A Hypertension Emergency department intervention Aimed at Decreasing Disparities

University Of Illinois At Chicago, Chicago IL

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Abstract

? DESCRIPTION (provided by applicant): Effective interventions that can address uncontrolled hypertension, particularly in underrepresented populations that use the emergency department (ED) for primary care, are critically needed. Uncontrolled hypertension (HTN) contributes significantly to cardiovascular morbidity and mortality and is more frequently encountered among patients presenting to the ED as compared to the primary care setting. EDs serve as the point of entry into the health care system for many high-risk patient populations, including minority and low-income patients. Based upon recent studies, the prevalence of uncontrolled/undiagnosed HTN in patients presenting to the ED is alarmingly high. Thus emergency department engagement and early risk assessment/stratification is a feasible innovation to help close health disparity gaps in HTN. This application involves a three-arm randomized controlled trial of 600 patients from the Emergency Department at University of Illinois Hospital with elevated blood pressure (BP) and no established PCP. The overarching goal is to improve follow-up rates and transition to PCP care at a federally qualified community health center (FQHC). The primary outcome will be blood pressure improvement and control. The central hypothesis of our application is that an ED-based screening, brief intervention, and referral for treatment program for HTN (SBIRT-HTN) using existing ED resources, coupled with a follow-up visit to an ED pharmacist-initiated Post-Acute Care Hypertension Transition Clinic (PACHT-c), can improve BPs by increasing follow-up rates, and consequently, treatment compliance and BP control in a predominately underrepresented hypertensive population.