EM, Lee JY, Rademaker A, Kaiser D, Eder M, French DD, Brown T, Wolf MS. Effect of Electronic Health Record-Based Medication Support and Nurse-Led Medication Therapy Management on Hypertension and Medication Self-management: A Randomized Clinical Trial. JAMA Intern Med. 2018 Aug 1;178(8):1069-1077. doi: 10.1001/jamainternmed.2018.2372.

  • Persell SD, Eder M, Friesema E, Connor C, Rademaker A, French DD, King J, Wolf MS. EHR-based medication support and nurse-led medication therapy management: rationale and design for a three-arm clinic randomized trial. J Am Heart Assoc. 2013 Oct 24;2(5):e000311. doi: 10.1161/JAHA.113.000311.

MeSH Terms

Conditions

HypertensionMedication Adherence

Interventions

Faculty, Nursing

Condition Hierarchy (Ancestors)

Vascular DiseasesCardiovascular DiseasesPatient CompliancePatient Acceptance of Health CareTreatment Adherence and ComplianceHealth BehaviorBehavior

Intervention Hierarchy (Ancestors)

Health PersonnelHealth Care Facilities Workforce and Services

Results Point of Contact

Title
Dr. Stephen Persell
Organization
Northwestern University

Study Officials

  • Stephen Persell, MD, MPH

    Northwestern University

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Assistant Professor

Study Record Dates

First Submitted

April 12, 2012

First Posted

April 17, 2012

Study Start

April 1, 2012

Primary Completion

June 1, 2016

Study Completion

June 1, 2016

Last Updated

June 28, 2019

Results First Posted

June 28, 2019

Record last verified: 2019-06

Locations