title: Hypertension management in primary care: study protocol for a cluster randomized controlled trial.
abstract: BACKGROUND
  Studies worldwide show insufficient blood pressure control rates, and effective management of hypertension remains a challenge in general practice. Although structured forms of care improved blood pressure in randomized controlled trials, little is known about their effects under routine primary care. This cluster randomized trial (CRT) evaluates the effects of a modern interactive medical education series for general practitioners on hypertension management, including practice redesign strategies.
  
  
  METHODS
  For this CRT, 24 primary care academic teaching practices of the University of Duisburg-Essen, Germany, are randomized into two study arms. With the objective of improving hypertension control, general practitioners of the intervention group participate in a three-session medical education program on structured hypertension management. The program aims at changing physician awareness and practice design. Various practice tools are provided: for example, checklists on valid blood pressure readings, medication selection, detection of secondary hypertension, and patient education. General practitioners of both study groups include hypertensive patients with and without hypertension-related diseases such as angiographically proven coronary disease, and peripheral or cerebral vascular disease. Blood pressure is measured by 24-hour readings. Analyses will focus on differences in blood pressure control and changes of practice management between intervention and control group.
  
  
  CONCLUSIONS
  The study will determine the effectiveness of our practice redesign intervention on hypertension control. The intervention addresses general practitioners and practice assistants, while aiming at benefits on the patient level. Therefore, the cluster design is used to evaluate the effects.
  
  
  BACKGROUND
  DRKS00006315 (date of registration: 14 July 2014).
authors: Institute for General Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany. birgitta.weltermann@uk-essen.de.
authors: Birgitta
authors: B
authors: Weltermann
authors: Institute for General Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany. anja.viehmann@uk-essen.de.
authors: Anja
authors: A
authors: Viehmann
authors: Institute for General Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany. christine.kersting@uk-essen.de.
authors: Christine
authors: C
authors: Kersting
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D001364:Awareness; D001794:Blood Pressure / Q000187:drug effects*; D002985:Clinical Protocols; D004502:Education, Medical, Continuing; D058005:General Practitioners / Q000193:education* / Q000458:organization & administration; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D007318:Inservice Training; D011216:Practice Management, Medical; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000458:organization & administration; D012107:Research Design; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents