Fixed-Dose Combinations Pragmatic Randomized Implementation Trial for Blood Pressure Control (FIX-BP)
Pharmacy-led Intervention to Increase the Adoption of Fixed-dose Single Pill Blood Pressure Lowering Medications: Hybrid Effectiveness-Implementation Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Julie Lauffenburger, PharmD, PhD
- Phone Number: 617-525-8865
- Email: jlauffenburger@bwh.harvard.edu
Study Contact Backup
- Name: Rasha Khatib, PhD, MHS
- Email: rasha.alkhatib@aah.org
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- patients with documented hypertension diagnosis
- had an elevated ambulatory blood pressure reading during the qualifying visit (systolic >140 mmHg or diastolic >90 mmHg
- have an upcoming scheduled visit
- have an active prescription for 1 blood pressure lowering medication with a fixed-dose combination (FDC) alternative
Exclusion Criteria:
- have received a prescription for a FDC in the preceding two years
- reside in a nursing home
- have a documented allergy to any FDC components
- are pregnant
- preferred language is not English or Spanish, defined as documentation in the EHR indicating a primary language other than English or Spanish, or a documented request for an interpreter in a language other than Spanish
- have a diagnosis of heart failure or renal failure, given that antihypertensive management in these populations typically requires disease-specific regimens and more frequent treatment adjustments
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Provider nudge only
Pharmacists will deliver targeted nudges to providers through clinical decision support integrated into the EHR.
|
Pharmacists will deliver targeted nudges to providers through clinical decision support integrated into the electronic health record (EHR)
|
|
Experimental: Provider nudge + Patient nudge
In addition to provider nudges (Provider nudge only arm), patients will receive pharmacist delivered nudges (e.g., text messages) 1-7 days before the visit to encourage fixed dose combination medications.
|
Pharmacists will deliver targeted nudges to providers through clinical decision support integrated into the electronic health record (EHR)
Patients will receive pharmacist-delivered nudges (e.g., text messages) 1-7 days before their visit to encourage fixed-dosed combinations
|
|
Experimental: Provider nudge + Pharmacist Virtual Visit
In addition to provider nudges (Provider nudge only arm), patients will receive pharmacist counseling and prescribing delivered via virtual encounters after the visit.
|
Pharmacists will deliver targeted nudges to providers through clinical decision support integrated into the electronic health record (EHR)
Patients will receive pharmacist counseling and prescribing delivered via virtual encounters after their visit
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in systolic blood pressure
Time Frame: 6 months
|
Data for this outcome will be extracted from electronic health records.
The primary effectiveness outcome will be a change in ambulatory systolic blood pressure at 3 months.
For patients who do not return within 3 months, their index visit reading will be carried forward.
|
6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in diastolic blood pressure
Time Frame: 6 months
|
Change in diastolic blood pressure from qualifying visit blood pressure reading to the end of the 6-month follow-up, using EHR data
|
6 months
|
|
Percentage of patients with well-controlled blood pressure
Time Frame: 6 months
|
Percentage of patients who reach blood pressure control defined as <140/90mmHg
|
6 months
|
|
PCP level adoption: FDC prescribing; FDC discussion in EHR notes
Time Frame: 6 months
|
Percentage of patients whose PCPs prescribe FDC within 6 months; any intensification at 6 months will also be explored; any FDC documentation in the notes
|
6 months
|
|
Patient level adoption: FDC adherence (fill)
Time Frame: 6 months
|
Percentage of patients who fill their first FDC prescription within 6 months; filling any intensified prescription within 6 months will also be explored.
|
6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2025P002849
- 2P30AG064199 (U.S. NIH Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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