Barriers to blood pressure control are multi-faceted and a silver-bullet
solution/intervention does not exist. Therefore, the literature highlights the importance
of creating multi-component interventions when addressing blood pressure control. The
ASPIRE intervention consists of 5 components identified based on the study team's prior
work and review of the literature.
Patients randomized to the intervention arm will receive all 5 components of the ASPIRE
intervention. Patients randomized to the control arm will receive only the first
component of the ASPIRE intervention and will continue to receive usual care. The ASPIRE
intervention consists of 5 components aimed at supporting both patients and clinic care
teams in successfully adopting self-measured blood pressure (SMBP) into their clinic
workflow.
The 5 ASPIRE components are:
Access to cuff (Patient). Patients in the intervention arm and control arm will be
measured for and will receive a blood pressure monitoring device to take home and
keep beyond the study timeline.
Training (Patient). Only patients in the intervention arm will receive training and
support on how to accurately measure their blood pressure. They will receive a
folder containing an infographic that demonstrates how to accurately measure blood
pressure at home. They will also receive a lifestyle infographic describing what
they can do to improve their blood pressure.
Clear instructions (Patient). Patients in the intervention arm will also receive
clear instructions on how to keep a record of their home blood pressure measures and
share with their care team. They will be provided with a 7-day blood pressure long
that details the number of blood pressure values they need to take in the mornings
and evenings for seven days. Additionally, a clinic care team member serving as the
ASPIRE coach will follow up with the intervention patients via a scheduled virtual
call one week after they receive their materials (blood pressure monitoring device,
infographics, and 7-day blood pressure log) to provide further support and
instructions on self-measured blood pressure and to emphasize the importance of
returning the blood pressure values to their care team.
SMBP EHR Documentation (ASPIRE Coach). To facilitate documentation of home blood
pressure values in the electronic health record (EHR), the ASPIRE coach will average
the blood pressure values patients return and document that average in the EHR.
These home blood pressure averages will be shared with the patient's doctor who can
use these values to modify treatment as appropriate.
Address Social Determinants of Health (Patient). Patients will be screened for
social needs via a social determinants of health (SDOH) questionnaire that they will
be asked to return to the care team. During the one week follow up virtual call the
ASPIRE coach will address any identified social needs by following up with referrals
as needed.