Optimizing Sustainable Cuff Access and Training Pathways for Self-Measured Blood Pressure Monitoring in Primary Care
Optimizing Sustainable Cuff Access and Training Pathways for Self-Measured Blood Pressure Monitoring in Primary Care: A Pragmatic Randomized Controlled Trial
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Detaillierte Beschreibung
The study team developed a clinical integration package as a multicomponent primary care-based approach to increase SMBP adoption through structured workflows, patient training, blood pressure logs, reminders/support, and clinical follow-up. Pilot work demonstrated that SMBP uptake can be significantly improved in underserved primary care settings. However, the pilot relied on research funds to purchase cuffs, which is not sustainable for health-system scale. A scalable model must identify practical pathways for patients to obtain standard validated blood pressure cuffs through routine care mechanisms, including vendor-supported, insurance-billed, consignment, or mail-order pathways, without depending on research-purchased devices.
In addition to cuff access, effective SMBP implementation also requires feasible approaches to patient training. Many patients do not receive standardized instruction on how to correctly measure and record home blood pressure readings, and intensive in-person training models may be difficult to sustain in routine primary care workflows. Health systems therefore need practical training strategies that balance effectiveness with scalability, ranging from brief hands-on education delivered during clinic visits to lower-touch written or self-guided educational materials.
Patients will be randomized to one of four arms:
- Mail-order cuff delivery with enhanced return conversation
- Mail-order cuff delivery with written instructions
- In-clinic cuff distribution with enhanced return conversation
- In-clinic cuff distribution with written instructions
All other intervention components will be standardized across study arms, including receipt of a blood pressure log, written instructions on when and how to obtain home blood pressure readings, and routine clinic processes for documenting or reviewing SMBP readings returned by patients. The design is intended to evaluate implementation pathways for SMBP delivery in routine care rather than to test the clinical efficacy of SMBP itself. This design is intended to evaluate operational implementation pathways for SMBP delivery in routine care rather than to test the clinical efficacy of SMBP itself.
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Rasha Khatib, PhD
- Telefonnummer: 7086843691
- E-Mail: Rasha.Alkhatib@aah.org
Studienorte
-
-
Illinois
-
Chicago, Illinois, Vereinigte Staaten, 60617
- Rekrutierung
- Advocate Medical Group Chicago (Southeast)
-
Kontakt:
- Nicole Glowacki, MPH
- Telefonnummer: 708-684-3691
- E-Mail: nicole.glowacki@aah.org
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Chicago, Illinois, Vereinigte Staaten, 60619
- Rekrutierung
- Advocate Medical Group Chicago (Imani Village)
-
Kontakt:
- Nicole Glowacki, MPH
- Telefonnummer: 708-684-3691
- E-Mail: nicole.glowacki@aah.org
-
Chicago, Illinois, Vereinigte Staaten, 60643
- Rekrutierung
- Advocate Medical Group Beverly
-
Kontakt:
- Nicole Glowacki, MPH
- Telefonnummer: 708-684-3691
- E-Mail: nicole.glowacki@aah.org
-
Merrionette Park, Illinois, Vereinigte Staaten, 60803
- Rekrutierung
- Advocate Medical Group Merrionette Park
-
Kontakt:
- Nicole Glowacki, MPH
- Telefonnummer: 708-684-3691
- E-Mail: nicole.glowacki@aah.org
-
Oak Lawn, Illinois, Vereinigte Staaten, 60453
- Rekrutierung
- Advocate Medical Group Oak Lawn (IM)
-
Kontakt:
- Nicole Glowacki, MPH
- Telefonnummer: 708-684-3691
- E-Mail: nicole.glowacki@aah.org
-
Oak Lawn, Illinois, Vereinigte Staaten, 60453
- Rekrutierung
- Advocate Medical Group Oak Lawn (FP)
-
Kontakt:
- Nicole Glowacki, MPH
- Telefonnummer: 708-684-3691
- E-Mail: nicole.gowacki@aah.org
-
-
Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
Inclusion Criteria:
- Age 18 years or older.
- Diagnosed hypertension documented prior to the index clinic visit.
- Scheduled for and attends an in-person visit with a participating clinician at a study clinic.
- Elevated BP (blood pressure) documented in Epic during rooming or the clinic visit before study enrollment, defined as systolic BP >=140 mmHg or diastolic BP >=90 mmHg.
Exclusion Criteria:
- Visit is canceled, rescheduled, or the patient does not attend the visit.
- Patient already has a usable home BP cuff provide through insurance within the past 5 years.
- Patient declines assistance obtaining a BP cuff.
- Patient declines submitting cuff order to insurance.
- Patient unable to participate for operational reasons.
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Unterstützende Pflege
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
|
Aktiver Komparator: Mail-order cuff delivery - Enhanced Return Conversation
Patients will receive a blood pressure cuff in the mail and have a conversation with the medical assistant on when and how to return their blood pressure log with the care team.
|
Complete vendor form; provide blood pressure log/instructions; discuss with patient how and when to return bp log; submit vendor form for mail delivery; complete envelope checklist.
|
|
Aktiver Komparator: Mail-order cuff delivery - Written instructions
Patients will receive a blood pressure cuff in the mail and receive written training on who and when to return their blood pressure log with the care team.
|
Complete vendor form; provide blood pressure log/instructions; submit vendor form for mail delivery; complete envelope checklist.
|
|
Aktiver Komparator: In-clinic cuff distribution - Enhanced Return Conversation
Patients will receive a blood pressure cuff in the clinic and have a conversation with the medical assistant on when and how to return their blood pressure log with the care team.
|
Complete vendor form; provide blood pressure log/instructions; discuss with patient how and when to return bp log; provide blood pressure cuff in clinic; submit vendor form as required; complete envelope checklist.
|
|
Aktiver Komparator: In-clinic cuff distribution - Written instructions
Patients will receive a blood pressure cuff in the mail and receive written training on who and when to return their blood pressure log with the care team.
|
Complete vendor form; provide blood pressure log/instructions; provide blood pressure cuff in clinic; submit vendor form as required; complete envelope checklist.
|
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Rate of Blood Pressure Receipt
Zeitfenster: up to day 14
|
Number of participants that have received their blood pressure cuff documented through the envelope checklist, vendor records, or vendor delivery confirmation when available
|
up to day 14
|
|
Rate of Cuff Order Completion
Zeitfenster: up to day 14
|
Number of participants that have ordered their blood pressure cuff documented through the envelope checklist, vendor records, or vendor delivery confirmation when available.
|
up to day 14
|
|
Rate of Return Modality Completion
Zeitfenster: up to day 14
|
Number of participants that completed the assigned return modality as documented on the envelope checklist.
|
up to day 14
|
Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Time to Complete Intervention
Zeitfenster: up to day 14
|
Number of days from index clinic visit to documentation of both cuff receipt and completion of assigned training modality.
|
up to day 14
|
|
Number of Participants Documenting at Least One Blood Pressure Reading
Zeitfenster: up to day 21
|
Number of participants with at least one self-monitored blood pressure reading documented in the EHR within 21 days of cuff receipt.
|
up to day 21
|
|
Time Between Cuff Receipt and First Documented Reading
Zeitfenster: up to day 21
|
Number of days between cuff receipt and first documented self-monitored blood pressure reading.
|
up to day 21
|
|
Rate of Workflow Barriers
Zeitfenster: up to day 14
|
Number of participants with documented workflow barriers contributing to incomplete or non-concordant intervention delivery, including shipment issues, incomplete vendor forms, patient decline after workflow initiation, return modality not completed, missing documentation, clinic cuff inventory depletion, supply limitations, or other workflow disruptions identified through routine workflow documentation or operational follow-up activities.
|
up to day 14
|
|
Rate of Fidelity
Zeitfenster: up to day 14
|
Number of participants that received the assigned cuff delivery modality and assigned return modality without crossover, reassignment, or missing assigned workflow components.
|
up to day 14
|
|
Rate of Differential Implementation Success
Zeitfenster: up to day 14
|
Number of participants with successful delivery of both blood pressure cuff and return modality.
|
up to day 14
|
Andere Ergebnismessungen
Andere Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Change in Systolic Blood Pressure
Zeitfenster: up to day 90
|
Change in systolic blood pressure using routinely documented clinic blood pressure values in Epic.
|
up to day 90
|
|
Rate of Medication Intensification
Zeitfenster: up to day 90
|
Number of participants with addition of a new antihypertensive medication class, dose increase, or regimen intensification consistent with clinician-directed care using Epic medication order data.
|
up to day 90
|
Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Hauptermittler: Rasha Khatib, PhD, Advocate Health
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- IRB00151173
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Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
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