Reach Out 2: Randomized Clinical Trial of Emergency Department-Initiated Hypertension Mobile Health Intervention Connecting Multiple Health Systems
Northwestern University
Summary
Emergency department visits provide an opportunity to identify people with undiagnosed, untreated, or uncontrolled high blood pressure. In Reach Out, we will test whether a mobile health intervention yields a greater reduction in blood pressure than usual care among individuals identified with high blood pressure during a safety-net emergency department visit. Subsequently, we will estimate the reduction in heart attack, stroke, and dementia if Reach Out were implemented across all U.S. safety-net emergency departments.
Description
Hypertension is the most important modifiable risk factor for cardiovascular disease. Black Americans have the highest prevalence of hypertension and the lowest rates of blood pressure (BP) control of any racial or ethnic group in the U.S., contributing to cardiovascular disease disparities. Low-income Americans are also disproportionally burdened by hypertension. To achieve health equity, new approaches to hypertension management leveraging safety-net healthcare systems to reach underserved populations are needed. One approach to addressing the hypertension epidemic is to identify and treat…
Eligibility
- Age range
- 18–99 years
- Sex
- All
- Healthy volunteers
- No
While in the ED, the patient must meet all of the following: * Adult (≥18 y/o) * At least one BP with Systolic BP ≥160 or a Diastolic BP ≥100 (criteria 1) * If the patient has repeated measurements after achieving Criteria 1, at least one of the repeat BP remains systolic BP ≥140 or a diastolic BP ≥90 * Must have cell phones with text-messaging capability * Likely to be discharged from the ED Exclusion Criteria for Main Trial Participants: * Critical illness * Unable to read English (\<1% at study site) * Incarcerated * Pregnant * Pre-existing condition making 6-month follow-up unlikely
Interventions
- BehavioralSelf-Measured Blood Pressure Monitoring
Prompted SMBP with tailored feedback
- BehavioralPhysician appointment and transportation scheduling
Physician appointment and transportation scheduling or none dependent on current BP control
Location
- Hurley Medical CenterFlint, Michigan