Trial reportJournal of general internal medicine2012
Effect of a physician uncertainty reduction intervention on blood pressure in uncontrolled hypertensives--a cluster randomized trial.
Trial report in Journal of general internal medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 19 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Physician Uncertainty Reduction for Hypertension
Testing of a Tool to Elicit Patient Preferences for CTS
Who cites it
19 citing papers in PubMed, 4 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- How Behavior Change Strategies are Used to Design Digital Interventions to Improve Medication Adherence and Blood Pressure Among Patients With Hypertension: Systematic Review.Journal of medical Internet research · 2020Pooled it
- Clinical inertia in the pharmacological management of hypertension: A systematic review and meta-analysis.Medicine · 2018Pooled it
- Providing physicians with feedback on medication adherence for people with chronic diseases taking long-term medication.The Cochrane database of systematic reviews · 2018Pooled it
- Cognitive biases associated with medical decisions: a systematic review.BMC medical informatics and decision making · 2016Pooled it
- Clinical Decision Support System, Antihypertensive Treatment Intensification, and Blood Pressure Control: A Post Hoc Secondary Analysis of a Cluster Randomized Trial.JAMA network open · 2026Trial
- Health literacy and exercise interventions on clinical outcomes in Chinese patients with diabetes: a propensity score-matched comparison.BMJ open diabetes research & care · 2020Trial
- Trial
- An Electronic Adherence Measurement Intervention to Reduce Clinical Inertia in the Treatment of Uncontrolled Hypertension: The MATCH Cluster Randomized Clinical Trial.Journal of general internal medicine · 2016Trial
- Effects of a web-based patient activation intervention to overcome clinical inertia on blood pressure control: cluster randomized controlled trial.Journal of medical Internet research · 2013Trial
- Characteristics, drug combinations and dosages of primary care patients with uncontrolled ambulatory blood pressure and high medication adherence.Journal of the American Society of Hypertension : JASHTrial
- Exploring Knowledge of Cognitive Disposition to Respond in Clinical Decision-Making among Early Clinical Learners.Maedica · 2023Article
- Reasons for poor blood pressure control in Eastern Sub-Saharan Africa: looking into 4P's (primary care, professional, patient, and public health policy) for improving blood pressure control: a scoping review.BMC cardiovascular disorders · 2021Article
- Medicine and heuristics: cognitive biases and medical decision-making.Irish journal of medical science · 2020Review
- Therapeutic Inertia: Still a Long Way to Go That Cannot Be Postponed.Diabetes spectrum : a publication of the American Diabetes Association · 2020Article
- Health literacy and exercise-focused interventions on clinical measurements in Chinese diabetes patients: A cluster randomized controlled trial.EClinicalMedicine · 2019Article
- Designing and evaluating health systems level hypertension control interventions for African-Americans: lessons from a pooled analysis of three cluster randomized trials.Current hypertension reviews · 2015Article
- Vitamin D: an examination of physician and patient management of health and uncertainty.Qualitative health research · 2014Article
- Patterns of nonadherence to antihypertensive therapy in primary care.Journal of clinical hypertension (Greenwich, Conn.) · 2013Article
- Predicting changes in hypertension control using electronic health records from a chronic disease management program.Journal of the American Medical Informatics Association : JAMIAArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundClinical inertia, provider failure to appropriately intensify treatment, is a major contributor to uncontrolled blood pressure (BP). Some clinical inertia may result from physician uncertainty over the patient's usual BP, adherence, or value of continuing efforts to control BP through lifestyle changes.
objectiveTo test the hypothesis that providing physicians with uncertainty reduction tools, including 24-h ambulatory BP monitoring, electronic bottle cap monitoring, and lifestyle assessment and counseling, will lead to improved BP control.
designCluster randomized trial with five intervention clinics (IC) and five usual care clinics (UCC).
settingSix public and 4 private primary care clinics.
participantsA total of 665 patients (63 percent African American) with uncontrolled hypertension (BP ≥140 mmHg/90 mmHg or ≥130/80 mmHg if diabetic).
interventionsAn order form for uncertainty reduction tools was placed in the IC participants' charts before each visit and results fed back to the provider. OUTCOME MEASURES: Percent with controlled BP at last visit. Secondary outcome was BP changes from baseline.
resultsMedian follow-up time was 24 months. IC physicians intensified treatment in 81% of IC patients compared to 67% in UCC (p < 0.001); 35.0% of IC patients and 31.9% of UCC patients achieved control at the last recorded visit (p > 0.05). Multi-level mixed effects longitudinal regression modeling of SBP and DBP indicated a significant, non-linear slope difference favoring IC (p (time × group interaction) = 0.048 for SBP and p = 0.001 for DBP). The model-predicted difference attributable to intervention was -2.8 mmHg for both SBP and DBP by month 24, and -6.5 mmHg for both SBP and DBP by month 36.
conclusionsThe uncertainty reduction intervention did not achieve the pre-specified dichotomous outcome, but led to lower measured BP in IC patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.