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The PCORnet Blood Pressure Control Laboratory: A Platform for Surveillance and Efficient Trials.

Publication ,  Journal Article
Pletcher, MJ; Fontil, V; Carton, T; Shaw, KM; Smith, M; Choi, S; Todd, J; Chamberlain, AM; O'Brien, EC; Faulkner, M; Maeztu, C; Wozniak, G ...
Published in: Circ Cardiovasc Qual Outcomes
March 2020

BACKGROUND: Uncontrolled blood pressure (BP) is a leading preventable cause of death that remains common in the US population despite the availability of effective medications. New technology and program innovation has high potential to improve BP but may be expensive and burdensome for patients, clinicians, health systems, and payers and may not produce desired results or reduce existing disparities in BP control. METHODS AND RESULTS: The PCORnet Blood Pressure Control Laboratory is a platform designed to enable national surveillance and facilitate quality improvement and comparative effectiveness research. The platform uses PCORnet, the National Patient-Centered Clinical Research Network, for engagement of health systems and collection of electronic health record data, and the Eureka Research Platform for eConsent and collection of patient-reported outcomes and mHealth data from wearable devices and smartphones. Three demonstration projects are underway: BP track will conduct national surveillance of BP control and related clinical processes by measuring theory-derived pragmatic BP control metrics using electronic health record data, with a focus on tracking disparities over time; BP MAP will conduct a cluster-randomized trial comparing effectiveness of 2 versions of a BP control quality improvement program; BP Home will conduct an individual patient-level randomized trial comparing effectiveness of smartphone-linked versus standard home BP monitoring. Thus far, BP Track has collected electronic health record data from over 826 000 eligible patients with hypertension who completed ≈3.1 million ambulatory visits. Preliminary results demonstrate substantial room for improvement in BP control (<140/90 mm Hg), which was 58% overall, and in the clinical processes relevant for BP control. For example, only 12% of patients with hypertension with a high BP measurement during an ambulatory visit received an order for a new antihypertensive medication. CONCLUSIONS: The PCORnet Blood Pressure Control Laboratory is designed to be a reusable platform for efficient surveillance and comparative effectiveness research; results from demonstration projects are forthcoming.

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Published In

Circ Cardiovasc Qual Outcomes

DOI

EISSN

1941-7705

Publication Date

March 2020

Volume

13

Issue

3

Start / End Page

e006115

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Telemedicine
  • Randomized Controlled Trials as Topic
  • Predictive Value of Tests
  • Population Surveillance
  • Patient Reported Outcome Measures
  • Hypertension
  • Humans
  • Electronic Health Records
  • Data Warehousing
 

Citation

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Pletcher, M. J., Fontil, V., Carton, T., Shaw, K. M., Smith, M., Choi, S., … Cooper-DeHoff, R. M. (2020). The PCORnet Blood Pressure Control Laboratory: A Platform for Surveillance and Efficient Trials. Circ Cardiovasc Qual Outcomes, 13(3), e006115. https://doi.org/10.1161/CIRCOUTCOMES.119.006115
Pletcher, Mark J., Valy Fontil, Thomas Carton, Kathryn M. Shaw, Myra Smith, Sujung Choi, Jonathan Todd, et al. “The PCORnet Blood Pressure Control Laboratory: A Platform for Surveillance and Efficient Trials.Circ Cardiovasc Qual Outcomes 13, no. 3 (March 2020): e006115. https://doi.org/10.1161/CIRCOUTCOMES.119.006115.
Pletcher MJ, Fontil V, Carton T, Shaw KM, Smith M, Choi S, et al. The PCORnet Blood Pressure Control Laboratory: A Platform for Surveillance and Efficient Trials. Circ Cardiovasc Qual Outcomes. 2020 Mar;13(3):e006115.
Pletcher, Mark J., et al. “The PCORnet Blood Pressure Control Laboratory: A Platform for Surveillance and Efficient Trials.Circ Cardiovasc Qual Outcomes, vol. 13, no. 3, Mar. 2020, p. e006115. Pubmed, doi:10.1161/CIRCOUTCOMES.119.006115.
Pletcher MJ, Fontil V, Carton T, Shaw KM, Smith M, Choi S, Todd J, Chamberlain AM, O’Brien EC, Faulkner M, Maeztu C, Wozniak G, Rakotz M, Shay CM, Cooper-DeHoff RM. The PCORnet Blood Pressure Control Laboratory: A Platform for Surveillance and Efficient Trials. Circ Cardiovasc Qual Outcomes. 2020 Mar;13(3):e006115.

Published In

Circ Cardiovasc Qual Outcomes

DOI

EISSN

1941-7705

Publication Date

March 2020

Volume

13

Issue

3

Start / End Page

e006115

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Telemedicine
  • Randomized Controlled Trials as Topic
  • Predictive Value of Tests
  • Population Surveillance
  • Patient Reported Outcome Measures
  • Hypertension
  • Humans
  • Electronic Health Records
  • Data Warehousing