About this trial
To leverage access to patients across the primary care network, EPIC tools for identifying eligible patients, and the Way to Health platform to launch and enroll a program that will be evaluated in a clinical trial that is focused on changing patient behavior and powered to detect differences in improving blood pressure and cholesterol over 6 months for Penn Medicine patients in West/Southwest Philadelphia and Lancaster.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
On the Penn Medicine Primary Care Service Line registry
Last 2 Blood Pressure readings with Systolic Blood Pressure >=140 from any outpatient encounter in the last 12 months AND
ASCVD dx OR ASCVD risk score ≥10% OR Diabetes dx OR A1c ≥6.5 in last year OR Diabetes registry OR Last LDL ≥190 in past five years AND
Not on a statinor PCSK9, Inclisiran OR on a Low-intensity/moderate-intensity statin) with LDL >100
Disqualifiers
Patients on PCSK9 inhibitors
Documented statin allergy/ or intolerance in the EMR
Pregnancy
Breast feeding
Trial design
Parallel
Treatments tested in this trial
Penn Med Healthy Heart Program
BehavioralPatients randomized to the intervention arm will be assigned a Patient Navigator (Clinical Research Coordinators, with support from Nurse Practitioners and a Medical Director) who will conduct an initial assessment with the patient to determine their main barriers to improving blood pressure and cholesterol control. The Patient Navigators will provide the patient with a home blood pressure cuff for remote monitoring, support from Way to Health text message reminders, referrals to established Penn Medicine smoking cessation programs, and referrals to nutrition and social workers as applicable. The Patient Navigators will help move the patients through four modules: Blood Pressure, Food Insecurity/Nutrition Screening, Statins, and Smoking Cessation. These modules provide patients with the chance to work on blood pressure, cholesterol control, access nutrition resources, and smoking cessation simultaneously or sequentially.
Treatment groups
Trial outcomes
Primary outcomes
Difference in mean Systolic Blood Pressure (SBP)
Whether mean SBP is improved among those assigned to intervention vs those assigned to control
Difference in mean LDL-c
Whether mean LDL-c is improved among those assigned to intervention vs those assigned to control
Secondary outcomes
Engagement in the BP intervention
Engagement in the BP intervention as measured by number of participants who agree to receive blood pressure monitor
Difference in Diastolic Blood Pressure (DBP)
Whether mean DBP is improved among those assigned to intervention vs those assigned to control Whether mean SBP is improved among those assigned to intervention vs those assigned to control
Sponsors and contacts
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