Improving Hypertension Control in Safety-Net Settings: The Boston Hypertension Equity Alliance in Treatment

Summary

High blood pressure (BP) or hypertension (HTN) affects over 100 million individuals in the US, increasing the risk of adverse outcomes, including stroke, myocardial infarction (MI), and chronic kidney disease (CKD). Effective therapies include non-pharmacologic approaches and multiple medication classes. Successful HTN management requires ongoing patient engagement for BP monitoring and treatment intensification. Reaching this goal is challenging, and many patients with HTN do not have controlled BP.

Using a collaborative partnership between patients, clinicians, health system and public health stakeholders, and the research team the investigators plan to overcome barriers to widespread implementation of evidence-based health system strategies to improve BP control in a large, urban, primary care-based safety-net setting for diverse populations experiencing disparities in HTN-related outcomes.

Conditions

• Hypertension
• Hypertension Complicated

Interventions

BEHAVIORAL

RBPM

Standardized blood pressure measurement and treatment protocols in clinical practice.

OTHER

MII

Team-based interventions including multiple evidence-proven interventions such as clinician decision support, monitoring medication non-adherence, use of combination pills, and formulary modifications.

Sponsors & Collaborators

• Patient-Centered Outcomes Research Institute

  collaborator OTHER

• Boston Healthcare for the Homeless Program (BHCHP)

  collaborator UNKNOWN

• Boston Medical Center General Internal Medicine primary care (BMC GIM)

  collaborator UNKNOWN

• Boston Medical Center Family Medicine Primary Care (BMC FM)

  collaborator UNKNOWN

• NeighborHealth Center Family Medicine at Maverick Street (NH FM)

  collaborator UNKNOWN

• NeighborHealth Center Internal Medicine at Gove Street (NH IM)

  collaborator UNKNOWN

• NeighborHealth South End (NH South End)

  collaborator UNKNOWN

• Manet Community Health Center (Maner CHC)

  collaborator UNKNOWN

• Mattapan Community Health Center (Mattapan)

  collaborator UNKNOWN

• Greater Roslindale Medical and Dental Center (GRMDC)

  collaborator UNKNOWN

• Boston University School of Public Health (BUSPH)

  collaborator UNKNOWN

• BUSPH Biostatistics and Epidemiology Data Analytics Center (BEDAC)

  collaborator UNKNOWN

• Boston Medical Center

  lead OTHER

Principal Investigators

• Michael Fischer, MD MS · Boston Medical Center, Internal Medicine

• Cheryl Clark, MD ScD · Institute for Health Equity Research, Evaluation & Policy, MA League of CHCs

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

SEQUENTIAL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-09-08

Primary Completion

2029-09-30

Completion

2029-09-30

Countries

• United States

Study Locations