The impact of a multidisciplinary information technology-supported program on blood pressure control in primary care

Circ Cardiovasc Qual Outcomes. 2009 May;2(3):170-7. doi: 10.1161/CIRCOUTCOMES.108.823765. Epub 2009 May 5.


Background: Hypertension is a leading mortality risk factor yet inadequately controlled in most affected subjects. Effective programs to address this problem are lacking. We hypothesized that an information technology-supported management program could help improve blood pressure (BP) control.

Methods and results: This randomized controlled trial included 223 primary care hypertensive subjects with mean 24-hour BP >130/80 and daytime BP >135/85 mm Hg measured with ambulatory monitoring (ABPM). Intervention subjects received a BP monitor and access to an information technology-supported adherence and BP monitoring system providing nurses, pharmacists, and physicians with monthly reports. Control subjects received usual care. The mean (+/-SD) follow-up was 348 (+/-78) and 349 (+/-84) days in the intervention and control group, respectively. The primary end point of the change in the mean 24-hour ambulatory BP was consistently greater in intervention subjects for both systolic (-11.9 versus -7.1 mm Hg; P<0.001) and diastolic BP (-6.6 versus -4.5 mm Hg; P=0.007). The proportion of subjects that achieved Canadian Guideline target BP (46.0% versus 28.6%) was also greater in the intervention group (P=0.006). We observed similar BP declines for ABPM and self-recorded home BP suggesting the latter could be an alternative for confirming BP control. The intervention was associated with more physician-driven antihypertensive dose adjustments or changes in agents (P=0.03), more antihypertensive classes at study end (P=0.007), and a trend toward improved adherence measured by prescription refills (P=0.07).

Conclusions: This multidisciplinary information technology-supported program that provided feedback to patients and healthcare providers significantly improved blood pressure levels in a primary care setting.

Trial registration: NCT00374829.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Ambulatory Care Information Systems / organization & administration*
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects
  • Blood Pressure Monitoring, Ambulatory
  • Drug Prescriptions
  • Feedback
  • Female
  • Humans
  • Hypertension / diagnosis
  • Hypertension / drug therapy*
  • Interdisciplinary Communication*
  • Male
  • Middle Aged
  • Nursing Staff
  • Patient Care Team / organization & administration*
  • Patient Compliance
  • Pharmacists
  • Physicians
  • Primary Health Care / methods*
  • Primary Health Care / organization & administration
  • Treatment Outcome


  • Antihypertensive Agents

Associated data