Trial results for a study evaluating an electronic health record (EHR) intervention for hypertension management were posted on ClinicalTrials.gov on 2025-06-06. The intervention led to a 1.02 risk ratio (95% CI: 1.0 to 1.03, p=0.011) for well-controlled blood pressure.
Background
Hypertension, or high blood pressure, is a common chronic condition that significantly increases the risk of heart disease, stroke, and kidney disease. Effective management is crucial, yet many patients experience uncontrolled hypertension, often exacerbated by health disparities. Electronic Health Record (EHR) tools offer a potential avenue to improve hypertension management by providing decision support and dashboards for providers. This study aimed to evaluate the impact of such a multicomponent EHR intervention on hypertension management, specifically targeting the reduction of health disparities.
Trial design
This completed study, designated as Phase NA, was a two-arm cluster randomized controlled trial that enrolled 49210 participants. The trial focused on conditions including Hypertension and Blood Pressure. The intervention consisted of enhancing existing EHR tools for primary care providers, including developing and implementing provider disparities dashboards and enhancing electronic decision support. Randomization was conducted at the site level, with all eligible providers in intervention sites receiving the intervention.
Key results
The trial reported several key measurements and analyses:
- Change in Systolic Blood Pressure: The Intervention Arm showed a mean change of -11.0 mmHg (Standard Deviation 19.2), while the Control Arm showed a mean change of -11.0 mmHg (Standard Deviation 19.1).
- Change in Diastolic Blood Pressure: The Intervention Arm showed a mean change of -4.4 mmHg (Standard Deviation 10.8), while the Control Arm showed a mean change of -4.3 mmHg (Standard Deviation 10.9).
- Percentage of Patients With Well-controlled Blood Pressure: The Intervention Arm included 16910 participants, and the Control Arm included 16441 participants.
Key analyses included:
- For the mean difference in final systolic blood pressure values, a mean difference of -0.04 (95% CI: -0.39 to 0.31) was reported, adjusted for the cluster design using generalized estimating equations (GEE).
- For the percentage of patients with well-controlled blood pressure, a Risk Ratio (RR) of 1.02 (95% CI: 1.0 to 1.03) with a p-value of 0.011 was observed. This outcome was evaluated using GEE, adjusting for clinic-level clustering.
- For the mean difference in final diastolic blood pressure values, a mean difference of -0.12 (95% CI: -0.38 to 0.15) with a p-value of 0.383 was reported, also adjusted for the cluster design using GEE.
What this means
The results indicate that the multicomponent EHR intervention had a statistically significant, albeit small, positive impact on the percentage of patients achieving well-controlled blood pressure, as evidenced by a risk ratio of 1.02 (p=0.011). While the mean changes in systolic and diastolic blood pressure were similar between the intervention and control arms, and the mean differences were not statistically significant, the improvement in the proportion of patients reaching control targets suggests that EHR-based tools can play a role in optimizing hypertension management. These findings support the potential of leveraging existing EHR infrastructure to enhance clinical practice and address health disparities in hypertension care.
Source
The information regarding these trial results was obtained from ClinicalTrials.gov, a public database of clinical studies. The results for the study NCT05030467, titled "Leveraging Electronic Health Record (EHR) Tools to Reduce Health Disparities for Patients With Uncontrolled Hypertension", were posted on 2025-06-06 on clinicaltrials.gov.