Evidence mapPaperPMID 20939913Full record

Trial reportTrials2010

Study protocol: the Adherence and Intensification of Medications (AIM) study--a cluster randomized controlled effectiveness study.

Michele Heisler, Timothy P Hofer, Mandi L Klamerus, Julie Schmittdiel, Joe Selby, Mary M Hogan, Hayden B Bosworth, Adam Tremblay, Eve A Kerr

Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00495794 (Adherence and Intensification of Medications), which is not on this map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 17% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT00495794 nacompletednot on this map

Adherence and Intensification of Medications: A Population-Based Clinical Pharmacists Implementation Study Among Hypertensive Diabetes Patients

TypeinterventionalSponsorUS Department of Veterans AffairsRan2008 to 2012Enrolled4,622ConditionsDiabetes, HypertensionArmsClinical pharmacist-based intervention
3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.

  1. Pooled it
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  4. Hypertension Management in Primary Care.Deutsches Arzteblatt international · 2016
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  18. Review
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  20. Most important outcomes research papers on hypertension.Circulation. Cardiovascular quality and outcomes · 2013
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Michele HeislerVeterans Affairs Center for Clinical Management Research, VA Ann Arbor Healthcare System 2215 Fuller Road, Ann Arbor, MI 48105, USA. mheisler@umich.edu
Timothy P Hofer
Mandi L Klamerus
Julie Schmittdiel
Joe Selby
Mary M Hogan
Hayden B Bosworth
Adam Tremblay
Eve A Kerr
VA Ann Arbor Healthcare System · USKaiser Permanente · USUniversity of Michigan–Ann Arbor · USDuke Medical Center · USVA Center for Clinical Management Research · US

Funding

PUBLIC HEALTH DEMONSTRATIONP60DK020572 · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 1985 to 2005
$11.9M
UCSF-KAISER Building Interdisciplinary Research Careers in Women's Health ProgramK12HD052163 · UNIVERSITY OF CALIFORNIA SAN FRANCISCO · 2005 to 2005
$487k
NCRR NIH HHS UL1RR024986NICHD NIH HHS K12HD052163NIDDK NIH HHS P60DK-20572NIDDK NIH HHS R18 DK076622-01A1
6 · The paper itself

Abstract

backgroundMany patients with diabetes have poor blood pressure (BP) control. Pharmacological therapy is the cornerstone of effective BP treatment, yet there are high rates both of poor medication adherence and failure to intensify medications. Successful medication management requires an effective partnership between providers who initiate and increase doses of effective medications and patients who adhere to the regimen.

methodsIn this cluster-randomized controlled effectiveness study, primary care teams within sites were randomized to a program led by a clinical pharmacist trained in motivational interviewing-based behavioral counseling approaches and authorized to make BP medication changes or to usual care. This study involved the collection of data during a 14-month intervention period in three Department of Veterans Affairs facilities and two Kaiser Permanente Northern California facilities. The clinical pharmacist was supported by clinical information systems that enabled proactive identification of, and outreach to, eligible patients identified on the basis of poor BP control and either medication refill gaps or lack of recent medication intensification. The primary outcome is the relative change in systolic blood pressure (SBP) measurements over time. Secondary outcomes are changes in Hemoglobin A1c, low-density lipoprotein cholesterol (LDL), medication adherence determined from pharmacy refill data, and medication intensification rates. DISCUSSION: Integration of the three intervention elements--proactive identification, adherence counseling and medication intensification--is essential to achieve optimal levels of control for high-risk patients. Testing the effectiveness of this intervention at the team level allows us to study the program as it would typically be implemented within a clinic setting, including how it integrates with other elements of care.

trial registrationThe ClinicalTrials.gov registration number is NCT00495794.

Indexed as

Medication AdherencePractice Patterns, Physicians'Antihypertensive AgentsBiomarkersBlood PressureCaliforniaCholesterol, LDLClinical ProtocolsCluster AnalysisDiabetes MellitusDrug PrescriptionsGlycated HemoglobinHealth Maintenance OrganizationsHumansHypertensionInsurance, Pharmaceutical ServicesAntihypertensive AgentsBiomarkersCholesterol, LDLGlycated Hemoglobinhemoglobin A1c protein, human

Identifiers

PMID20939913
PMCPMC2967508
OpenAlexW2145338500

What Socratic holds

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LicenceCC BY
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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 Socratic graph.