Skip to main content
Journal cover image

Patient education and provider decision support to control blood pressure in primary care: a cluster randomized trial.

Publication ,  Journal Article
Bosworth, HB; Olsen, MK; Dudley, T; Orr, M; Goldstein, MK; Datta, SK; McCant, F; Gentry, P; Simel, DL; Oddone, EZ
Published in: Am Heart J
March 2009

BACKGROUND: Less than one third of the 65 million Americans with hypertension have adequate blood pressure (BP) control. This study examined the effectiveness of 2 interventions for improving patient BP control. METHODS: This was a 2-level (primary care provider and patient) cluster randomized trial with 2-year follow-up occurring among patients with hypertension enrolled from a Veterans Affairs Medical Center primary care clinic. Primary care providers (n = 17) in the intervention received computer-generated decision support designed to improve guideline concordant medical therapy at each visit; control providers (n = 15) received a reminder at each visit. Patients received usual care or a bimonthly tailored nurse-delivered behavioral telephone intervention to improve hypertension treatment. The primary outcome was proportion of patients who achieved a BP <140/90 mm Hg (<130/85 for diabetic patients) over the 24-month intervention. RESULTS: Of the 816 eligible patients contacted, 190 refused and 38 were excluded. The 588 enrolled patients had a mean age of 63 years, 43% had adequate baseline BP control, and 482 (82%) completed the 24-month follow-up. There were no significant differences in amount of change in BP control in the 3 intervention groups as compared to the hypertension reminder control group. In secondary analyses, rates of BP control for all patients receiving the patient behavioral intervention (n = 294) improved from 40.1% to 54.4% at 24 months (P = .03); patients in the nonbehavioral intervention group improved from 38.2% to 43.9% (P = .38), but there was no between-group differences at the end of the study. CONCLUSION: The brief behavioral intervention showed improved outcomes over time, but there were not significant between group differences.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

March 2009

Volume

157

Issue

3

Start / End Page

450 / 456

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Primary Health Care
  • Practice Guidelines as Topic
  • Patient Education as Topic
  • North Carolina
  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • Hospitals, Veterans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bosworth, H. B., Olsen, M. K., Dudley, T., Orr, M., Goldstein, M. K., Datta, S. K., … Oddone, E. Z. (2009). Patient education and provider decision support to control blood pressure in primary care: a cluster randomized trial. Am Heart J, 157(3), 450–456. https://doi.org/10.1016/j.ahj.2008.11.003
Bosworth, Hayden B., Maren K. Olsen, Tara Dudley, Melinda Orr, Mary K. Goldstein, Santanu K. Datta, Felicia McCant, Pam Gentry, David L. Simel, and Eugene Z. Oddone. “Patient education and provider decision support to control blood pressure in primary care: a cluster randomized trial.Am Heart J 157, no. 3 (March 2009): 450–56. https://doi.org/10.1016/j.ahj.2008.11.003.
Bosworth HB, Olsen MK, Dudley T, Orr M, Goldstein MK, Datta SK, et al. Patient education and provider decision support to control blood pressure in primary care: a cluster randomized trial. Am Heart J. 2009 Mar;157(3):450–6.
Bosworth, Hayden B., et al. “Patient education and provider decision support to control blood pressure in primary care: a cluster randomized trial.Am Heart J, vol. 157, no. 3, Mar. 2009, pp. 450–56. Pubmed, doi:10.1016/j.ahj.2008.11.003.
Bosworth HB, Olsen MK, Dudley T, Orr M, Goldstein MK, Datta SK, McCant F, Gentry P, Simel DL, Oddone EZ. Patient education and provider decision support to control blood pressure in primary care: a cluster randomized trial. Am Heart J. 2009 Mar;157(3):450–456.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

March 2009

Volume

157

Issue

3

Start / End Page

450 / 456

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Primary Health Care
  • Practice Guidelines as Topic
  • Patient Education as Topic
  • North Carolina
  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • Hospitals, Veterans