Improving Hypertension Management Through Preference List Defaults

NCT07298694 | Enrolling By Invitation

• 1 other identifier: 2025-0593
• Study Type: interventional
• Target: 12,150
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to evaluate whether modifying the EPIC preference list to display combination blood pressure (BP) medications at the top and/or adding "(PREFERRED)" to the beginning of the medication listing increases prescribing of these medications. Combination BP medications are aligned with value-based care guidelines and may improve patient adherence and reduce pill burden. Currently, these medications may be under-prescribed in part due to their low visibility in the EPIC prescribing interface.

Conditions

Hypertension; Clinical Decision Support; Choice Behavior; Quality Improvement

Keywords

Hypertension; Clinical Decision Support; Choice Behavior; Quality Improvement

Outcome Measures

Primary Outcomes (1)

• Prescribing of Combination Antihypertensive Medication (y/n)

  Defined as whether a provider prescribes a combination blood pressure medication (e.g., a single pill containing two medication classes) on the day of the patient's appointment. This is measured at the patient level using EHR prescribing data.

  Day of the appointment (1 day)

Other Outcomes (2)

• Change in Systolic Blood Pressure

  6 months to 1 year after enrollment (whenever a qualifying reading is taken)

• Change in Diastolic Blood Pressure

  6 months to 1 year after enrollment (whenever a qualifying reading is taken)

Study Arms (2)

Revised Preference List

EXPERIMENTAL

"(PREFERRED)" will be added to the beginning of the preference list for selected BP medications, which will frequently cause these medications to be listed first.

Behavioral: Revising preference list by adding "(PREFERRED)" to combination medication names

No Change to the Preference List

NO INTERVENTION

Clinics will retain the usual EHR preference list order, with no changes to the default medication display.

Interventions

Revising preference list by adding "(PREFERRED)" to combination medication names BEHAVIORAL

Providers in the intervention group will see "(PREFERRED)" listed before combination blood pressure medication names, which will frequently cause the combination medications to appear at the top of the EHR preference list.

Revised Preference List

Eligibility Criteria

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

You may qualify if:

• Order placed for a medication starting with any of the following: "amlodipine", "benazepril", "valsartan", "lisinopril", "hctz", "hydrochlorothiazide", "hydro", "losartan"
• The order is placed at an in-person, virtual (telemed), telephone, or nurse encounter in a clinic included in the study
• Patient is age 18+
• \- Order was placed by a clinical leader who was aware of the study

Sponsors & Collaborators

• Geisinger Clinic: lead

Study Sites (1)

Geisinger

Danville, Pennsylvania, 17822, United States

Location

MeSH Terms

Conditions

Hypertension

Condition Hierarchy (Ancestors)

Vascular Diseases; Cardiovascular Diseases

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: December 11, 2025
• First Posted: December 23, 2025
• Study Start: April 13, 2026
• Primary Completion (Estimated): October 1, 2026
• Study Completion (Estimated): October 1, 2026
• Last Updated: April 28, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)