Tailoring a Telemedicine Hypertension Management Intervention for Black Patients
Wake Forest University Health Sciences
Summary
Current clinic-based hypertension (HTN) management models have several limitations, resulting in episodic care that does not adequately support patients' self-care skills, and fails to achieve blood pressure (BP) control.
Description
Telemedicine management of HTN (TM-HTN) can augment and overcome challenges by allowing more support for patients' HTN self-care skills, providing multiple home Blood Pressure values and overcoming failure to appropriately intensify treatment. TM-HTN consists of 1) home BP monitoring, 2) home BP based pharmacotherapy, and 3) telemedicine-based self-management support.
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Subjects must be African American or Black * experiencing socially disadvantage * Patients with systolic Blood Pressure ≥140 mmHg on their last two clinic visits and baseline systolic BP \>130 mmHg using the mean of two research BP values measured by trained staff * Subjects must be on stable Blood Pressure medications for the preceding 6 weeks Exclusion Criteria: * Unable to read or speak English * diminished ability to measure home Blood Pressure * chronic kidney disease ≥stage 4 * persistent/chronic atrial fibrillation * severe hypertension \>180/110 mmHg * acute he…
Interventions
- BehavioralTelemedicine management of Hypertension
TM-HTN intervention includes tailored and frequent self-management support, home blood pressure monitoring, pharmacotherapy, and as-needed assistance for health-related social needs provided by pharmacists, nurses, community health workers, and social workers. This will be compared with usual care
- BehavioralUsual Care
This includes usual clinic based HTN care using routinely available clinic resources (e.g., community health worker, social worker). Clinicians can offer self-management support (e.g., dietician referral) or recommend a home BP monitor. These activities mirror current primary care practice.
Location
- Wake Forest University Health SciencesWinston-Salem, North Carolina