ArticleArchives of internal medicine2010
Impact of the ALLHAT/JNC7 Dissemination Project on thiazide-type diuretic use.
Article in Archives of internal medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Academic Detailing Interventions and Evidence-Based Prescribing: A Systematic Review.JAMA network open · 2025Pooled it
- The effectiveness of interventions to disseminate the results of non-commercial randomised clinical trials to healthcare professionals: a systematic review.Implementation science : IS · 2024Pooled it
- Patterns and Correlates of Baseline Thiazide-Type Diuretic Prescription in the Systolic Blood Pressure Intervention Trial.Hypertension (Dallas, Tex. : 1979) · 2016Trial
- Diuretics: a review of the pharmacology and effects on glucose homeostasis.Frontiers in pharmacology · 2025Review
- Trends of Antihypertensive Prescription Among US Adults From 2010 to 2019 and Changes Following Treatment Guidelines: Analysis of Multicenter Electronic Health Records.Journal of the American Heart Association · 2024Article
- The 18-year risk of cancer, angioedema, insomnia, depression, and erectile dysfunction in association with antihypertensive drugs: post-trial analyses from ALLHAT-Medicare linked data.Frontiers in cardiovascular medicine · 2023Article
- Effects of Posttrial Antihypertensive Drugs on Morbidity and Mortality: Findings from 15-Year Passive Follow-Up after ALLHAT Ended.International journal of hypertension · 2021Article
- Planning theory- and evidence-based behavior change interventions: a conceptual review of the intervention mapping protocol.Psicologia, reflexao e critica : revista semestral do Departamento de Psicologia da UFRGS · 2017Review
- Comparative effectiveness of antihypertensive drugs in nondiabetic patients with hypertension: A population-based study.Journal of clinical hypertension (Greenwich, Conn.) · 2017Article
- Modulatory effects of hydrochlorothiazide and triamterene on resistant hypertension patients.Experimental and therapeutic medicine · 2017Article
- Comparison of the Effect of Thiazide Diuretics and Other Antihypertensive Drugs on Central Blood Pressure: Cross-Sectional Analysis Among Nondiabetic Patients.Journal of clinical hypertension (Greenwich, Conn.) · 2015Article
- Patient-specific academic detailing for smoking cessation: feasibility study.Canadian family physician Medecin de famille canadien · 2014Article
- Diuretic use in black patients with uncontrolled hypertension.American journal of hypertension · 2013Article
- A brief overview of academic detailing in Canada: Another role for pharmacists.Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPC · 2012Article
- Antihypertensive effect of a fixed-dose combination of losartan/hydrochlorothiazide in patients with uncontrolled hypertension: a multicenter study.Clinical and experimental nephrology · 2012Article
- Advancing cardiovascular research.Chest · 2012Review
- Why are we still using hydrochlorothiazide?Journal of clinical hypertension (Greenwich, Conn.) · 2011Article
- Change in antihypertensive drug prescribing after guideline implementation: a controlled before and after study.BMC family practice · 2011Article
- Renewed interest in chlorthalidone: evidence from the Veterans Health Administration.Journal of clinical hypertension (Greenwich, Conn.) · 2010Article
- Comparative effectiveness research and its utility in In-clinic practice.Perspectives in clinical researchReview
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12 authors.
Funding
Abstract
backgroundStrategies are needed to improve the translation of clinical trial results into practice. We assessed the impact of the ALLHAT/JNC7 Dissemination Project's academic detailing component on thiazide-type diuretic prescribing (ALLHAT indicates Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial; JNC7 indicates the Seventh Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure).
methodsWe used 2 national databases available from IMS Health: a physician survey of medications reported for hypertension and a pharmacy dispensing database on antihypertensive medications. At a county level, we correlated medication data with Dissemination Project intensity. Practices before the Dissemination Project in 2004 were compared with those after its completion in 2007. We also examined 2000-2008 national trends.
resultsAcademic detailing reached 18 524 physicians in 1698 venues via 147 investigator-educators. We noted an association between ALLHAT/JNC7 academic detailing activities and increased prescribing of thiazide-type diuretics. Physician survey data showed that the percentage of hypertension visits where the physician recorded a thiazide-type diuretic increased the most in counties where academic detailing activity was the highest (an increase of 8.6%, from 37.9% to 46.5%) compared with counties where activity was moderate (an increase of 2%) or low (a decrease of 2%), or where there was none (an increase of 2%; P value for trend, <.05). Pharmacy dispensing data showed that thiazide-type diuretic prescribing increased by 8.7% in counties with Dissemination Project activities compared with 3.9% in those without activities (P < .001). Nationally, thiazide-type diuretic use did not increase between 2004 and 2008.
conclusionsThe ALLHAT/JNC7 Dissemination Project was associated with a small effect on thiazide-type diuretic use consistent with its small dose and the potential of external factors to diminish its impact. Academic detailing may increase physicians' implementation of clinical trial results, thereby making prescribing more consistent with evidence.
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