Leveraging Electronic Health Record (EHR) Tools to Reduce Health Disparities for Patients With Uncontrolled Hypertension

NCT05030467 | Completed Results DMC

• 2 other identifiers: 2021P002479R01MD014874
• Study Type: interventional
• Target: 49,210
• Locations: 1 country
• Sites: 1

Brief Summary

A two-arm cluster randomized controlled trial targeting primary care providers will be conducted to evaluate the impact of a multicomponent electronic health record (EHR) intervention on hypertension management. Given the cluster trial design, randomization will be conducted at the site level, and in the intervention sites, all eligible providers will receive the intervention. The intervention consists of enhancing tools already available to primary care providers in the EHR system, including developing and implementing provider disparities dashboards, enhancing electronic decision support, and simplifying self-monitoring orders and communication materials. The intervention aims to improve blood pressure control and reduce health disparities in racial and ethnic minorities. Findings from this trial will provide important insight into whether a multicomponent intervention targeting providers and leveraging health information technology can reduce health disparities.

Conditions

Hypertension; Blood Pressure

Outcome Measures

Primary Outcomes (1)

• Change in Systolic Blood Pressure

  Change in systolic blood pressure from identification to the end of the 12-month follow-up, using values in the EHR from ambulatory care encounters

  12 months

Secondary Outcomes (5)

• Percentage of Patients With Well-controlled Blood Pressure

  12 months

• Percentage of Patients With Intensification of Medication

  12 months

• Percentage of Patients With Guideline-concordant Medications

  12 months

• Change in Diastolic Blood Pressure

  12 months

• Systolic Blood Pressure Differences

  12 months

Study Arms (2)

Intervention Arm

EXPERIMENTAL

Providers within the clinics randomized to the intervention arm will receive a variety of EHR-based tools for eligible patients with uncontrolled hypertension.

Behavioral: REDUCE-BP Intervention

Control Arm

NO INTERVENTION

Providers within the clinics randomized to usual care will receive no EHR tools, except those currently available in clinical practice.

Interventions

REDUCE-BP Intervention BEHAVIORAL

Pre-visit: Providers in the intervention arm will receive dashboards which will highlight racial/ethnic differences in rates of achieving blood pressure control within their patient panel. The dashboard will also provide individual-level information for patients with poorly controlled blood pressure. During visit: Providers will receive clinical decision support within relevant patients' charts that highlight the patient's under-treated blood pressure and potential impacts of social needs. Providers will have the opportunity to provide enhanced patient education materials, which can be automatically ordered within the clinical decision support. Post-visit: Patient-subjects' access to the online patient portal will be streamlined by the inclusion of information about the patient portal in the patients' after-visit summary. Providers will also be able to referral patients automatically to nurse BP visits.

Intervention Arm

Eligibility Criteria

• Age: 18 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Medical Group Medical Home Population: 1 visit with Primary Care Physician (PCP) in past 2 years (rolling 24 months) and Patient has a medical group PCP as their EPIC General PCP
• Current age 18-85 years
• Hypertension diagnosis on EPIC Problem list OR at least 2 visits (office/telehealth/telephonic) with an encounter diagnosis of hypertension on different dates, with any during the last 24 months (rolling dates) performing provider
• Latest outpatient/ambulatory (exclude urgent care) systolic blood pressure ≥140 or diastolic blood pressure ≥90 (12 months rolling) (lowest measure if more than one taken at the same time)

You may not qualify if:

• Among these eligible patients, patients included in the primary analysis will be those that had an in-person visit at one of the trial clinics.

Sponsors & Collaborators

• Brigham and Women's Hospital: lead
• National Institute on Minority Health and Health Disparities (NIMHD): collaborator

Study Sites (1)

Advocate Health Care

Chicago, Illinois, 60515, United States

Location

MeSH Terms

Conditions

Hypertension

Condition Hierarchy (Ancestors)

Vascular Diseases; Cardiovascular Diseases

Results Point of Contact

• Title: Niteesh Choudhry
• Organization: Brigham and Women's Hospial

nkchoudhry@bwh.harvard.edu

617-278-0930

Study Officials

• Niteesh K Choudhry, MD, PhD

  Brigham and Women's Hospital

  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: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Medicine

Study Record Dates

• First Submitted: August 26, 2021
• First Posted: September 1, 2021
• Study Start: May 3, 2022
• Primary Completion: May 3, 2024
• Study Completion: June 1, 2024
• Last Updated: June 6, 2025
• Results First Posted: June 6, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)