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N/A N=595 Randomized Single-blind Health Services Research

Implementing Hypertension Screening Guidelines in Primary Care

Hypertension,Essential · White Coat Hypertension

Enrolled (actual)
595
Serious AEs
0.0%
Results posted
Jun 2025
Primary outcome: Primary: Percentage of Patient Visits With Completion of Out-of-office BP Monitoring Within 6 Months of an Eligible Visit During the Pre-Implementation Period — 0.6; 5.4 percentage of visits

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Multifaceted Implementation Strategy (Behavioral); Usual care (Other)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Columbia University
Primary completion
Jul 2022

Outcome Measures

OutcomeResultp-value
PRIMARY
Percentage of Patient Visits With Completion of Out-of-office BP Monitoring Within 6 Months of an Eligible Visit During the Pre-Implementation Period
0.6; 5.4
PRIMARY
Percentage of Patient Visits With Completion of Out-of-office BP Monitoring Within 6 Months of an Eligible Visit During the Post-Implementation Period
5.7; 4.3
SECONDARY
Percentage of Patient Visits With Out-of-office BP Monitoring Test Ordered by Clinician During the Pre-Implementation Period
2.8; 8.7
SECONDARY
Percentage of Patient Visits With Out-of-office BP Monitoring Test Ordered by Clinician During the Post-Implementation Period
7.9; 9.2

Summary

The goal of this study is to use a cluster-randomized design (1:1 ratio) among 8 primary care clinics affiliated with New York-Presbyterian Hospital to test the effectiveness of a theory-informed multifaceted implementation strategy designed to increase the uptake of the 2015 United States Preventive Services Task Force (USPSTF) hypertension screening guidelines. The primary outcome is the ordering of out-of-office blood pressure testing, either ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM), by primary care clinicians for patients with newly elevated office blood pressure (BP), as recommended by the 2015 guidelines.

Eligibility Criteria

Patient Inclusion Criteria (as per electronic medical records):

  • Elevated blood pressure (BP) (systolic BP>=140 mmHg or diastolic BP >=90 mmHg) at a scheduled clinic visit with a primary care provider from a clinic that is participating in the study; if multiple BP readings were taken from a visit, then the average of the readings will be used

Patient Exclusion Criteria (as per electronic medical records):

  • Prior diagnosis of hypertension
  • Prior diagnosis of white-coat hypertension
  • Prior evaluation for white-coat hypertension by 24-hr ABPM or HBPM
  • Prescribed antihypertensive medication
  • Manual office BP =180 mmHg or diastolic BP>=110 mmHg)
  • Evidence of target-organ damage (chronic kidney disease, cardiovascular disease)

Clinic Inclusion Criteria:

  • Primary care clinics that are part of the New York-Presbyterian Hospital Ambulatory Care Network and were not part of implementation development

Clinic Exclusion Criteria:

  • Medical director of clinic declines to participate in cluster randomized trial
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03480217). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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