Electronic Communications and Home Blood Pressure Monitoring (e-BP) study: Design, delivery, and evaluation framework

Beverly B. Green, James D. Ralston, Paul A. Fishman, Sheryl L Catz, Andrea Cook, Jim Carlson, Lynda Tyll, David Carrell, Robert S. Thompson

Research output: Contribution to journalArticle

42 Scopus citations

Abstract

Background: Randomized controlled trials have provided unequivocal evidence that treatment of hypertension decreases mortality and major disability from cardiovascular disease; however, blood pressure remains inadequately treated in most affected individuals. This large gap continues despite the facts that more than 90% of adults with hypertension have health insurance, and hypertension is the leading cause of visits to the doctor. New approaches are needed to improve hypertension care. Objectives: The Electronic Communications and Home Blood Pressure Monitoring (e-BP) study is a three-arm randomized controlled trial designed to determine whether care based on the Chronic Care Model and delivered over the Internet improves hypertension care. The primary study outcomes are systolic, diastolic, and blood pressure control; secondary outcomes are medication adherence, patient self-efficacy, satisfaction and quality of life, and healthcare utilization and costs. Methods: Hypertensive patients receiving care at Group Health medical centers are eligible if they have uncontrolled blood pressure on two screening visits and access to the Web and an e-mail address. Study participants are randomly assigned to three intervention groups: (a) usual care; (b) home blood pressure monitoring receipt and proficiency training on its use and the Group Health secure patient website (with secure e-mail access to their healthcare provider, access to a shared medical record, prescription refill and other services); or (c) this plus pharmacist care management (collaborative care management between the patient, the pharmacist, and the patient's physician via a secure patient website and the electronic medical record). Conclusion: We will determine whether a new model of patient-centered care that leverages Web communications, self-monitoring, and collaborative care management improves hypertension control. If this model proves successful and cost-effective, similar interventions could be used to improve the care of large numbers of patients with uncontrolled hypertension.

Original languageEnglish (US)
Pages (from-to)376-395
Number of pages20
JournalContemporary Clinical Trials
Volume29
Issue number3
DOIs
StatePublished - May 2008
Externally publishedYes

Keywords

  • Blood pressure control
  • Blood pressure monitoring
  • Care management
  • Chronic Care Model
  • Electronic communication
  • Electronic medical record
  • Hypertension
  • Randomized controlled trial
  • Self-care
  • Study design

ASJC Scopus subject areas

  • Medicine(all)
  • Pharmacology (medical)

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  • Cite this

    Green, B. B., Ralston, J. D., Fishman, P. A., Catz, S. L., Cook, A., Carlson, J., Tyll, L., Carrell, D., & Thompson, R. S. (2008). Electronic Communications and Home Blood Pressure Monitoring (e-BP) study: Design, delivery, and evaluation framework. Contemporary Clinical Trials, 29(3), 376-395. https://doi.org/10.1016/j.cct.2007.09.005