- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05760898
Reducing Hypertension Disparities in Rheumatoid Arthritis
Reducing Disparities in Hypertension Care for Patients With Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a autoimmune disease associated with an increased risk of developing coronary artery disease (CAD) and premature death, particularly in Black patients. Traditional CAD risk factors like hypertension (HTN) are both very common and poorly controlled among Black RA patients. Disparities in RA disease activity further increase the risk of CAD in this population. Black patients face significant barriers when seeking RA care, and the investigators suspect similar challenges affect HTN care in this population. The goals of this project are to identify and address barriers to HTN care in patients with RA to reduce disparities in HTN and CAD outcomes for Black RA patients.
Interviews with Black RA patients, rheumatology providers, and primary care providers in the Duke University Health System will be conducted to describe barriers to HTN care in Black RA patients. Interviews will focus on access to care, patient-provider communication, coordination of care, and the challenges of managing HTN in patients with RA. These interviews will help us to develop an intervention that will focus on improving uncontrolled HTN in Black RA patients. The investigators plan to do this by empowering Black RA patients to actively participate in their HTN care, improving patient-provider communication, and improving coordination between primary care and rheumatology providers. If successful, our intervention has the potential to reduce rates of CAD and associated death for Black RA patients.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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North Carolina
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Durham, North Carolina, United States, 27710
- Duke Health System
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 18 years old or older
- Race self-identified as "Black" or "African American"
- Uncontrolled hypertension
- History of rheumatoid arthritis
- Receive both primary care and rheumatology care from Duke Health System
Exclusion Criteria:
- Age less than 18 years old
- Other self-identified race
- Healthy volunteers without rheumatoid arthritis and hypertension
- Do not receive both primary care and rheumatology care from Duke Health System
- Cognitive impairment with lack the capacity to consent to study participation
- Pregnant women
- Prisoners
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Blood pressure intervention arm
The investigators will recruit 25 Black RA patients with HTN for the study.
Participants will be provided with a home blood pressure monitor, teaching from nursing staff regarding the correct use of the monitor, and a guide to help interpret normal and elevated blood pressure values.
Participants will be instructed to obtain and record blood pressure values at least three times per week over the course of 3 months.
Every 2 weeks, these results will be sent to the study team, and participants will complete a brief survey regarding other factors that may influence blood pressure control, including RA disease activity (RAPID3 score), pain, current use of acute RA therapies, anti-hypertensive medication use, anti-hypertensive medication adherence, and current perceived barriers to HTN self-management.
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The intervention will focus on empowering patients to actively participate in their HTN care, facilitating patient-provider communication, and creating a cohesive care team to close the coordination loop for HTN management.
This pilot intervention will help achieve these goals by providing participants with home blood pressure monitors and teaching, improving patient-provider communication regarding blood pressure and RA management, and initiating care coordination between rheumatology and primary care providers.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Intervention feasibility as measured by participant accrual rates
Time Frame: 6 months
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Rate at which participants are able to be successfully recruited
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6 months
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Intervention feasibility as measured by participant retention
Time Frame: 6 months
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Percentage of participants who successfully complete the study
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6 months
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Intervention feasibility as measured by adherence to blood pressure monitoring
Time Frame: 6 months
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Percentage of expected blood pressures reported by participants
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6 months
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Intervention feasibility as measured by adherence to survey reporting
Time Frame: 6 months
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Percentage of expected surveys completed by participants
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6 months
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Intervention feasibility as measured by sample characteristics
Time Frame: 6 months
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Description of sociodemographic characteristics of population, rheumatoid arthritis characteristics (eg, duration, medications, severity), and hypertension characteristics (eg, duration, medications, severity)
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6 months
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Intervention feasibility as measured by use of resources
Time Frame: 6 months
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Cost of participant recruitment, education, blood pressure monitors, participant compensation, research coordinator time and cost needed to collect data, and statistical analysis
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6 months
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Intervention feasibility as measured by sustainability of data collection procedures
Time Frame: 6 months
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Financial and time commitments required to successfully collect participant surveys, blood pressure monitoring results, send information to providers, and monitor provider responses
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6 months
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Intervention acceptability as measured by qualitative interviews
Time Frame: 6 months
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Qualitative interviews will be performed at the end of the pilot intervention with all study participants to assess the acceptability of the intervention.
Rheumatology and primary care providers caring for study participants will also be invited to comment on the acceptability of the intervention.
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6 months
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Perceived appropriateness of the intervention to address the health care disparity in HTN (hypertension) control for Black RA patients as measured by qualitative interviews
Time Frame: 6 months
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Qualitative interviews will be performed at the end of the pilot intervention with all study participants to assess the perceived appropriateness of the intervention to address the health care disparity in HTN control for Black RA patients.
Rheumatology and primary care providers caring for study participants will also be invited to comment on the appropriateness of the intervention.
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6 months
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Barriers to and enablers of participating in the intervention as measured by qualitative interviews
Time Frame: 6 months
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Qualitative interviews will be performed at the end of the pilot intervention with all study participants to assess barriers to and enablers of participating in the intervention.
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6 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Participant blood pressure values
Time Frame: 6 months
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Systolic and diastolic blood pressures taken at least three times per week and reported to the study team every 2 weeks for 6 months
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6 months
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Participant rheumatoid arthritis disease activity
Time Frame: 6 months
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Rheumatoid arthritis disease activity self-reported by participants using the RAPID3 score every 2 weeks for 6 months
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6 months
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Participant medication use
Time Frame: 6 months
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Medication use for hypertension and rheumatoid arthritis reported by participants every 2 weeks for 6 months
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6 months
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Anti-hypertensive medication adherence
Time Frame: 6 months
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Participant self-reported adherence percentage to anti-hypertensive medications collected every 2 weeks for 6 months
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6 months
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Perceived barriers to hypertension self-management
Time Frame: 6 months
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Participant self-reported barriers to hypertension self-management collected every 2 weeks for 6 months
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6 months
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Provider engagement as measured by response to study team messages
Time Frame: 6 months
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Frequency and type of provider responses to study team messages
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6 months
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Provider engagement as measured by interactions with participants
Time Frame: 6 months
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Frequency and type of provider interactions with participants after receiving a study team message
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6 months
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Care coordination
Time Frame: 6 months
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Activation of care team members
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6 months
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Number of participants with a change in medical therapy
Time Frame: 6 months
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Changes in anti-hypertensive or RA therapies
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6 months
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Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- PRO00112307
- 3U54MD012530-05S2 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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