R01HL156355
Project Grant
Overview
Grant Description
Addressing Antihypertensive Medication Adherence Through EHR-Enabled Teamlets in Primary Care - Resubmission - 1
Project Summary
Medication nonadherence is common among patients with hypertension and is associated with increased cardiovascular morbidity and mortality. Nonetheless, medication adherence is often not addressed in clinical practice due to a number of factors, including lack of readily available assessment tools and provider competing demands.
Recent uptake of electronic prescribing from the electronic health record (EHR) to pharmacies offers the opportunity for scalable, real-time measurement of medication adherence that can be used for interventions at the point of care. In addition, we have demonstrated that an intervention utilizing medical assistants (MAs) trained as health coaches can improve medication adherence among patients with hypertension.
The objective of this application is to implement a multicomponent intervention that utilizes linked EHR-pharmacy data and teamlets, consisting of primary care providers (PCPs) and MAs who will receive brief training in health coaching, to pragmatically address medication adherence in a real-world, primary care setting.
The intervention consists of four components:
1) Patients with hypertension will be automatically screened for low medication adherence using linked EHR-pharmacy data at the time of a PCP encounter;
2) MAs will deliver a validated, rapid, 12-item survey of common causes of non-adherence;
3) MAs will address specific barriers to adherence tailored to survey response, including delivery of brief health coaching based on motivational interviewing; and
4) PCPs will address specific barriers to adherence based on survey response.
The central hypothesis is that this multicomponent intervention will improve medication adherence and blood pressure for patients with hypertension. We will test this hypothesis in a hybrid type I effectiveness-implementation pragmatic, cluster-randomized trial in 22 diverse primary care clinics. We will also evaluate the implementation of the intervention, including adoption, acceptability, fidelity, cost-effectiveness, and sustainability.
The project is innovative because it proposes to:
1) Measure adherence using pharmacy fill data available in the EHR for use in real-time clinical interventions;
2) Utilize teamlets in which MAs will be given the tools to assess reasons for non-adherence and deliver tailored health coaching in a pragmatic, scalable way; and
3) Incorporate user-centered design principles to maximize incorporation of the intervention into both PCP and MA workflows.
The proposed project is significant because it is expected to provide a scalable implementation model that utilizes linked EHR-pharmacy fill data, clinical decision support, and teamlets to improve antihypertensive medication adherence. If shown to be successful, this multicomponent, clinic-based intervention can be scaled to ultimately improve cardiovascular outcomes for millions of patients with hypertension.
Project Summary
Medication nonadherence is common among patients with hypertension and is associated with increased cardiovascular morbidity and mortality. Nonetheless, medication adherence is often not addressed in clinical practice due to a number of factors, including lack of readily available assessment tools and provider competing demands.
Recent uptake of electronic prescribing from the electronic health record (EHR) to pharmacies offers the opportunity for scalable, real-time measurement of medication adherence that can be used for interventions at the point of care. In addition, we have demonstrated that an intervention utilizing medical assistants (MAs) trained as health coaches can improve medication adherence among patients with hypertension.
The objective of this application is to implement a multicomponent intervention that utilizes linked EHR-pharmacy data and teamlets, consisting of primary care providers (PCPs) and MAs who will receive brief training in health coaching, to pragmatically address medication adherence in a real-world, primary care setting.
The intervention consists of four components:
1) Patients with hypertension will be automatically screened for low medication adherence using linked EHR-pharmacy data at the time of a PCP encounter;
2) MAs will deliver a validated, rapid, 12-item survey of common causes of non-adherence;
3) MAs will address specific barriers to adherence tailored to survey response, including delivery of brief health coaching based on motivational interviewing; and
4) PCPs will address specific barriers to adherence based on survey response.
The central hypothesis is that this multicomponent intervention will improve medication adherence and blood pressure for patients with hypertension. We will test this hypothesis in a hybrid type I effectiveness-implementation pragmatic, cluster-randomized trial in 22 diverse primary care clinics. We will also evaluate the implementation of the intervention, including adoption, acceptability, fidelity, cost-effectiveness, and sustainability.
The project is innovative because it proposes to:
1) Measure adherence using pharmacy fill data available in the EHR for use in real-time clinical interventions;
2) Utilize teamlets in which MAs will be given the tools to assess reasons for non-adherence and deliver tailored health coaching in a pragmatic, scalable way; and
3) Incorporate user-centered design principles to maximize incorporation of the intervention into both PCP and MA workflows.
The proposed project is significant because it is expected to provide a scalable implementation model that utilizes linked EHR-pharmacy fill data, clinical decision support, and teamlets to improve antihypertensive medication adherence. If shown to be successful, this multicomponent, clinic-based intervention can be scaled to ultimately improve cardiovascular outcomes for millions of patients with hypertension.
Awardee
Funding Goals
TO FOSTER HEART AND VASCULAR RESEARCH IN THE BASIC, TRANSLATIONAL, CLINICAL AND POPULATION SCIENCES, AND TO FOSTER TRAINING TO BUILD TALENTED YOUNG INVESTIGATORS IN THESE AREAS, FUNDED THROUGH COMPETITIVE RESEARCH TRAINING GRANTS. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO STIMULATE TECHNOLOGICAL INNOVATION, USE SMALL BUSINESS TO MEET FEDERAL RESEARCH AND DEVELOPMENT NEEDS, FOSTER AND ENCOURAGE PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY SOCIALLY AND ECONOMICALLY DISADVANTAGED PERSONS, AND INCREASE PRIVATE-SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE TECHNOLOGICAL INNOVATION, FOSTER TECHNOLOGY TRANSFER THROUGH COOPERATIVE R&D BETWEEN SMALL BUSINESSES AND RESEARCH INSTITUTIONS, AND INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL R&D.
Grant Program (CFDA)
Awarding / Funding Agency
Place of Performance
New York,
New York
100168203
United States
Geographic Scope
Single Zip Code
Related Opportunity
Analysis Notes
Amendment Since initial award the total obligations have increased 423% from $761,344 to $3,978,996.
New York University was awarded
Enhancing Hypertension Management: EHR-Enabled Teamlets Medication Adherence
Project Grant R01HL156355
worth $3,978,996
from National Heart Lung and Blood Institute in May 2021 with work to be completed primarily in New York New York United States.
The grant
has a duration of 5 years and
was awarded through assistance program 93.837 Cardiovascular Diseases Research.
The Project Grant was awarded through grant opportunity Improving Patient Adherence to Treatment and Prevention Regimens to Promote Health (R01 Clinical Trial Optional).
Status
(Ongoing)
Last Modified 6/20/25
Period of Performance
5/1/21
Start Date
4/30/26
End Date
Funding Split
$4.0M
Federal Obligation
$0.0
Non-Federal Obligation
$4.0M
Total Obligated
Activity Timeline
Transaction History
Modifications to R01HL156355
Additional Detail
Award ID FAIN
R01HL156355
SAI Number
R01HL156355-1763559497
Award ID URI
SAI UNAVAILABLE
Awardee Classifications
Private Institution Of Higher Education
Awarding Office
75NH00 NIH National Heart, Lung, and Blood Institute
Funding Office
75NH00 NIH National Heart, Lung, and Blood Institute
Awardee UEI
M5SZJ6VHUHN8
Awardee CAGE
3D476
Performance District
NY-12
Senators
Kirsten Gillibrand
Charles Schumer
Charles Schumer
Budget Funding
| Federal Account | Budget Subfunction | Object Class | Total | Percentage |
|---|---|---|---|---|
| National Heart, Lung, and Blood Institute, National Institutes of Health, Health and Human Services (075-0872) | Health research and training | Grants, subsidies, and contributions (41.0) | $1,619,970 | 100% |
Modified: 6/20/25