Home Blood Pressure Monitoring Project (HBPM)

Home Blood Pressure Monitoring Program

The goal of this project is to improve hypertension control at Kaiser Permanente Colorado (KPCO) by implementing a population-based multi-factorial intervention that uses home BP monitors that can download BP readings to KPCO's health records via internet, interactive voice response (IVR) technology, and multidisciplinary care team. Participants will be randomized to either the home blood pressure monitoring group receiving the multi-factorial intervention or the usual care group who will be receiving Kaiser standard of care. We will determine the proportion of patients in each group who achieve their target BP goals at 6 months, according to national clinical practice guidelines. The study hypothesis is that a higher proportion of patients with uncontrolled hypertension in the home blood pressure monitoring (HBPM) group will achieve their target blood pressure compared to those in the usual care (UC) group.

Study Overview

• Status: Completed
• Conditions: Hypertension
• Intervention / Treatment: Behavioral: Home Blood Pressure Monitoring

Detailed Description

STUDY OBJECTIVES:

Primary:

• To determine the proportion of patients in each group who achieve their target BP goals at 6 months, according to national clinical practice guidelines

Secondary:

The following parameters will be evaluated between groups:

• Change in BP measures between baseline and at 6 months
• Proportion of patients who are receiving antihypertensive treatments in accordance to national clinical practice guidelines
• Adherence to hypertensive medication regimen during the 6-month follow-up period
• Patient satisfaction with the care model.

• Study Type: Interventional
• Enrollment (Actual): 348
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Colorado
    • Denver, Colorado, United States, 80231
      • Kaiser Permanente Colorado, Institute of Health Research

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 85 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Age 18 to 85 years At least 1 diagnosis for hypertension,

  • Receive primary care from one of the participating clinics,
  • The two most recent BPs documented within that last 24 months are elevated (SBP>140 and/or DBP>90)
  • Receiving < 3 antihypertensive medications, and
  • Have access to a computer with a USB port.

Exclusion Criteria:

• Pregnant, or breast-feeding,
• Patients on dialysis or being followed by nephrology,
• Patients with coronary artery disease, given these patients are already followed by the Clinical Pharmacy Cardiac Risk Service (CPCRS),
• On KPCO "Do Not Call" or deceased list,
• PCP does not give permission to include patient in the study,
• BP is at or below target at the baseline study visit,
• Not English-speaking.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Usual Care; The control group receiving usual care
Experimental: Home Blood Pressure Monitoring Group; Intervention group	Behavioral: Home Blood Pressure Monitoring; Home blood pressure readings are taken at least 3 times a week, uploaded to a Microsoft Health Vault account through American Heart Association Heart360 at least 1 time per week. Patients are followed by a clinical pharmacist, with physician oversight, who will make adjustments to antihypertensive medications or suggest additional medications using national JNC VII and KPCO hypertension guidelines.; Other Names: HBPM

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
BP at 6 months	6 months

Collaborators and Investigators

• Sponsor: Kaiser Permanente
• Collaborators: American Heart Association
• Investigators: Principal Investigator: David J Magid, MD, MPH, Kaiser Permanente; Principal Investigator: Kari Olson, PharmD, Kaiser Permanente; Principal Investigator: Sarah J Billups, PharmD, Kaiser Permanente

Publications and helpful links

General Publications

• Magid DJ, Olson KL, Billups SJ, Wagner NM, Lyons EE, Kroner BA. A pharmacist-led, American Heart Association Heart360 Web-enabled home blood pressure monitoring program. Circ Cardiovasc Qual Outcomes. 2013 Mar 1;6(2):157-63. doi: 10.1161/CIRCOUTCOMES.112.968172. Epub 2013 Mar 5.

Study record dates

Study Major Dates

• Study Start: July 1, 2008
• Primary Completion (Actual): July 1, 2010
• Study Completion (Actual): July 1, 2010

Study Registration Dates

• First Submitted: July 13, 2010
• First Submitted That Met QC Criteria: July 13, 2010
• First Posted (Estimate): July 15, 2010

Study Record Updates

• Last Update Posted (Estimate): April 6, 2012
• Last Update Submitted That Met QC Criteria: April 4, 2012
• Last Verified: April 1, 2012

More Information

Terms related to this study

• Keywords: hypertension, intervention
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Hypertension
• Other Study ID Numbers: CO-08DMagi-01