A Collaborative Model to Improve Blood Pressure (BP) Control and Minimize Racial Disparities



Status:Archived
Conditions:Asthma, High Blood Pressure (Hypertension)
Therapuetic Areas:Cardiology / Vascular Diseases, Pulmonary / Respiratory Diseases
Healthy:No
Age Range:Any
Updated:7/1/2011
Start Date:January 2010
End Date:February 2014

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A Collaborative Model to Improve BP Control and Minimize Racial Disparities-CCC


The purpose of the study is to determine the degree to which pharmacist-physician
collaborative management (PPCM) of hypertension can be adopted and implemented in clinics
with geographic and racial diversity and whether patients in clinics which implement PPCM
achieve greater blood pressure control than patients in clinics which do not implement PPCM.

Primary Hypothesis: BP control at 9 months will be significantly greater in patients from
clinics randomized to the two PPCM BP intervention groups compared to the control group.


Blood pressure (BP) is controlled in only 34% of patients with high BP, leading to
unnecessary strokes, myocardial infarctions and other cardiovascular events. BP control can
be improved with physician/ pharmacist collaborative management (PPCM). Our long-range goal
is to achieve excellent BP control rates using PPCM that can be implemented in private
practices in diverse communities. The objective of this application is to conduct a large
multi-center clinical trial in clinics with geographic, racial and ethnic diversity to
determine the extent to which the model is implemented. This practice-based research
network (PBRN) is unique with a large minority population and great diversity in operation
and community size. This prospective, cluster-randomized trial uses 27 clinics, matched and
randomized to the active intervention (2 groups) or a control group in 648 patients.
Following 9 months of the intervention, one intervention group will continue the
intervention following 9 months while the other will discontinue it. We will also randomize
18 patients per clinic into a passive observation group (n=486) to determine if PPCM is
implemented more broadly in the clinic. Patients in all three groups will be followed for
24 months. We will accomplish our objectives and test our central hypothesis by pursing
the following aims:

Aim 1: To determine if patients in clinics randomized to PPCM can achieve better BP control
at 9 months compared to patients in clinics randomized to the control group.

Primary Hypothesis: BP control at 9 months will be significantly greater in patients from
clinics randomized to the two PPCM BP intervention groups compared to the control group.

Aim 2: To determine if patients in clinics randomized to continuation of PPCM achieve
better long-term BP control compared to patients in clinics randomized to discontinuation of
PPCM after 9 months and to patients in control clinics.

Our innovative approach addresses critical organizational barriers and challenges existing
approaches to achieving better BP control. This study is novel because it will: 1) be the
largest study to test this model, 2) use a cluster randomized design to include many more
clinics than previously used, 3) use a diverse group of clinics with broad geographic
distribution, 4) include large numbers of patients from minority groups to assess potential
health disparities, 5) evaluate whether the effect can be sustained long-term, 6) include
standardized BP measurements rather than error-prone office BPs, 7) minimize selection bias,
and 8) evaluate a "passive observation group" to evaluate dissemination of PPCM throughout
the practice. We expect that our study will find a 6-8 mm Hg difference in systolic BP
which would lead to 20-30% fewer coronary deaths and 25-40% fewer stroke deaths if applied
across broadly across similar settings.


We found this trial at
24
sites
34515 Ninth Ave. S.
Federal Way, Washington 98003
(253) 944-8100
St. Francis Hospital St. Francis Hospital, conveniently located near the center of Federal Way, serves...
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Gainesville, Florida 32611
(352) 392-3261
University of Florida Gainesville UF has a long history of established programs in international education,...
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Gainesville, FL
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101 Jessup Hall
Iowa City, Iowa 52242
(319) 335-3500
University of Iowa With just over 30,000 students, the University of Iowa is one of...
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Iowa City, IA
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4200 Fifth Ave
Pittsburgh, Pennsylvania 15260
(412) 624-4141
University of Pittsburgh The University of Pittsburgh is a state-related research university, founded as the...
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4502 Medical Drive
San Antonio, Texas 78284
(210) 567-7000
University of Texas Health Science Center at San Antonio The University of Texas Health Science...
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San Antonio, TX
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Tampa, FL 33612Bus: -
Tampa, Florida 33612
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Amarillo, TX
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Austin, Texas 78701
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Buffalo, New York 14260
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Cambridge, Massachusetts 02139
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Cambridge, MA
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101 Manning Dr
Chapel Hill, North Carolina 27599
(919) 966-4131
University of North Carolina Hospital at Chapel Hill The UNC Health Care System is a...
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Chapel Hill, NC
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171 Ashley Avenue
Charleston, South Carolina 29425
843-792-1414
Medical University of South Carolina The Medical University of South Carolina (MUSC) has grown from...
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Davenport, Iowa 52803
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Des Moines, Iowa 50314
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2301 Erwin Rd
Durham, North Carolina 27710
919-684-8111
Duke Univ Med Ctr As a world-class academic and health care system, Duke Medicine strives...
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Durham, NC
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El Paso, Texas 79968
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Houston, TX
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Madison, Wisconsin 53706
(608) 263-2400
University of Wisconsin-Madison In achievement and prestige, the University of Wisconsin-Madison has long been recognized...
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Madison, WI
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Milwaukee, Wisconsin 53210
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Pocatello, Idaho 83209
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500 Parnassus Ave
San Francisco, California 94143
(415) 476-9000
University of California at San Francisco (UCSF) The leading university exclusively focused on health, UC...
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Spartanburg, South Carolina 29303
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Waterloo, IA
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1 Medical Center Blvd
Winston-Salem, North Carolina 27103
(336) 716-2011
Wake Forest University Baptist Medical Center Welcome to Wake Forest Baptist Medical Center, a fully...
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Winston-Salem, NC
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