title: A Brief, Multifaceted, Generic Intervention to Improve Blood Pressure Control and Reduce Disparities Had Little Effect.
abstract: Poor blood pressure (BP) control and racial disparities therein may be a function of clinical inertia and ineffective communication about BP care.
  
  
  
  We compared two different interventions (electronic medical record reminder for BP care (Reminder only, [RO]), and clinician training on BP care-related communication skills plus the reminder (Reminder + Training, [R+T]) with usual care in three primary care clinics, examining BP outcomes among 8,866 patients, and provider-patient communication and medication adherence among a subsample of 793.
  
  
  
  Clinician counseling improved most at R+T. BP improved overall; R+T had a small but significantly greater reduction in diastolic BP (DBP; -1.7 mm Hg). White patients at RO experienced greater overall improvements in BP control. Site and race disparities trends suggested that disparities decreased at R+T, either stayed the same or decreased at Control; and stayed the same or increased at RO.
  
  
  
  More substantial or racial/ethnically tailored interventions are needed.
authors: Boston VA Healthcare System; Center for Healthcare Organization and Implementation Research, Boston/Bedford VA Medical Centers; Section of General Internal Medicine, Boston University School of Medicine; Health/care Disparities Research Program.
authors: Nancy R
authors: NR
authors: Kressin
authors: Center for Health Equity Research and Promotion, Philadelphia VAMC; Department of Internal Medicine, University of Pennsylvania School of Medicine.
authors: Judith A
authors: JA
authors: Long
authors: Center for Healthcare Organization and Implementation Research, Boston/Bedford VA Medical Centers; Health Policy and Management Department, Boston University School of Public Health.
authors: Mark E
authors: ME
authors: Glickman
authors: Center for Healthcare Organization and Implementation Research, Boston/Bedford VA Medical Centers; Health Policy and Management Department, Boston University School of Public Health.
authors: Barbara G
authors: BG
authors: Bokhour
authors: Center for Healthcare Organization and Implementation Research, Boston/Bedford VA Medical Centers.
authors: Michelle B
authors: MB
authors: Orner
authors: Jesse Brown VAMC; University of Illinois at Chicago.
authors: Christine
authors: C
authors: Clark
authors: Center for Healthcare Organization and Implementation Research, Boston/Bedford VA Medical Centers; Health Policy and Management Department, Boston University School of Public Health.
authors: James A
authors: JA
authors: Rothendler
authors: Center for Healthcare Organization and Implementation Research, Boston/Bedford VA Medical Centers; Health Policy and Management Department, Boston University School of Public Health.
authors: Dan R
authors: DR
authors: Berlowitz
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D003376:Counseling; D057286:Electronic Health Records; D005006:Ethnicity; D054624:Health Status Disparities; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000208:ethnology; D055118:Medication Adherence; D044469:Racial Groups; D017010:Reminder Systems; D044465:White People / Q000523:psychology
chemical_list: D000959:Antihypertensive Agents
keywords: Hypertension; Patient Compliance; Physician-Patient Relations