From JAMA Cardiol ogy: A centralized, population health coordinator-led notification and clinical support pathway improved the initiation of antihypertensive therapy in patients with left ventricular hypertrophy.
Despite the recognition that poorly controlled hypertension leads to adverse cardiovascular events, there are often barriers in care systems that contribute to substandard recognition and treatment.19 Notably, prior work employing trained nonphysicians focused on closing gaps in cardiovascular disease management has yielded significant improvements in disease-specific metrics using remote, centralized interventions.20-25 Similarly, there is a growing body of evidence demonstrating the effectiveness of clinician-directed support systems—often in the form of “nudges”—that have made meaningful advances in a variety of clinical outcomes.26,27 Whether a methodologic approach combining clinician nudges with the support of trained nonphysicians can be applied to LVH-associated diseases—including hypertension—is unknown.
Accordingly, the NOTIFY-LVH pragmatic randomized clinical trial28 sought to determine whether potentially underutilized echocardiogram data could be leveraged to improve patient care by augmenting the traditional ambulatory care framework. Specifically, this study tested whether a centralized clinical support pathway targeting clinicians of patients with LVH on their prior echocardiograms would increase the rate of treatment for hypertension and the earlier diagnosis of LVH-associated diseases.