A Hypertension Emergency Department Intervention Aimed at Decreasing Disparities
Effective interventions that can address uncontrolled hypertension, particularly in underrepresented populations that use the emergency department (ED) for primary care, are critically needed. Uncontrolled hypertension (HTN) contributes significantly to cardiovascular morbidity and mortality and is more frequently encountered among patients presenting to the ED. EDs serve as the point of entry into the health care system for many high-risk patient populations, particularly minority and low-income individuals.
The AHEAD2 (A Hypertension Emergency Department Intervention Aimed at Decreasing Disparities) project underscores the following: 1) The prevalence of uncontrolled/undiagnosed HTN in underrepresented groups presenting to the ED is alarmingly high, and 2) ED engagement and early risk assessment/stratification is a cost-effective, feasible innovation to help close health disparity gaps in HTN. This study involves a three-arm randomized controlled trial of patients from the Emergency Department at University of Illinois Hospital with elevated blood pressure (BP). The overarching goal is to improve follow-up rates and transition to PCP care at a federally qualified community health center (FQHC). The primary outcome is BP improvement and control. The central hypothesis of our proposal is that an ED-based screening/risk assessment, intervention, and referral for treatment program for HTN (SBIRT-HTN) using existing ED resources, coupled with a follow-up visit to an ED pharmacist-initiated Post-Acute Care Hypertension Transition Clinic (PACHT-c), can improve BPs by increasing patient motivation, follow-up rates, and consequently, treatment compliance and BP control in a predominately underrepresented hypertensive population.
Heather Prendergast, MD, MS, MPH