Mark J Pletcher1,2, Valy Fontil2,3, Thomas Carton4, Kathryn M Shaw5, Myra Smith5, Sujung Choi6, Jonathan Todd7, Alanna M Chamberlain8, Emily C O'Brien6, Madelaine Faulkner1, Carlos Maeztu, Gregory Wozniak9, Michael Rakotz9, Christina M Shay10, Rhonda M Cooper-DeHoff11. 1. Department of Epidemiology and Biostatistics (M.J.P., M.F.), University of California, San Francisco. 2. Division of General Internal Medicine, Department of Medicine (M.J.P., V.F.), University of California, San Francisco. 3. Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital (V.F.), University of California, San Francisco. 4. Division of Health Services Research, Louisiana Public Health Institute, Tulane University, New Orleans, LA. (T.C.). 5. Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL (K.M.S., M.S.). 6. Duke Clinical Research Institute, and Department of Population Health Sciences, Duke University School of Medicine, Durham, NC (S.C., E.C.O.). 7. OCHIN, Portland, OR (J.T.). 8. Department of Health Sciences Research, Mayo Clinic, Rochester, MN (A.M.C.). 9. Improving Health Outcomes, American Medical Association, Chicago, IL (G.W., M.R.). 10. Center for Health Metrics and Evaluation, American Heart Association (C.M.S.). 11. Department of Pharmacotherapy and Translational Research, University of Florida, College of Pharmacy, Gainesville, FL (R.M.C.D.).
Abstract
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.
RCT Entities:
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.
Authors: Caitrin W McDonough; Kyle Babcock; Kristen Chucri; Dana C Crawford; Jiang Bian; François Modave; Rhonda M Cooper-DeHoff; William R Hogan Journal: Pharmacoepidemiol Drug Saf Date: 2020-08-26 Impact factor: 2.890
Authors: Brent A Williams; Stephen Voyce; Stephen Sidney; Véronique L Roger; Timothy B Plante; Sharon Larson; Michael J LaMonte; Darwin R Labarthe; Bailey M DeBarmore; Alexander R Chang; Alanna M Chamberlain; Catherine P Benziger Journal: J Am Heart Assoc Date: 2022-04-12 Impact factor: 6.106
Authors: Steven M Smith; Raj A Desai; Marta G Walsh; Ester Kim Nilles; Katie Shaw; Myra Smith; Alanna M Chamberlain; Catherine G Derington; Adam P Bress; Cynthia H Chuang; Daniel E Ford; Bradley W Taylor; Sravani Chandaka; Lav Parshottambhai Patel; James McClay; Elisa Priest; Jyotsna Fuloria; Kruti Doshi; Faraz S Ahmad; Anthony J Viera; Madelaine Faulkner; Emily C O'Brien; Mark J Pletcher; Rhonda M Cooper-DeHoff Journal: Am Heart J Plus Date: 2022-03-02
Authors: Rhonda M Cooper-DeHoff; Valy Fontil; Thomas Carton; Alanna M Chamberlain; Jonathan Todd; Emily C O'Brien; Kathryn M Shaw; Myra Smith; Sujung Choi; Ester K Nilles; Daniel Ford; Kristen M Tecson; Princess E Dennar; Faraz Ahmad; Shenghui Wu; James C McClay; Kristen Azar; Rajbir Singh; Madelaine Faulkner Modrow; Christina M Shay; Michael Rakotz; Gregory Wozniak; Mark J Pletcher Journal: J Am Heart Assoc Date: 2021-10-06 Impact factor: 5.501
Authors: Anitha S John; Jamie L Jackson; Philip Moons; Karen Uzark; Andrew S Mackie; Susan Timmins; Keila N Lopez; Adrienne H Kovacs; Michelle Gurvitz Journal: J Am Heart Assoc Date: 2022-03-17 Impact factor: 6.106
Authors: Alanna M Chamberlain; Véronique L Roger; Peter A Noseworthy; Lin Y Chen; Susan A Weston; Ruoxiang Jiang; Alvaro Alonso Journal: J Am Heart Assoc Date: 2022-03-29 Impact factor: 6.106