A driving force for health equity

Study Examines Effectiveness of AMA-Developed Program and Protocols for Blood Pressure Control

By April Lee and Jonathan Todd, PhD, MSPH

As part of National High Blood Pressure Education Month, we’re excited to share some details regarding the BP-MAP study, part of the PaCR study, a partnership between OCHIN, University of California at San Francisco, American Medical Association (AMA), American Heart Association (AHA), and several other clinical research networks across the US. The OCHIN team is working with these stakeholders to implement the M.A.P. (Measure Accurately, Act Rapidly, and Partner with Patients) program, a clinic-level blood pressure control protocol developed by the AMA, in ten OCHIN clinics across our network. This protocol equips clinicians with tools, including a digital guide and a newly developed hypertension dashboard in the OCHIN Epic electronic health record, to help them manage their patients’ blood pressure. In pilot work, clinics implementing the BP-MAP program achieved robust, persistent gains in blood pressure control.[1,2] OCHIN is excited to participate in a larger-scale randomized controlled trial to compare the effectiveness of the M.A.P. program when delivered in two distinct formats: a full support model and a self-guided model.

Both study arms will receive access to a M.A.P. digital guide, with modules, videos, and other tools to help manage blood pressure, and a new hypertension dashboard in the OCHIN Epic electronic health record. Through this new dashboard, clinicians at participating clinics will be able to view lists of patients not meeting recommended targets, helping them to act rapidly to address the issue with the patient’s help. The full support arm will also have access to an OCHIN practice coach as they implement the M.A.P. program. The study outcomes include blood pressure-related metrics at the clinic level, which will be measured over a period of six months. We hope that the program, in both formats, will reduce both diagnostic uncertainty and therapeutic inertia, and increase treatment adherence.

We have successfully recruited clinics into the study and are preparing for a mid-2019 launch. Our team is excited to partner with these clinics to help them improve blood pressure control. We believe this evidence-based quality improvement program will provide clear guidance, knowledge, and tools to support clinical care teams looking to improve their processes around diagnosis and management of hypertension, leading to measureable benefits to patients in OCHIN clinics. Stay tuned for further updates as we move towards launch!

Please contact April Lee (leea@ochin.org), Research Associate, or Jonathan Todd (toddj@ochin.org), Senior Research Associate, with any questions.

[1] Hanlin RB, Asif IM, Wozniak G, Sutherland SE, Shah B, Yang J, et al. Measure Accurately, Act Rapidly, and Partner With Patients (MAP) improves hypertension control in medically underserved patients: Care Coordination Institute and American Medical Association Hypertension Control Project Pilot Study results. J Clin Hypertens. 2018:1–9.

[2] Egan BM, Sutherland SE, Rakotz M, et al. Improving hypertension control in primary care with the measure accurately, act rapidly, and partner with patients protocol. Hypertension. 2018;72(6):1320-1327.