NHLBI African American Blood Pressure Control RCTs Tools and Resources for Dissemination

Project Background: African Americans suffer disproportionately higher rates of hypertension-related complications compared to whites. Practice-based approaches for hypertension control in African Americans are limited.

Objective:  To evaluate the effectiveness of a practice-based, multi-component intervention compared with usual care (UC), in improving blood pressure (BP) control among hypertensive African Americans.

Design: Cluster randomized controlled multicenter trial.

From research to practice, a need for a shift in focus
Although empirical evidence supports the efficacy of interventions designed to improve blood pressure (BP) control in treated hypertensive (HTN) patients, translation of these approaches to clinical practice is suboptimal especially among hypertensive African Americans. However, if these interventions cannot find a place in standard medical care, their impact on public health will be negligible.

This study emphasizes the translation of a series of empirically-validated interventions into clinical practice by focusing on their integration into standard practice in several C/MHCs that serve minority populations.

 

RFA: INTERVENTIONS TO IMPROVE HYPERTENSION CONTROL RATES IN AFRICAN AMERICANS

RFA-HL-04-007 (NHBLI)
URL RFA: http://grants.nih.gov/grants/guide/rfa-files/RFA-HL-04-007.html
Einhorn PT. National Heart, Lung, and Blood institute-initiated program interventions to improve hypertension control rates in African Americans: Background and implementation. Circ Cardiovasc Qual Outcomes 2009; 2(3): 236-40. PMC ID #: 20031843
Pubmed URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2798164/
Full Article URL: http://circoutcomes.ahajournals.org/content/2/3/236.full.pdf+html

Affiliation & Grant Number:

  • Baylor College of Medicine (TX) Grant No. R01 HL078589 (NHLBI)
  • New York University-Clinical Directors Network, Inc. (NY/NJ) Grant No. R01 HL078566 (NHLBI)
  • Visiting Nurse Service of New York (NY/NJ) Grant No. R01 HL078585 (NHLBI)
  • University of Wisconsin-Madison (Midwest) Grant No. R01 Hl078580 (NHLBI)

Research Study Components:

1. Meta-Analysis and Dissemination Webcast
presentations:

Tobin, J.N., Pavlik, V.N., Ogedegbe, G., Hyman, D.J., Feldman, P., Schwartz, J.E., Chan, W., Mcdonald, M., Svarstad, B.L., Cassells, A., Einhorn, P. “Multi-Level Interventions to Improve Hypertension Control for African-Americans: Lessons Learned and Tools from NHLBI-Funded Cluster Randomized Trials” Accepted for Presentation at ISHIB2015: The 28th Annual International Interdisciplinary Conference on Hypertension and Related Risk Factors in Ethnic Populations, New York, NY, May 14 – 15, 2015.

Multi-level Interventions to Improve Hypertension Control for African-Americans: Lessons Learned & Tools from NHLBI-funded Cluster Randomized Trials
Presented by: Paula Einhorn, MD, MS, Gbenga Ogedegbe, MD, MS, Penny Feldman, PhD, David Hyman, PhD, Bonnie L. Svarstad, PhD, Valory Pavlik, PhD, Jonathan N. Tobin, PhD

Tuesday, June 9, 2015, 12:00-1:30 PM EDT (CDN Webcast)

Click Here to View

2. Methods

 

 

 

3. Baseline Results

 

 

4. Main Effects/Results

Other Papers/Publications

Baylor College of Medicine (TX) Grant No. R01 HL078589 (NHLBI)

 

 
New York University-Clinical Directors Network, Inc. (NY/NJ) Grant No. R01 HL078566 (NHLBI)

 

 
Visiting Nurse Service of New York (NY/NJ) Grant No. R01 HL078585 (NHLBI)

MANUAL OF OPERATIONS

Home Blood Pressure Monitoring Tools & Home Blood Pressure Log

PATIENT:

New York University-Clinical Directors Network, Inc. (NY/NJ) Grant No. R01 HL078566 (NHLBI)

PATIENT:

University of Wisconsin-Madison (Midwest) Grant No. R01 Hl078580 (NHLBI)

  • Home Blood Pressure Monitoring Tools
    Blood Pressure Tracker: Know Your Numbers
    Home Blood Pressure Log
    Manage Your Medications
  • Patient Help Tools
    Shake Your Salt Habit
    Add Steps to Your Day
    DASH Eating Plan
    NHLBI Guide to Lowering Blood Pressure

CLINICIAN:

New York University-Clinical Directors Network, Inc. (NY/NJ) Grant No. R01 HL078566 (NHLBI)

  • Clinician Feedback Monitoring
  • Clinician Feedback Form

CLINICIAN:

Visiting Nurse Service of New York (NY/NJ) Grant No. R01 HL078585 (NHLBI)

    • VNSNY Hypertension Study Intervention Contact and Management Protocol Review

CLINICIAN:

University of Wisconsin-Madison (Midwest) Grant No. R01 Hl078580 (NHLBI)
Brief Medication Questionnaire-

  • Clinical Checklist and Procedures
  • Health Checklist
  • Consultation Tips Health Checklist
  • Protocol for Measurement of Blood Pressure by Intervention Team
  • Team Action Plan

PRACTICE:

Baylor College of Medicine (TX) Grant No. R01 HL078589 (NHLBI)

  • Blood Pressure Monitoring Tool
  • Hypertension Monitoring and Tracking Form

PRACTICE:

New York University-Clinical Directors Network, Inc. (NY/NJ) Grant No. R01 HL078566 (NHLBI)

  • Clinician Chart Audit

PRACTICE:

University of Wisconsin-Madison (Midwest) Grant No. R01 Hl078580 (NHLBI)

  • Appointment Materials
  • Appointment Cards
  • Reminder First Visit
  • Reminder Missed you
  • Reminder Follow-up Visit
  • Record Keeping
  • Pharmacist Counseling Tips: BMQ
  • TEAM Log and Progress Notes

CME Education

CDN CAATCH Project – Hypertension and Heart Failure/span>
Presented by: Gbenga Ogedegbe, MD, MPH, MS

ALLHAT Clinical Trial Results
Presented by: Michael Alderman, MD

Improving Blood Pressure Treatment in the Community: How the JNC7 Recommendations and ALLHAT Trial Results Relate to Your Practice
Presented by: M. Monica Sweeney, MD, MPH

Blood Pressure Control in Hispanic Participants in ALLHAT
Presented by: Karen Margolis, MD, MPH

Role of Lifestyle Changes in the Treatment of Hypertension: When and How?
Presented by: Lawrence Appel, MD

Management of Hypertension in Chronic Kidney Disease: A Report from the ALLHAT Study
Presented by: Mahboob Rahman, MD, MS

Outcomes in Hypertensive Black and Non-Black Patients Treated with Chlorthalidone, Amlodipine and Lisinopril
Presented by: Jackson Wright, MD, PhD

Publications:

1. Pavlik, V.N., Chan, W., Hyman, D.J., Feldman, P., Ogedegbe, G., Schwartz, J.E., McDonald, M., Einhorn, P., Tobin, J.N., “Evaluating Health-Systems Level Hypertension Control Interventions for African-Americans: Lessons from a Pooled Analysis of Three Cluster Randomized Trials.” Current Hypertension Reviews (In Press, 2015).PMC ID#: 25808682
Pubmed URL: http://www.ncbi.nlm.nih.gov/pubmed/25808682