COVID-19-Related Project Enhancement
How hypertension and different types of hypertension medications affect COVID-19 infection are areas of ongoing investigation. Researchers are working to better understand the relationship between treatment with angiotensin coverting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) and COVID infection and the severity of COVID outcomes.
The enhancement will use the PCORnet® Common Data Model to analyze the association between ACEI/ARB medication exposure versus different types of blood pressure medication exposures and the likelihood of diagnosed COVID-19 infection and severity of COVID-19 outcomes among patients with hypertension.
Enhancement Award Amount: $357,993
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?
Uncontrolled high blood pressure causes nearly 400,000 deaths each year in the United States. Medicine can help patients control their blood pressure. But patients and doctors need better ways of managing blood pressure to make sure that treatments work well for patients in practice. New clinic programs and technologies for patients may help.
The research team is creating a system to monitor how well clinics and patients are controlling blood pressure. The team is using this system in three studies. The studies are
- Describing blood pressure control in the United States overall and in different patients and places (Study 1)
- Comparing blood pressure control between clinics that receive extra support for doctors in using educational materials about blood pressure control versus those that don’t have this extra support (Study 2)
- Comparing blood pressure control between patients who receive a home blood pressure monitor with and without a smartphone app (Study 3)
Who can this research help?
Results may help clinics considering ways to help doctors and patients control blood pressure.
What is the research team doing?
Study 1. The research team is using electronic health records, or EHRs, from healthcare organizations across the United States to study blood pressure control at their clinics. The team is looking at indicators including
- Prescriptions for uncontrolled blood pressure
- Repeat high blood pressure readings in clinics
- How often patients return to the doctor’s office within four weeks after a high blood pressure reading
The research team is using this information to learn which clinics control their patients’ blood pressure well and which clinics need help. In addition, the team is building a registry where doctors and nurses can see how well their clinics are doing compared with other clinics. They can also compare patient outcomes at their clinics before and after treatment and by factors such as age, sex, and race.
Study 2. Twenty clinics receive access to a website with educational materials on blood pressure control. Site champions, who are existing clinic staff members like doctors and nurses, use these materials to help their peers at the clinic improve how they control blood pressure.
The research team is assigning clinics by chance to either receive extra help for their site champions or not. Site champions who receive extra help work with a site facilitator to improve their clinic processes and monitor how well clinics are controlling blood pressure. Expert staff from the American Medical Association train and support the facilitators. Site champions from clinics assigned not to receive help use the educational materials without help from a facilitator.
The research team is measuring clinic patients’ blood pressure at the start of the study and again six months later. The team is also measuring how often doctors prescribe new medicines for patients with uncontrolled blood pressure. The team is comparing these outcomes between clinics with and without site facilitator support for the site champions, and between study clinics and non-study clinics that provide usual care.
Study 3. The research team is assigning 2,000 patients with high blood pressure to one of two groups by chance. Patients in the first group receive a home blood pressure monitoring, or HBPM, device with instructions. Patients track their blood pressure over time using the device and can share this information with their doctor.
Patients in the second group receive a HBPM device linked to a smartphone app. They receive instructions on how to download the app and use the HBPM device to measure blood pressure. Patients can get reminders to check their blood pressure, track their blood pressure over time, and share this information with their doctor using the app.
The research team is collecting information on patients’ blood pressure, measured in their doctor’s offices, from EHRs for at least six months and up to 18 months. The team is also surveying patients on an online portal about whether they would recommend the HBPM device to a friend. From patients in the second group, the team is collecting data from the app.
Patients are helping to design all three studies and study materials for patient use.
Research methods at a glance
Other Health Services Interventions
Training and Education Interventions
Partnerships to Conduct Research within PCORnet (PaCR)