The Patient-Centered Outcomes Research Institute (PCORI) plans to reissue a Targeted PCORI Funding Announcement on May 2, 2023 (Cycle 2 2023) seeking to fund large randomized controlled trials (RCTs) comparing health system strategies to improve hypertension control and health outcomes for populations experiencing disparities in outcomes, e.g., Black, Hispanic, rural, and/or uninsured individuals. This preannouncement provides potential applicants additional time to identify collaborators; obtain patient and stakeholder input on potential studies; and develop responsive, high-quality applications.
Hypertension affects almost half of US adults, with the highest prevalence among non-Hispanic Black men and women. Despite hypertension’s treatability, most US adults with hypertension do not have their blood pressure under control, especially people of color, those without access to care or health insurance, and individuals living in rural areas. Health systems factors including the delayed identification of high-risk patients, insufficient linkage to treatment and services, and/or a failure to initiate or intensify treatment when needed may inhibit patients’ ability to control their blood pressure. Implicit bias among healthcare providers may contribute to treatment inertia; inhibit timely, appropriate care delivery; and encumber patient-provider communication, further contributing to poor health outcomes for patients.
National organizations have identified several effective health systems strategies—including practice facilitation, team-based care, health coaching, and home blood pressure monitoring—to be effective for improving rates of hypertension control when implemented as part of multicomponent, multilevel health systems strategies. Although the evidence base for these health systems strategies is robust, questions remain about the optimal health system strategies to eliminate disparities in hypertension control; strategies for the integration of and communication with community-based team members (nurse, pharmacist, community health worker); models for the provision of simplified pharmacotherapy regimens or free or low-cost medications; and the impact of remote care delivery on the initiation and intensification of treatment, patient engagement and experience, and clinical outcomes, especially in historically excluded, under-researched, and/or under-resourced populations and safety net healthcare settings.
Deadline for Required Letter of Intent: May 31, 2023
Applicant Eligibility: To be eligible for this PFA, applicants may either a) propose to implement a shared decision making (SDM) strategy that was formally tested and demonstrated to be effective in the context of a PCORI-funded research award, or b) propose an implementation project that will incorporate new CER evidence from PCORI-funded research into an existing, tested shared decision making strategy, and then implement the updated shared decision making strategy. Applicants proposing to implement a PCORI-funded SDM strategy must either be the PI of the original PCORI-funded study or be a member of the project team. Applicants proposing to incorporate findings from a PCORI-funded study (or studies) into an existing and effective SDM strategy can search from a list of completed PCORI-funded projects with results, which can be found here.