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4 results on '"Muna Anabtawi"'

1. Recruitment and retention of primary care practices in the Southeastern Collaboration to Improve Blood Pressure Control

Author

James M. Shikany, Monika M. Safford, Andrea L. Cherrington, Jacqueline R. Halladay, Muna Anabtawi, Erica L. Richman, Alyssa D. Adams, Charlotte Holt, Suzanne Oparil, Orysya Soroka, and Doyle M. Cummings

Subjects
Black Belt, Hypertension, Peer coaching, Practice facilitation, Pragmatic trial, Primary care practices, Medicine (General), R5-920
Abstract

Background: Racial disparities related to hypertension prevalence and control persist, with Black persons continuing to have both high prevalence and suboptimal control. The Black Belt region of the US Southeast is characterized by multiple critical priority populations: rural, low-income, and minority (Black). Methods: In a cluster-randomized, controlled, pragmatic implementation trial, the Southeastern Collaboration to Improve Blood Pressure Control evaluated two multi-component, multi-level functional interventions – peer coaching (PC) and practice facilitation (PF) (separately and combined) – as adjuncts to usual care to improve blood pressure control in the Black Belt. The overall goal was to randomize 80 primary care practices (later reduced to 69 practices) in Alabama and North Carolina to one of four interventions: 1) enhanced usual care (EUC); 2) EUC plus PC; 3) EUC plus PF; or 4) EUC plus both PC and PF. Several measures to facilitate recruitment and retention of practices were employed, including practice readiness assessment. Results: Contact was initiated with 248 practices during the study enrollment period. Of these, 99 declined participation, 39 were ineligible, and 41 were being evaluated for inclusion when the target number of practices was reached. The remaining 69 practices eventually were enrolled, with 18 practices randomized to EUC, 19 to PC, 16 to PF, and 16 to PC plus PF. Only two practices (2.9%) were withdrawn during the study. Several facilitators of and barriers to practice recruitment and retention were identified. Conclusion: Our findings underscore the importance of a structured approach to recruiting primary care practices in a pragmatic implementation trial.ClinicalTrials.gov registration number NCT02866669

Published
2023
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3. The design and rationale of a multicenter real-world trial: The Southeastern Collaboration to Improve Blood Pressure Control in the US Black Belt – Addressing the Triple Threat

Author

Monika M. Safford, Doyle M. Cummings, Jacqueline Halladay, James M. Shikany, Joshua Richman, Suzanne Oparil, James Hollenberg, Alyssa Adams, Muna Anabtawi, Lynn Andreae, Elizabeth Baquero, Joanna Bryan, Debra Clark, Ethel Johnson, Erica Richman, Orysya Soroka, James Tillman, and Andrea L. Cherrington

Subjects
Pharmacology (medical), General Medicine
Published
2023

4. Abstract 11070: Antihypertensive Medication Challenges, Adherence, and Blood Pressure in African Americans with a History of Uncontrolled Hypertension

Author

Doyle M Cummings, Alyssa Adams, Jacquie Halladay, Erica Richman, Andrea Cherrington, Muna Anabtawi, joanna Ringel, Orysya Soroka, and Monika M Safford

Subjects
Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract

Introduction: African American adults with uncontrolled hypertension may have structural inequities in access to, intensity of, as well as greater challenges using antihypertensive medications, all of which may contribute to inadequate blood pressure (BP) control. Traditional self-reported measures of adherence suffer from social desirability bias and are not consistently correlated with BP control. Hypothesis: African Americans with higher systolic BP (SBP) experience more medication challenges (access, med taking) that are correlated with BP. Methods: Data at baseline are from a cluster randomized trial of patient-level coaching vs. practice level facilitation and the combination of the two interventions in 1596 adult African American patients (39% male; mean age 57 ± 12 yrs.) seen in rural primary care practices with a history of uncontrolled hypertension (average over the last year ≥ 140/90 mmHg). In bivariate and correlation analyses, we examined the cross-sectional association of self-reported medication adherence vs. self-reported medication challenges with SBP level at baseline. These relationships were further examined in a linear regression model with SBP as the outcome while controlling for age, gender, and annual income. Results: Patients were taking a mean of 2.4 antihypertensive medications. SBP level was significantly correlated with the number of antihypertensive medication challenges reported (p < 0.01). While those reporting lower medication adherence also reported significantly more medication challenges, mean SBP was not significantly different by self-reported medication adherence level. However, mean SBP was significantly higher in patients reporting 4 or more medication challenges (158 vs. 155mmHg, p=0.004). In linear regression analysis, age, income, and self-reported medication challenges (β = 0.3; .95% CI: 0.03 - 0.6; p = 0.028) were independently associated with SBP level while gender and self-reported medication adherence were not. Conclusion: African Americans with uncontrolled BP often require more intensive antihypertensive regimens. However, such regimens may be associated with more medication challenges that may adversely impact adherence and BP control.

Published
2021

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