Achieving Blood Pressure Control Through Enhanced Discharge (AchieveBP)

The primary aim of the study is to determine if enhanced discharge from the emergency department will improve blood pressure control and self-care management. Enhanced discharge will include a hypertension intervention delivered by a touch-screen kiosk over a three month period.

Study Overview

• Status: Completed
• Conditions: Hypertension
• Intervention / Treatment: Behavioral: Patient education

Detailed Description

A targeted sample of patients with uncontrolled blood pressure at the time of their emergency department visit discharge will be randomized into either standard or enhanced discharge. To control for medication effects in achieving blood pressure control, both groups will receive similar blood pressure medication while actively participating in the study.

• Study Type: Interventional
• Enrollment (Actual): 139
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Michigan
    • Detroit, Michigan, United States, 48201
      • Detroit Receiving Hospital Emergency Department

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 89 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Present with uncontrolled blood pressure to the emergency department (>140/90 for non-diabetics and >130/80 for diabetics)
• Self-reported history of hypertension

Exclusion Criteria:

• End-stage renal disease
• No history of hypertension
• Do not present with uncontrolled blood pressure

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Enhanced discharge; Patient education about hypertension delivered through a touch-screen kiosk at 4 time points in addition to standard discharge.	Behavioral: Patient education; Patient education on hypertension delivered through a touchscreen kiosk.
No Intervention: Standard discharge; Standard discharge is patient instruction, instructions for follow-up to primary care and medication/prescription

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Blood Pressure (Systolic) at 180 Days	Systolic Blood Pressure (SDB) at 180 days post-discharge	180 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient Activation Measure (PAM)	Measure of how actively involved patient is in their medical care.	Baseline

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Emergency Department Visitation Rate	Emergency department visits related to hypertension	Baseline to 180 days
Cost Effectiveness		180 days

Collaborators and Investigators

• Sponsor: Wayne State University
• Collaborators: Blue Cross Blue Shield of Michigan Foundation
• Investigators: Principal Investigator: Phillip D Levy, MD, Wayne State University; Principal Investigator: Julie A Gleason-Comstock, PhD, Wayne State University

Publications and helpful links

General Publications

• Gleason-Comstock JA, Streater A, Jen KL, Artinian NT, Timmins J, Baker S, Joshua B, Paranjpe A. Consumer health information technology in an adult public health primary care clinic: a heart health education feasibility study. Patient Educ Couns. 2013 Dec;93(3):464-71. doi: 10.1016/j.pec.2013.07.010. Epub 2013 Aug 12.
• Levy PD, Cline D. Asymptomatic hypertension in the emergency department: a matter of critical public health importance. Acad Emerg Med. 2009 Nov;16(11):1251-7. doi: 10.1111/j.1553-2712.2009.00512.x. Epub 2009 Oct 20.
• Levy P, Ye H, Compton S, Zalenski R, Byrnes T, Flack JM, Welch R. Subclinical hypertensive heart disease in black patients with elevated blood pressure in an inner-city emergency department. Ann Emerg Med. 2012 Oct;60(4):467-74.e1. doi: 10.1016/j.annemergmed.2012.03.030. Epub 2012 May 31. Erratum In: Ann Emerg Med. 2013 Jan;61(1):61.
• Gleason-Comstock J, Streater A, Ager J, Goodman A, Brody A, Kivell L, Paranjpe A, Vickers J, Mango L, Dawood R, Levy P. Patient education and follow-up as an intervention for hypertensive patients discharged from an emergency department: a randomized control trial study protocol. BMC Emerg Med. 2015 Dec 21;15:38. doi: 10.1186/s12873-015-0052-3.
• Gleason-Comstock J, Streater A, Goodman A, Janisse J, Brody A, Mango L, Dawood R, Levy P. Willingness to pay and willingness to accept in a patient-centered blood pressure control study. BMC Health Serv Res. 2017 Aug 7;17(1):538. doi: 10.1186/s12913-017-2451-5.
• Gleason Comstock J, Janisse J, Streater A, Brody A, Goodman A, Zhang L, Mango L, Dawood R, Costello W, Patton S, Paranjpe A, Welsh C, Welch R, Levy P. Efficacy of enhanced emergency department discharge for chronic hypertension management - Results of a randomized controlled trial. Contemp Clin Trials Commun. 2020 Jul 18;19:100613. doi: 10.1016/j.conctc.2020.100613. eCollection 2020 Sep.

Study record dates

Study Major Dates

• Study Start: October 1, 2013
• Primary Completion (Actual): June 1, 2015
• Study Completion (Actual): June 1, 2016

Study Registration Dates

• First Submitted: February 19, 2014
• First Submitted That Met QC Criteria: February 20, 2014
• First Posted (Estimate): February 21, 2014

Study Record Updates

• Last Update Posted (Actual): December 22, 2020
• Last Update Submitted That Met QC Criteria: December 21, 2020
• Last Verified: December 1, 2020

More Information

Terms related to this study

• Keywords: Hypertension; Patient education; Patient activation
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Hypertension
• Other Study ID Numbers: BCBSMF 1956.11