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Impact of Computerized Decision Support on Racial/Ethnic Disparities in Hypertension Outcomes

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01083940
Recruitment Status : Unknown
Verified June 2011 by Brigham and Women's Hospital.
Recruitment status was:  Active, not recruiting
First Posted : March 10, 2010
Last Update Posted : June 27, 2011
Robert Wood Johnson Foundation
Information provided by:
Brigham and Women's Hospital

Brief Summary:
In response to the Finding Answers: Disparities Research for Change call for proposals by the Robert Wood Johnson Foundation, we were funded to evaluate the effectiveness of a planned computerized decision support (CDS) intervention aimed at medical providers to overcome clinical inertia when treating blood pressure for hypertensive patients. Based on prior evaluation of the Brigham and Women's Hospital (BWH) adult primary care clinics, we hypothesize that racial and ethnic differences in blood pressure outcomes are largely attributable in differences in providers' aggressiveness in managing patients with hypertension based on patients' race and ethnicity. Within our network of 14 hospital and community-based Brigham and Women's Hospital adult primary care clinics, we aim to determine if the use of CDS to remind to medical providers of poorly controlled hypertensive patients to intensify their hypertension therapy will improve overall rates of blood pressure control and reduce the previously documented racial and ethnic disparities in blood pressure outcomes among our hypertensive patient population. Clinics will first be stratified by location (hospital-based versus community-based) and within each strata will be randomized to either have their providers receive CDS for hypertensive patients whose most recent blood pressure was uncontrolled or to usual care for hypertensive patients. More specifically, we will evaluate our planned intervention by utilizing an 18 month cluster-randomized controlled trial to examine the effectiveness the CDS for intensification of hypertension therapy in: improving levels of blood pressure control, improving provider adherence with recommended changes in drug therapy, and reducing racial/ethnic disparities in the processes of hypertension care and outcomes among our patients receiving primary care for a diagnosis of hypertension.

Condition or disease Intervention/treatment Phase
Hypertension Other: Computerized reminders on hypertension intensification Early Phase 1

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 3600 participants
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Single (Participant)
Primary Purpose: Health Services Research
Official Title: Evaluating the Impact of Computerized Decision Support on Racial/Ethnic Disparities in Hypertension Outcomes
Study Start Date : October 2010
Estimated Primary Completion Date : October 2011
Estimated Study Completion Date : October 2011

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: Reminders to providers Other: Computerized reminders on hypertension intensification
Reminder generated to prompt providers to intensify therapy when patient's blood pressure remains uncontrolled

No Intervention: usual care

Primary Outcome Measures :
  1. Rate of blood pressure control at outcome between study arms [ Time Frame: 10/1/2010-10/1/2011 ]

Secondary Outcome Measures :
  1. Rate of appropriate intensification of antihypertensive therapy [ Time Frame: 10/2010-7/2011 ]

Information from the National Library of Medicine

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Ages Eligible for Study:   20 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Adult patients (> 20 years) with ICD-9 of hypertension with a minimum of 2 outpatient primary care visits in from 10/2008-10/2009 who receive care for hypertension in the outpatient practices at least once for hypertension from 10/2009-7/2001

Exclusion Criteria:

  • Pregnancy, age < 20 years, fewer than two hypertension-related visits from 10/2008-10/2009

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01083940

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United States, Massachusetts
Brigham and Women's Hospital
Boston, Massachusetts, United States, 02120
Sponsors and Collaborators
Brigham and Women's Hospital
Robert Wood Johnson Foundation
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Responsible Party: LeRoi Hicks, MD, MPH, Brigham and Women's Hospital Identifier: NCT01083940    
Other Study ID Numbers: 66708
First Posted: March 10, 2010    Key Record Dates
Last Update Posted: June 27, 2011
Last Verified: June 2011
Additional relevant MeSH terms:
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Vascular Diseases
Cardiovascular Diseases