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Reducing clinical inertia in hypertension treatment: a pragmatic randomized controlled trial
The Journal of Clinical Hypertension, 05/03/2012
Huebschmann AG et al. – Future primary care–focused interventions might benefit from the use of specific medication titration protocols, treatment adherence support, and more sustained patient follow–up visits.
- Clinical inertia is a major contributor to poor blood pressure (BP) control.
- The authors tested the effectiveness of an intervention targeting physician, patient, and office system factors with regard to outcomes of clinical inertia and BP control.
- A total of 591 adult primary care patients with elevated BP (mean systolic BP ≥140 mm Hg or mean diastolic BP ≥90 mm Hg) were randomized to intervention or usual care.
- An outreach coordinator raised patient and provider awareness of unmet BP goals, arranged BP–focused primary care clinic visits, and furnished providers with treatment decision support.
- The intervention reduced clinical inertia (–29% vs –11%, P=.001).
- Nonetheless, change in BP did not differ between intervention and usual care (–10.1/–4.1 mm Hg vs –9.1/–4.5 mm Hg, P=.50 and 0.71 for systolic and diastolic BP, respectively).