NCT05160012

Peer Comparison Feedback to Providers to Improve Hypertension Control

• Status: Active Not Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 93 (actual)
• Sponsor: University of Pennsylvania · Academic / Other
• Sex: All
• Age: 18 Years – 85 Years
• Healthy volunteers: Not accepted

Summary

As part of a roll out of new payment model for physicians based on hypertension control, the investigators will evaluate a monthly peer comparison message to Primary Care Providers at Penn Medicine Lancaster to see whether provider engagement with patients' overall hypertension management increases, as measured by new or increasing doses of anti-hypertensive medications.

Detailed description

Hypertension (HTN) affects about 30% of US adults, and effective treatment that reduces long-term risk of subsequent cardiovascular disease is widely available; however, only about half of adults maintain good control. HTN control requires diagnosis, initiation of treatment, adherence to medications, and titration of medications. The investigators' prior work from Way2Text and SupportBP showed that there is significant clinical inertia in escalating medications for HTN through increasing dosage or adding new medications. Prior studies have shown that providing feedback to providers with peer comparison data can leverage social norms to improve evidence-based practices in antibiotic and statin prescribing. Penn Medicine Lancaster General Primary Care is rolling out a Hypertension Control Implementation Plan (HCIP) as an initiative to improve hypertension control through creation of a clinic-based pathway to identify patients with hypertension, appropriately measure blood pressure, and prescribe medications to reduce blood pressure. Busy PCPs have competing demands of care, so there is an opportunity to leverage peer comparison to nudge providers to adhere to the HCIP and intensify medications. The study design is a stratified parallel-group cluster-randomized trial. PCPs will be randomized in a 1:1 ratio, stratified by practice, to either: 1) Control: Usual Care- This will include the standard HCIP roll-out, and PCPs can access their HTN control rates using the existing EPIC dashboard.

Conditions

• Hypertension

Interventions

Type	Name	Description
BEHAVIORAL	Peer Comparison Message	In addition to usual care, PCPs will receive a monthly report as an EPIC in basket message describing what category they are in: 1. If HTN control rate \<50th percentile, PCP is told they are below median 2. If HTN control rate is between 50-89th percentile , PCP is told they are below top performer 3. If HTN control rate is between 90-100th percentile, PCP is told they are a high performer

Timeline

• Start date: 2022-04-05
• Primary completion: 2022-10-06
• Completion: 2026-04-01
• First posted: 2021-12-16
• Last updated: 2025-12-04

Locations

1 site across 1 country: United States