Ignite Creation Date:
2024-05-05 @ 11:45 AM
Last Modification Date:
2024-10-26 @ 9:12 AM
Study NCT ID:
NCT00122161
Status:
COMPLETED
Last Update Posted:
2015-04-07
First Post:
2005-07-18
Brief Title:
Guidelines for Drug Therapy of Hypertension Multi-Site Implementation
Sponsor:
US Department of Veterans Affairs
Organization:
VA Office of Research and Development
Study Overview
Official Title:
Guidelines for Drug Therapy of Hypertension Multi-Site Implementation
Status:
COMPLETED
Status Verified Date:
2007-10
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Clinical trial of implementation of clinical practice guidelines for managing hypertension in primary care clinics
Detailed Description:
Background
Hypertension the most commonly reported medical problem in veterans is a major risk factor for heart disease and stroke Lowering blood pressure decreases the risk of these adverse clinical outcomes Widely promoted evidence-based clinical practice guidelines set target blood pressures for adequate control yet most hypertensives including VA patients do not meet the targets Guidelines also call for use of specific drugs depending on the patients pattern of comorbid characteristics yet clinicians often prescribe drugs that are not guideline-concordant
Objectives
The long term objective of this work is to contribute to the VAs ability to respond flexibly to rapidly evolving medical knowledge by establishing a system guidelines that can be used throughout the VA nationally for implementing multiple different clinical practice In collaboration with Stanford Medical Informatics we developed an automated decision support system for hypertension management known as ATHENA DSS built with EON technology for guideline-based decision support ATHENA DSS incorporates hundreds of knowledge rules to operationalize guidelines for hypertension
Methods
ATHENA DSS combines patient information from VistA with an automated knowledge base of hypertension to generate patient-specific recommendations for management of hypertension that are displayed to primary care clinicians in pop-up windows in the VAs Computerized Patient Record System CPRS when the record for appropriate patients is opened on the day of scheduled primary care clinic visits The ATHENA DSS pop-up provides advice on adequacy of control of blood pressure and specific recommendations for drug therapy of hypertension a visual display of the patients medication history and concurrent blood pressures evidence supporting the main recommendations and other information We deployed the system at three VA medical centers--Durham San Francisco and Palo Altoand conducted a clinician-randomized trial We logged data on use of the system monitored comments entered by clinicians and conducted a questionnaire survey of clinicians We planned analyses of impact on clinician prescribing and patient blood pressures We planned preparation for dissemination of the system to additional VA medical centers
Status
Project work is ongoing at time of preparing this report We recently received notice of funding for a VISN collaborative that will use the ATHENA DSS in five medical centers in VISN 1 New England
Hypertension the most commonly reported medical problem in veterans is a major risk factor for heart disease and stroke Lowering blood pressure decreases the risk of these adverse clinical outcomes Widely promoted evidence-based clinical practice guidelines set target blood pressures for adequate control yet most hypertensives including VA patients do not meet the targets Guidelines also call for use of specific drugs depending on the patients pattern of comorbid characteristics yet clinicians often prescribe drugs that are not guideline-concordant
Objectives
The long term objective of this work is to contribute to the VAs ability to respond flexibly to rapidly evolving medical knowledge by establishing a system guidelines that can be used throughout the VA nationally for implementing multiple different clinical practice In collaboration with Stanford Medical Informatics we developed an automated decision support system for hypertension management known as ATHENA DSS built with EON technology for guideline-based decision support ATHENA DSS incorporates hundreds of knowledge rules to operationalize guidelines for hypertension
Methods
ATHENA DSS combines patient information from VistA with an automated knowledge base of hypertension to generate patient-specific recommendations for management of hypertension that are displayed to primary care clinicians in pop-up windows in the VAs Computerized Patient Record System CPRS when the record for appropriate patients is opened on the day of scheduled primary care clinic visits The ATHENA DSS pop-up provides advice on adequacy of control of blood pressure and specific recommendations for drug therapy of hypertension a visual display of the patients medication history and concurrent blood pressures evidence supporting the main recommendations and other information We deployed the system at three VA medical centers--Durham San Francisco and Palo Altoand conducted a clinician-randomized trial We logged data on use of the system monitored comments entered by clinicians and conducted a questionnaire survey of clinicians We planned analyses of impact on clinician prescribing and patient blood pressures We planned preparation for dissemination of the system to additional VA medical centers
Status
Project work is ongoing at time of preparing this report We recently received notice of funding for a VISN collaborative that will use the ATHENA DSS in five medical centers in VISN 1 New England
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None