A ED-based Intervention to Improve Antihypertensive Adherence

Completed · Not applicable

Conditions studied: Hypertensive Emergency, Hypertension, Blood Pressure

In brief

Despite great strides, hypertension remains an incredibly important disease and public health problem. This study addresses this critical need among ED patients, a unique population of patients who are (a) likely to benefit from an antihypertensive adherence intervention due to their high prevalence of uncontrolled blood pressure and poor adherence, and (b) at high risk for poor cardiovascular outcomes. The protocol provides for a multicomponent intervention bundle to be tested among ED patients. Successful clinic-based behavioral interventions generally target a combination of barriers to adherence; bundled interventions have shown success in a wide range of settings and diseases. In some cases, bundled components were necessary to achieve blood pressure benefit in a primary care setting; isolated educational efforts have had mixed success in the ED.

Key facts

Study ID

NCT02672787

Run by

Vanderbilt University

People needed

220

Starts

2016-02-01

Expected to finish

2018-06-01

Last updated by the study team

2018-08-13

Who can join

Age: 21 and older, up to 85. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• <6 hours since initial evaluation by a treating physician in the ED
• Prescribed only antihypertensives detected by the mass spectrometry plasma assay
• Prescribed at least 1 antihypertensive detected by the mass spectrometry plasma assay
• Functioning peripheral IV, available left over (after clinical testing) blood, or willing to undergo venipuncture to obtain blood
• Anticipated discharge from the ED, per ED attending
• Elevated blood pressure in the ED, including triage systolic blood pressure of at least 140 mmHg or triage diastolic blood pressure of at least 90 mmHg, or 2 or more elevated BP measurements after triage (>=140/90 mmHg)
• Able and willing to complete \~45 minutes of surveys, discussion in the ED as well as return for 2 follow up visits (i.e., no plans to move away or change medical providers in the next 6 months)
• Willing to receive reminder messages via chosen method (e.g., text, phone call, or letter) for 45 days after enrollment
• Has a healthcare provider who prescribes blood pressure medication, defined as having had a clinic visit within the past year
• Age ≥21 years and <85 years

You may not qualify if…

• Received vasoactive medication (including prescribed BP medications) in the ED prior to enrollment
• Previously enrolled
• End stage renal disease or on hemodialysis
• Known pregnancy or anticipated pregnancy within 6 months
• Sepsis, acute blood loss, acute alcohol withdrawal, or inability to tolerate medications in the 24 hours prior to arrival
• Unable to provide informed consent (e.g., altered mental status, chronic dementia, prisoner, or inability to speak/understand English)
• Enrolled in home health or other chronic care coordination management plan

Where it is running

• Vanderbilt University Medical Center — Nashville, Tennessee, United States

Full record on ClinicalTrials.gov

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