RICH LIFE Hypertension Treatment Study Rising Above Challenges

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The JHU Center for Health Equity’s RICH LIFE (Reducing Inequities in Care of Hypertension: Lifestyle Improvement for Everyone) Project, dedicated to exploring new approaches to high blood pressure management, continues to make great strides despite the current COVID-19 pandemic.

BACKGROUND

First launched in 2015, the RICH LIFE study examines whether an at-home approach for monitoring and treating hypertension, in combination with team-based collaborative support that considers a patient’s ethnicity, economic status and place of residence, can produce similar or better results than typical purely clinic-based approaches. The study involves up to 1890 patients recruited from 30 primary care clinics across Maryland and Pennsylvania. The participant pool is divided into two groups, one of which uses current clinic-based treatment practices, while the other uses a more collaborative and team-based approach that uses both clinical staff and non-clinical caregivers called Community Health Workers to help patients.

PROGRESS ACHIEVED TO DATE

Recruitment for the study concluded on October 31, 2019 and we have been able to recruit 1,822 out of the targeted 1,890 patients across all five health systems—a very successful effort! Since that time, Care Managers and Community Health Workers have been focused on conducting follow-up visits with patients as well as closing out patients who have participated for least 12 months in the team-based cohort of the study.

Despite the upheavals caused by the COVID-19 crisis, research and patient care activities have been continuing. To follow social distancing guidelines, our Care Managers and Community Health Workers halted their usual home visits but continue to engage with patients via telephone and using remotely administered follow-up surveys.

And as many of our RICH LIFE patients are already a vulnerable group given their underlying health conditions, age, and social circumstances, the RICH LIFE team developed a COVID-19 Patient Needs Assessment tool to help identify any new needs or issues the pandemic is creating for study participants.

With these changes in place, we have continued to interact with patients and collect data. We also have continued to conduct monthly meetings using remote meeting technology and conference calls with our Care Managers and Community Health Workers to discuss patient cases in detail. As a result of these meetings (both pre- and during the pandemic), Care Managers have formally referred 254 patients to work with a Community Health Worker, and 19 patients have been referred to the RICH LIFE “Specialist Core,” dedicated to particularly complicated situations that may need specialist care.

Since last October, the study team also conducted the last four of sixteen Health Equity Learning Network (HELN) webinars and one coaching call to strengthen the effectiveness of the various care providers in the study. Topics covered during the HELN sessions included general public health issues, COVID-19 specific best practices, and new trainings on how to move the health care system towards providing more equitable care for all patients.

In what we feel is a recognition of how important this research is, we are also excited to announce that an article about the RICH LIFE study’s design has been accepted for publication in the American Heart Journal! This publication will help ensure that the innovative “beyond the medical clinic” approach to caring for high blood pressure patients explored by the RICH LIFE study gets shared with a broader audience. We’ll link to the article in the next update.  

The RICH LIFE team is rising above the challenges of the pandemic, adapting to the new ways of providing patient care, and achieving its aims. We are truly grateful for all of our partners continued dedication and support of the RICH LIFE Project.

Baltimore, RICHLifeCHE Team