Leveraging Electronic Health Record Technology and Team Care to Address Medication Adherence: Protocol for a Cluster Randomized Controlled Trial
BackgroundLow medication adherence is a common cause of high blood pressure but is often unrecognized in clinical practice. Electronic data linkages between electronic health records (EHRs) and pharmacies offer the opportunity to identify low medication adherence, which can b...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2023-07-01
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| Series: | JMIR Research Protocols |
| Online Access: | https://www.researchprotocols.org/2023/1/e47930 |
| _version_ | 1797734046854283264 |
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| author | Saul Blecker Antoinette Schoenthaler Tiffany Rose Martinez Hayley M Belli Yunan Zhao Christina Wong Cassidy Fitchett Harris R Bearnot Devin Mann |
| author_facet | Saul Blecker Antoinette Schoenthaler Tiffany Rose Martinez Hayley M Belli Yunan Zhao Christina Wong Cassidy Fitchett Harris R Bearnot Devin Mann |
| author_sort | Saul Blecker |
| collection | DOAJ |
| description |
BackgroundLow medication adherence is a common cause of high blood pressure but is often unrecognized in clinical practice. Electronic data linkages between electronic health records (EHRs) and pharmacies offer the opportunity to identify low medication adherence, which can be used for interventions at the point of care. We developed a multicomponent intervention that uses linked EHR and pharmacy data to automatically identify patients with elevated blood pressure and low medication adherence. The intervention then combines team-based care with EHR-based workflows to address medication nonadherence.
ObjectiveThis study aims to describe the design of the Leveraging EHR Technology and Team Care to Address Medication Adherence (TEAMLET) trial, which tests the effectiveness of a multicomponent intervention that leverages EHR-based data and team-based care on medication adherence among patients with hypertension.
MethodsTEAMLET is a pragmatic, cluster randomized controlled trial in which 10 primary care practices will be randomized 1:1 to the multicomponent intervention or usual care. We will include all patients with hypertension and low medication adherence who are seen at enrolled practices. The primary outcome is medication adherence, as measured by the proportion of days covered, and the secondary outcome is clinic systolic blood pressure. We will also assess intervention implementation, including adoption, acceptability, fidelity, cost, and sustainability.
ResultsAs of May 2023, we have randomized 10 primary care practices into the study, with 5 practices assigned to each arm of the trial. The enrollment for the study commenced on October 5, 2022, and the trial is currently ongoing. We anticipate patient recruitment to go through the fall of 2023 and the primary outcomes to be assessed in the fall of 2024.
ConclusionsThe TEAMLET trial will evaluate the effectiveness of a multicomponent intervention that leverages EHR-based data and team-based care on medication adherence. If successful, the intervention could offer a scalable approach to address inadequate blood pressure control among millions of patients with hypertension.
Trial RegistrationClinicalTrials.gov NCT05349422; https://clinicaltrials.gov/ct2/show/NCT05349422
International Registered Report Identifier (IRRID)DERR1-10.2196/47930 |
| first_indexed | 2024-03-12T12:38:35Z |
| format | Article |
| id | doaj.art-9f5dd45f35864cf4ad226c9823171665 |
| institution | Directory Open Access Journal |
| issn | 1929-0748 |
| language | English |
| last_indexed | 2024-03-12T12:38:35Z |
| publishDate | 2023-07-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Research Protocols |
| spelling | doaj.art-9f5dd45f35864cf4ad226c98231716652023-08-29T00:02:04ZengJMIR PublicationsJMIR Research Protocols1929-07482023-07-0112e4793010.2196/47930Leveraging Electronic Health Record Technology and Team Care to Address Medication Adherence: Protocol for a Cluster Randomized Controlled TrialSaul Bleckerhttps://orcid.org/0000-0003-4460-1046Antoinette Schoenthalerhttps://orcid.org/0000-0003-4905-5136Tiffany Rose Martinezhttps://orcid.org/0000-0001-8038-307XHayley M Bellihttps://orcid.org/0000-0002-0816-6844Yunan Zhaohttps://orcid.org/0000-0002-0665-5572Christina Wonghttps://orcid.org/0000-0002-8812-1565Cassidy Fitchetthttps://orcid.org/0009-0000-6737-6043Harris R Bearnothttps://orcid.org/0009-0007-6993-8186Devin Mannhttps://orcid.org/0000-0002-2099-0852 BackgroundLow medication adherence is a common cause of high blood pressure but is often unrecognized in clinical practice. Electronic data linkages between electronic health records (EHRs) and pharmacies offer the opportunity to identify low medication adherence, which can be used for interventions at the point of care. We developed a multicomponent intervention that uses linked EHR and pharmacy data to automatically identify patients with elevated blood pressure and low medication adherence. The intervention then combines team-based care with EHR-based workflows to address medication nonadherence. ObjectiveThis study aims to describe the design of the Leveraging EHR Technology and Team Care to Address Medication Adherence (TEAMLET) trial, which tests the effectiveness of a multicomponent intervention that leverages EHR-based data and team-based care on medication adherence among patients with hypertension. MethodsTEAMLET is a pragmatic, cluster randomized controlled trial in which 10 primary care practices will be randomized 1:1 to the multicomponent intervention or usual care. We will include all patients with hypertension and low medication adherence who are seen at enrolled practices. The primary outcome is medication adherence, as measured by the proportion of days covered, and the secondary outcome is clinic systolic blood pressure. We will also assess intervention implementation, including adoption, acceptability, fidelity, cost, and sustainability. ResultsAs of May 2023, we have randomized 10 primary care practices into the study, with 5 practices assigned to each arm of the trial. The enrollment for the study commenced on October 5, 2022, and the trial is currently ongoing. We anticipate patient recruitment to go through the fall of 2023 and the primary outcomes to be assessed in the fall of 2024. ConclusionsThe TEAMLET trial will evaluate the effectiveness of a multicomponent intervention that leverages EHR-based data and team-based care on medication adherence. If successful, the intervention could offer a scalable approach to address inadequate blood pressure control among millions of patients with hypertension. Trial RegistrationClinicalTrials.gov NCT05349422; https://clinicaltrials.gov/ct2/show/NCT05349422 International Registered Report Identifier (IRRID)DERR1-10.2196/47930https://www.researchprotocols.org/2023/1/e47930 |
| spellingShingle | Saul Blecker Antoinette Schoenthaler Tiffany Rose Martinez Hayley M Belli Yunan Zhao Christina Wong Cassidy Fitchett Harris R Bearnot Devin Mann Leveraging Electronic Health Record Technology and Team Care to Address Medication Adherence: Protocol for a Cluster Randomized Controlled Trial JMIR Research Protocols |
| title | Leveraging Electronic Health Record Technology and Team Care to Address Medication Adherence: Protocol for a Cluster Randomized Controlled Trial |
| title_full | Leveraging Electronic Health Record Technology and Team Care to Address Medication Adherence: Protocol for a Cluster Randomized Controlled Trial |
| title_fullStr | Leveraging Electronic Health Record Technology and Team Care to Address Medication Adherence: Protocol for a Cluster Randomized Controlled Trial |
| title_full_unstemmed | Leveraging Electronic Health Record Technology and Team Care to Address Medication Adherence: Protocol for a Cluster Randomized Controlled Trial |
| title_short | Leveraging Electronic Health Record Technology and Team Care to Address Medication Adherence: Protocol for a Cluster Randomized Controlled Trial |
| title_sort | leveraging electronic health record technology and team care to address medication adherence protocol for a cluster randomized controlled trial |
| url | https://www.researchprotocols.org/2023/1/e47930 |
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