Research News

The Cleveland Clinic has been approved for funding from the Patient-Centered Outcomes Research Institute (PCORI) to implement an intensive hypertension management program at all internal medicine and family medicine practice sites in Northeast Ohio.

High blood pressure, or hypertension, affects 47% of U.S. adults. Left untreated, hypertension can damage your arteries over time and lead to serious complications like heart attack and stroke. Hypertension is often called a “silent killer” by healthcare providers because it typically does not show any symptoms. The project, led by Anita Misra-Hebert, MD, MPH, director of Cleveland Clinic’s Healthcare Delivery and Implementation Science Center, and co-principal investigator Christopher Babiuch, MD, a family medicine physician, proposes new strategies for a unified approach to address a gap in hypertension care following diagnosis.

“The prevalence of uncontrolled blood pressure remains significant throughout our Northeast Ohio primary care practices at ~27% of patients, with only 28% of those following up as requested four weeks after a high reading,” Dr. Misra-Hebert says. “I’m very grateful to PCORI for funding the evaluation of a more proactive and sophisticated program to address this critical gap.”

The program will enlist a team of clinical pharmacists and advance practice providers in collaboration with primary care providers at 57 eligible health system primary care practices in Northeast Ohio to use new strategies for reaching and engaging with patients with hypertension. All primary care pharmacists and advanced practice providers will be offered training on the new model. The award for this project totals about $1 million.

Strategies to help address patient engagement include:

• checking in on patients with a high blood pressure reading after two to four weeks
• offering a virtual visit option for the initial intake appointment
• using home blood pressure monitors paired with patient documentation of readings
• increased outreach to patients who do not have upcoming PCP appointments scheduled
• routine follow-up to patients over an extended period if home blood pressure readings remain uncontrolled

“As a family medicine physician, I see first-hand how difficult it can be for patients with hypertension to stay on top of managing the condition,” Dr. Babiuch explains. “They’re all busy and it’s easy to push to the side because it doesn’t always show symptoms. I feel strongly this program will make it as easy as possible for them to be active participants in their treatment.”

Cleveland Clinic is part of PCORI’s Health Systems Implementation Initiative (HSII), which connects selected health systems across the U.S. to reduce the time needed to bring a research discovery to patient care. Cleveland Clinic launched its own Healthcare Delivery & Implementation Science Center in 2019, initiated by Tom Mihaljevic, MD, CEO, President and Morton L. Mandel CEO Chair of Cleveland Clinic. Dr. Misra-Hebert is co-lead on programs through the Health Systems Implementation Initiative with Beri Ridgeway, MD, Cleveland Clinic’s Chief of Staff. PCORI is also supporting a continued study of MS patients, comparing two common MS treatment philosophies to better inform treatment decisions. 

"We're so grateful to have the support of PCORI on two initiatives that will have a long-lasting impact on patients with hypertension and multiple sclerosis — conditions that are complicated to treat and severely affect patients' quality of life. The careful and deliberate methods we're undertaking to make inroads with hypertension and MS management would not be possible without PCORI by our side," Dr. Ridgeway says.