JMIR Publications

ABSTRACT

Background:

Low medication adherence is a common cause of high blood pressure but is often unrecognized in clinical practice. Electronic data linkages between electronic health records (EHRs) and pharmacies offers the opportunity to identify low medication adherence which can be used for interventions at the point of care. This study describes the design of the Leveraging EHR Technology and Team care to Address Medication adherence (TEAMLET) trial, which aims to evaluate the effectiveness of a multicomponent intervention that uses linked EHR and pharmacy data to automatically identify patients with elevated blood pressure and low medication adherence. The intervention then combines team based-care with EHR-based workflows to address medication nonadherence. Methods/Design: TEAMLET is a pragmatic, cluster randomized control trial in which ten primary care practices will be randomized 1:1 to the multicomponent intervention or usual care. We will include all patients with hypertension and low medication adherence who are seen at enrolled practices. The primary outcome is medication adherence, as measured by proportion of days covered (PDC), and the secondary outcome is clinic systolic blood pressure. We will also assess intervention implementation, including adoption, acceptability, fidelity, cost and cost-effectiveness, and sustainability. Discussion: The trial will assess the effectiveness of a multicomponent intervention that leverages EHR-based data and team-based care on medication adherence. If successful, the intervention could offer a scalable approach to address inadequate blood pressure control among millions of patients with hypertension.