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A web-based patient activation intervention to improve hypertension care: Study design and baseline characteristics in the web hypertension study
Authors:Jeffrey Thiboutot  Heather Stuckey  Aja Binette  Donna Kephart  William Curry  Bonita Falkner  Christopher Sciamanna
Institution:1. Pennsylvania State University College of Medicine, M.S. Hershey Medical Center, Hershey, PA 17033, United States;2. Department of Medicine, Pennsylvania State University College of Medicine, M.S. Hershey Medical Center, Hershey, PA 17033, United States;3. Department of Public Health Sciences, Pennsylvania State University College of Medicine, M.S. Hershey Medical Center, Hershey, PA 17033, United States;4. Department of Family and Community Medicine, M.S. Hershey Medical Center, Hershey, PA 17033, United States;5. Division of Nephrology, Department of Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, United States
Abstract:BackgroundDespite the known health risks of hypertension, many hypertensive patients still have uncontrolled blood pressure. Clinical inertia, the tendency of physicians not to intensify treatment, is a common barrier in controlling chronic diseases. This trial is aimed at determining the impact of activating patients to ask providers to make changes to their care through tailored feedback.MethodsDiagnosed hypertensive patients were enrolled in this RCT and randomized to one of two study groups: (1) the intervention condition – Web-based hypertension feedback, based on the individual patient's self-report of health variables and previous BP measurements, to prompt them to ask questions during their next physician's visit about hypertension care (2) the control condition – Web-based preventive health feedback, based on the individual's self-report of receiving preventive care (e.g., pap testing), to prompt them to ask questions during their next physician's visit about preventive care. The primary outcome of the study is change in blood pressure and change in the percentage of patients in each group with controlled blood pressure.ConclusionFive hundred participants were enrolled and baseline characteristics include a mean age of 60.0 years; 57.6% female; and 77.6% white. Overall 37.7% participants had uncontrolled blood pressure; the mean body mass index (BMI) was in the obese range (32.4) and 21.8% had diabetes. By activating patients to become involved in their own care, we believe the addition of the web-based intervention will improve blood pressure control compared to a control group who receive web-based preventive messages unrelated to hypertension.
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