A brief, multifaceted, generic intervention to improve blood pressure control and reduce disparities had little effect

Abstract

Background: Poor blood pressure (BP) control and racial disparities therein may be a function of clinical inertia and ineffective communication about BP care. Methods: We compared two different interventions (electronic medical record reminder for BP care (Reminder only, [RO]), and clinician training on BP care-related communication skills plus the reminder (Reminder + Training, [R+T]) with usual care in three primary care clinics, examining BP outcomes among 8,866 patients, and provider-patient communication and medication adherence among a subsample of 793. Results: Clinician counseling improved most at R+T. BP improved overall; R+T had a small but significantly greater reduction in diastolic BP (DBP;-1.7 mm Hg). White patients at RO experienced greater overall improvements in BP control. Site and race disparities trends suggested that disparities decreased at R+T, either stayed the same or decreased at Control; and stayed the same or increased at RO. Conclusions: More substantial or racial/ ethnically tailored interventions are needed.