Patient-driven Management of BP in CKD
Pharmacist-guided, Patient-driven Management of High Blood Pressure in CKD: A Novel Approach
VA Office of Research and Development
160 participants
Dec 15, 2022
INTERVENTIONAL
Conditions
Summary
The proposed research will evaluate if patients managing their blood pressure medications under the guidance of a clinical pharmacist works better to lower blood pressure than patients monitoring their blood pressure at home and the standard care. 60 Veterans with chronic kidney disease (CKD) will be included in the study. The study will further evaluate factors that may influence the Veteran to accept the self-management approach and what factors in the VHA healthcare system affect the implementation of the self-management approach.
Eligibility
Inclusion Criteria4
- Age \>= 18 years,
- CKD stage 3 or 4 (estimated GFR: 15-59 mL/min/1.73m2) or
- Stage 2 CKD (estimated GFR 60-89 mL/min/1.73m2) with urinary albumin/creatinine ratio (ACR 300 mg/g if no DM and 30 mg/g if with DM), and
- Uncontrolled hypertension defined as the avg of 2 readings \> 140 systolic.
Exclusion Criteria9
- Severely uncontrolled hypertension defined as systolic BP \>180,
- Patients with resistant hypertension and taking 4 BP medications,
- Orthostatic hypotension defined as reduced systolic BP by 20 mmHg or diastolic BP by 10 mmHg after 3 minutes of standing,
- Severe CKD defined as estimated GFR \< 20 mL/min/1.73m2,
- Life expectancy \<1 year,
- Severe liver disease,
- Severe congestive heart failure,
- Severe cognitive decline due to dementia,
- Pregnant, breastfeeding, or unwilling to use adequate birth control
Interventions
Patients will be educated on how to manage their home BP based on a pre-determined protocol. They will then monitor home BP and adjust meds accordingly and under the guidance of the clinical pharmacist.
Patients will be educated on how to monitor home BP and will be educated to contact their primary care provider/CKD provider if the BP is above the goal.
Locations(1)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT05546099