Project Summary

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

About one in three American adults has high blood pressure, a chronic health problem where the force of blood against artery walls is too high. High blood pressure can lead to serious health problems such as heart disease and stroke. There are effective ways to lower high blood pressure to recommended levels. Doing so can reduce the risk of heart attack and stroke. However, half of all people with high blood pressure do not reduce their blood pressure to recommended levels.

In this study, the research team is comparing two ways for healthcare teams to help patients lower their high blood pressure: in the clinic and having patients monitor it at home. The team also wants to know how patients want to receive care. Finally, the team is looking to see how well clinic- and home-based methods work in large health systems. 

Who can this research help?

Results of this study may help health system administrators decide whether to offer clinic- or home-based blood pressure monitoring.

What is the research team doing?

The study includes 21 primary care clinics in Minnesota and western Wisconsin that are part of a large healthcare system. The research team is assigning half of the clinics by chance to use a clinic-based model of care and the other half to use a home-based model. In total, 2,000 adult patients with high blood pressure are taking part in the study.

At clinics offering clinic-based care, 1,000 patients meet face-to-face with doctors and medical assistants to discuss and track blood pressure. Patients have follow-up meetings with their doctors every two to four weeks. At clinics offering home-based care, 1,000 patients work with a pharmacist or nurse practitioner to track blood pressure using a home blood pressure monitoring device. Patients in the home-based program check in as needed with a pharmacist or nurse by telephone or email. Both models of care track and save patient blood pressure information.

The team is comparing results from the two programs to see if patients’ blood pressure levels change over 12 months. Researchers are also asking patients about their care experiences, including treatment side effects, success with self-monitoring, and how confident patients feel about caring for themselves. Finally, the team is looking at care in the clinics and having interviews and focus groups with patients and staff to see how fully the clinics carry out the two care models in practice.

Patients, patient advisors, and health system administrators take part in the study at all stages. For example, patients help design and select the questions for the survey the team is using to collect patient-reported outcomes.

Research methods at a glance

Design Elements Description
Design Randomized controlled trial
Population Adults ages 18 to 85 years with uncontrolled hypertension noted in their medical records twice in the last 24 months
Interventions/
Comparators
  • Clinic-based care
  • Home-based telehealth care
Outcomes

Primary: systolic blood pressure

Secondary: side effects of antihypertensive medications, patient experience/satisfaction with care, patient confidence in self-management of blood pressure, diastolic blood pressure, lipid levels, statin use, smoking status, 10-year cardiovascular event risk, 30-year cardiovascular event risk, lab abnormalities related to hypertension and antihypertensive drug treatment, hypotension or fainting

Timeframe Timeframe Length of follow-up for collecting data on primary outcomes. View Glossary 1-year follow-up for primary outcome

More to Explore...

Videos

Helping Patients Better Control High Blood Pressure
Principal Investigator Karen Margolis speaks about this study, which is comparing two methods of monitoring high blood pressure to determine whether telehealth offers an edge over more traditional clinic-based care.

More Telehealth Research Needed
Principal Investigator Karen Margolis says more research is needed to determine whether telehealth offers an advantage to patients as it becomes more widely available.

Project Information

Karen L. Margolis, MD, MPH
HealthPartners Institute
$6,021,508
Pragmatic Trial Comparing Telehealth Care and Optimized Clinic-Based Care for Uncontrolled High Blood Pressure

Key Dates

April 2016
September 2022
2016

Study Registration Information

Tags

Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Funding Opportunity Type
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
Research Priority Area
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: April 26, 2022