A new approach to managing high blood pressure

Collaboration Oriented Approach to Controlling High Blood Pressure

This study is testing a new app called COACH to see if it can help adults with high blood pressure manage their condition better by tracking their readings and making decisions with their doctors.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 550 (estimated)
• Ages: 18 Years to 100 Years
• Sex: All
• Sponsor: Oregon Health and Science University (Academic / other)
• Locations: 3 sites (Columbia, Missouri and 2 other locations)
• Trial ID: NCT06124716 on ClinicalTrials.gov

What this trial studies

This study evaluates the effectiveness of a clinical decision support app called COACH, designed to help patients manage their high blood pressure through self-monitoring and shared decision-making. The app integrates home blood pressure data into electronic health records and utilizes behavioral economics principles to enhance patient engagement. Conducted in multiple primary care settings, the study aims to improve blood pressure control among adults with hypertension and multiple chronic conditions. By implementing this tool across various health systems, the study seeks to address the challenges of managing hypertension in a patient-centered manner.

Who should consider this trial

Good fit: Ideal candidates include adults aged 18-100 with high blood pressure who have been seen in a participating primary care clinic within the last year.

Not a fit: Patients who may not benefit include those with severe cognitive impairment, end-stage renal disease, or those for whom tight blood pressure control poses greater risks.

Why it matters

Potential benefit: If successful, this approach could significantly improve blood pressure management and reduce the risk of heart attacks and strokes for patients.

How similar studies have performed: Other studies have shown promise with similar patient-centered approaches to hypertension management, indicating potential for success in this novel application.

Eligibility criteria

Inclusion Criteria:

* Adult patients aged 18-100 years old
* Patient receives care at a participating primary care clinic and has been seen in the last year
* Patient has high BP, defined as an average of 4 BPs \> 140 systolic or \> 90 diastolic (clinic) or \> 135 OR \> 85 (home)
* Patient is enrolled in online health portal
* Patient can communicate in English
* Patient has been recommended by their physician who thinks the patient would benefit from a home blood pressure monitoring program.

Exclusion Criteria:

* Patient is pregnant at the time of consent
* Patient who, in the opinion of the primary care clinician, has severe cognitive impairment
* Patient is on hospice care and/or has a life expectancy of less than 2 years
* Patient has end stage renal disease
* Patient for whom tight blood pressure control presents a greater risk, such as those with a history of adverse events from hypertension treatment (falls, dizziness, electrolyte disturbances, hypotension, active heart failure)
* Patient has any other disease or disorder that in the opinion of the investigator or the patient's primary care clinician, could put participants at risk and affect trial results, or hinder participation will exclude them from participating

Where this trial is running

Columbia, Missouri and 2 other locations

• University of Missouri-Columbia — Columbia, Missouri, United States (Recruiting)
• Oregon Health & Science University — Portland, Oregon, United States (Recruiting)
• Vanderbilt University Medical Center — Nashville, Tennessee, United States (Not_yet_recruiting)

Study contacts

• Principal investigator: David Dorr, MD, MS, FACMI, FAMIA — Oregon Health and Science University
• Study coordinator: LeAnn Michaels

Conditions Hypertension; Multiple Chronic Conditions; Pragmatic trial; Primary care; Clinical decision support