Effect of EHR-based medication support and nurse-led MTM on hypertension and medication self-management

Because juggling multiple medications can be difficult to manage, a clinical trial led by Northwestern University examined whether electronic health record (EHR) tools would be helpful in this respect.

Because juggling multiple medications can be difficult to manage, a clinical trial led by Northwestern University examined whether electronic health record (EHR) tools would be helpful in this respect. The study population included nearly 800 hypertensive patients in the Chicago area who were taking at least three different medications at the same time, for any reason. Participating community health centers were randomly selected to offer EHR-based medication management resources, EHR-based tools along with nurse-led medication education, or standard care. The primary endpoint was systolic blood pressure at 1-year followup, which turned out to be higher for patients who received EHR medication management tools alone despite improved medication reconciliation in this group. Blood pressure declined among participants who received the EHR tools plus nurse-led support compared with patients who received EHR tools only—but not compared with patients who received standard care. Meanwhile, adding nurse involvement to EHR tools did not change medication adherence or understanding of drug indication. The results, the researchers conclude, underscore the importance of testing system-level changes for unintended effects.