Implementation of Multifaceted Patient-Centered Treatment Strategies for Intensive Blood Pressure Control (IMPACTS):...

Area of Science:

• Cardiology
• Public Health
• Implementation Science

Background:

• The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated intensive blood pressure (BP) treatment benefits.
• Implementing intensive BP treatment in real-world settings remains a challenge.
• Underserved populations with hypertension require effective BP management strategies.

Purpose of the Study:

• To evaluate the effectiveness of a multifaceted intervention for intensive BP treatment.
• To assess the feasibility, fidelity, and sustainability of this intervention in underserved populations.
• To bridge the gap between clinical trial findings and real-world hypertension management.

Main Methods:

• The Implementation of Multifaceted Patient-Centered Treatment Strategies for Intensive Blood Pressure Control (IMPACTS) is a cluster randomized trial.
• 36 Federally Qualified Health Center clinics in Louisiana and Mississippi were randomized.
• Intervention included protocol-based treatment, SPRINT algorithm, BP audit, home BP monitoring, and health coaching versus enhanced usual care.

Main Results:

• Primary effectiveness outcome: difference in mean systolic BP change from baseline to 18 months.
• Primary implementation outcome: intervention fidelity (treatment intensification, medication adherence).
• Planned sample size of 1,260 participants with 90% power to detect a 5.0-mm Hg BP difference.

Conclusions:

• IMPACTS will provide crucial data on intensive BP treatment effectiveness and implementation.
• The findings could significantly reduce BP-related disease burden in minority and low-income populations.
• This study addresses the critical need for effective hypertension management in underserved communities.