Changing care delivery models to address uncontrolled hypertension (HTN) while decreasing the secondary cardiovascular complications commonly seen 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 proposal involves a two-arm randomized controlled trial of 686 patients from the Emergency Department at University of Illinois Hospital with moderately elevated blood pressures (BP ? 140/90 mmHg). The primary outcome will be blood pressure improvement. Secondary outcomes will be blood pressure control, improvement of cardiovascular risk score, medication adherence, primary care engagement, patient motivation, and HTN knowledge. The central hypothesis of our proposal is that an ED-based educational and empowerment (E2) intervention coupled with an ED pharmacist/Advanced Practice Nurse (APN) Post-Acute Care Hypertension Transition Consultation (PACHT-c) and mobile health remote BP monitoring will educate and empower patients to improve their BPs and decrease their cardiovascular risk profile as measured by the Framingham Risk Score, and can be impactful in a predominately underrepresented hypertensive population.
Hypertension affects more than 76 million individuals in the United States and uncontrolled hypertension is the primary risk factor for the subsequent development of cardiovascular complications such as heart failure, renal failure, and stroke. The central hypothesis of our proposal is that an ED-based educational and empowerment (E2) intervention coupled with an ED pharmacist/Advanced Practice Nurse (APN) Post-Acute Care Hypertension Transition Consultation (PACHT-c) and mobile health home BP monitoring platform will educate and empower patients to improve their blood pressures and decrease their cardiovascular risk as measured by the Framingham Risk Score. The proposal leverages the existing partnership between an academic urban ED and a federally qualified health center (FQHC) as a model for integrating secondary cardiovascular prevention that is portable to other urban settings with similar patient demographics.
