Hypertension affects 50 million adults and is the leading cause of stroke and congestive heart failure in the United States. While many factors contribute to hypertension, there is overwhelming evidence linking excessive alcohol consumption to increased blood pressure. Either total abstinence or reduction in consumption to one drink a day results in a rapid and significant drop in blood pressure in many patients. Unfortunately, routine alcohol screening and intervention with hypertensive patients is rare in spite of the availability of clinical guidelines and screening tools. The primary objective of this study is to utilize the Practice Partner Research Network's Translating Research into Practice (PPRNet-TRIP) model to improve detection and management of excessive drinking among primary care patients with hypertension. PPRNet-TRIP is a validated, practice-based quality improvement system using electronic medical records, reminder prompts, academic detailing and performance feedback. An enhanced PPRNet-TRIP model, providing concentrated focus on alcohol screening for hypertensive patients, will be applied to ten primary care practices to improve detection and management of alcohol problems among patients with hypertension. Ten control practices will receive a more general quality improvement program without special emphasis on alcohol screening. A secondary goal of the study is to evaluate whether the enhanced intervention has a greater impact on reductions in blood pressure in hypertensive patients than the control condition. The significance of this study is that it may provide an evidence-based educational intervention to facilitate the routine use of alcohol screening with patients whose hypertension may be exacerbated by excessive alcohol consumption. Such screening and intervention should improve blood pressure control in many of these patients and, in turn, reduce risk of chronic disease and death.
| Rose, Heather Liszka; Miller, Peter M; Nemeth, Lynne S et al. (2008) Alcohol screening and brief counseling in a primary care hypertensive population: a quality improvement intervention. Addiction 103:1271-80 |
| Miller, Peter M; Stockdell, Ruth; Nemeth, Lynne et al. (2006) Initial steps taken by nine primary care practices to implement alcohol screening guidelines with hypertensive patients: the AA-TRIP project. Subst Abus 27:61-70 |
