The following is the summary of “Reducing ethnic and racial disparities by improving undertreatment, control, and engagement in blood pressure management with health information technology (REDUCE-BP) hybrid effectiveness-implementation pragmatic trial: Rationale and design” published in the January 2023 issue of Heart Journal by Lauffenburger et al.
Although there is evidence of racial and ethnic variations in blood pressure regulation, few strategies have been shown to narrow these discrepancies effectively. Significant factors are believed to include inadequate prescribing, treatment intensification, and follow-up care. These obstacles may be overcome with the aid of electronic health record (EHR) tools, which could be improved through the application of behavioral science methods. The goal of this study is to assess the effectiveness of a multi-component EHR-based intervention for managing blood pressure.
The REDUCE-BP (NCT05030467) trial is a 2 cluster-randomized hybrid type 1 pragmatic trial in a large multi-ethnic health care system aimed at reducing ethnic and racial disparities in blood pressure management by improving undertreatment, control, and engagement with health information technology. Multi-component EHR-based intervention or usual care is randomly assigned to 24 clinics (>350 primary care providers (PCPs) and >10,000 eligible patients). PCPs working in intervention clinics will have access to multiple EHR tools aimed at reducing disparities, including a dashboard of all patients visible upon logging on to the EHR displaying blood pressure control by race/ethnicity compared to their PCP peers, and a set of tools in an individual patient’s chart containing decision support to encourage treatment intensification, ordering home blood pressure measurement, interventions to address health-relative social determinants of health, and more.
Change in systolic blood pressure from baseline to 12 months post-intervention between arms is the primary endpoint, with changes in disparities and other clinical outcomes serving as secondary outcomes. REDUCE-BP will shed light on whether or not a behavioral science-informed electronic health record-based intervention can help improve hypertension control and decrease inequalities.