Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Effect of a patient activation intervention on hypertension medication optimization: results from a randomized clinical trial.

Howren MB, Steinman MA, Carter B, Vander Weg MW, Kaboli PJ. Effect of a patient activation intervention on hypertension medication optimization: results from a randomized clinical trial. The American journal of managed care. 2020 Sep 1; 26(9):382-387.

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions


OBJECTIVES: To examine the effect of a patient activation intervention with financial incentives to promote switching to a thiazide in patients with controlled hypertension using calcium channel blockers (CCBs). STUDY DESIGN: The Veterans Affairs Project to Implement Diuretics, a randomized clinical trial, was conducted at 13 Veterans Affairs primary care clinics. METHODS: Patients (n = 236) with hypertension previously controlled using CCBs were randomized to a control group (n = 90) or 1 of 3 intervention groups designed to activate patients to talk with their primary care providers about switching to thiazides: Group A (n = 53) received an activation letter, group B (n = 42) received a letter plus a financial incentive to discuss switching from a CCB to a thiazide, and group C (n = 51) received a letter, a financial incentive, and a telephone call encouraging patients to speak with their primary care providers. The primary outcome was thiazide prescribing at the index visit. RESULTS: At the index visit, the rate of switching to a thiazide was 1.1% in the control group and 9.4% (group A), 26.2% (group B), and 31.4% (group C) for the intervention groups (P < .0001). In adjusted analysis, patients randomized to group C were significantly more likely to switch from a CCB to thiazide at the index visit (odds ratio, 4.14; 95% CI, 1.45-11.84; P < .01). CONCLUSIONS: This low-cost, low-intensity patient activation intervention resulted in increased rates of switching to a thiazide in those whose hypertension was controlled using another medication, suggesting that such interventions may be used to overcome medication optimization challenges, including clinical inertia.

Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.