A Hypertension Emergency department intervention Aimed at Decreasing Disparities

高血压急诊科干预旨在减少差异

基本信息

批准号：
9130433
负责人：
HEATHER Marie PRENDERGAST
金额：
$ 58.69万
依托单位：
UNIVERSITY OF ILLINOIS AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-09-08 至 2018-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9130433
关键词：
Accident and Emergency department Achievement Acute Address Affect Algorithms Appointment Blood Pressure Cardiovascular Diseases Cardiovascular system Caring Chronic Disease Clinic Community Health Centers Coupled Data Development Early identification Echocardiography Educational Intervention Effectiveness Emergency Department patient Emergency department visit Functional disorder Goals Health Healthcare Systems Heart Diseases Heart failure Hospitals Hypertension Illinois Individual Instruction Intervention Kidney Failure Knowledge Left Ventricular Hypertrophy Low income Minority Modeling Morbidity - disease rate Patient Education Patients Pharmacists Population Prevalence Prevalence Study Prevention Primary Health Care Provider Qualifying Randomized Randomized Controlled Trials Recommendation Resources Risk Risk Assessment Risk Factors Severities Staging Stratification Stroke Treatment Protocols Underrepresented Minority United States Universities Visit arm base blood pressure regulation compliance behavior effective intervention follow-up health disparity high risk improved innovation medication compliance mortality novel patient population primary care setting primary outcome programs prospective routine care screening, brief intervention, referral, and treatment treatment as usual treatment program

项目摘要

DESCRIPTION (provided by applicant): Effective interventions that can address uncontrolled hypertension, particularly in underrepresented populations that use the emergency department (ED) for primary care, are critically needed. Uncontrolled hypertension (HTN) contributes significantly to cardiovascular morbidity and mortality and is more frequently encountered among patients presenting to the ED as compared to the primary care setting. EDs serve as the point of entry into the health care system for many high-risk patient populations, including minority and low-income patients. Based upon recent studies, the prevalence of uncontrolled/undiagnosed HTN in patients presenting to the ED is alarmingly high. Thus emergency department engagement and early risk assessment/stratification is a feasible innovation to help close health disparity gaps in HTN. This application involves a three-arm randomized controlled trial of 600 patients from the Emergency Department at University of Illinois Hospital with elevated blood pressure (BP) and no established PCP. The overarching goal is to improve follow-up rates and transition to PCP care at a federally qualified community health center (FQHC). The primary outcome will be blood pressure improvement and control. The central hypothesis of our application is that an ED-based screening, brief intervention, and referral for treatment program for HTN (SBIRT-HTN) using existing ED resources, coupled with a follow-up visit to an ED pharmacist-initiated Post-Acute Care Hypertension Transition Clinic (PACHT-c), can improve BPs by increasing follow-up rates, and consequently, treatment compliance and BP control in a predominately underrepresented hypertensive population.

描述（由适用提供）：非常需要解决不受控制的高血压的有效干预措施，尤其是在代表性不足的人群中使用急诊科（ED）进行初级保健。不受控制的高血压（HTN）对心血管发病率和死亡率产生了重大贡献，与初级保健环境相比，在ED的患者中更常见。 EDS是许多高风险患者人群（包括少数族裔和低收入患者）进入医疗保健系统的点。根据最近的研究，在ED出现的患者中，未控制/未诊断的HTN的患病率令人震惊地很高。急诊部门的参与和早期风险评估/分层是可行的创新，可帮助弥合HTN的健康差异差距。该申请涉及来自伊利诺伊大学医院急诊系的600名患者的三臂随机对照试验，血压升高（BP），没有既定的PCP。总体目标是在联邦合格的社区健康中心（FQHC）中提高随访率并过渡到PCP护理。主要结果将是血压改善和控制。我们应用的核心假设是，使用现有ED资源进行基于ED的筛查，简短的干预和针对HTN（SBIRT-HTN）的治疗计划的转诊，再加上对ED药剂师发起的急性急性护理高压过渡过渡诊所（PACHT-C）的后续访问，可以通过增强BPS来改善BPS的依从性，并且可以改善BPS的依从性，并依赖于随后的后续率和BP，并获得BP的依从性，并可以提高bp的范围。人口。