CONSORT-EHEALTH Checklist V1.6.2 Report

1b-i) Key features/functionalities/components of the intervention and comparator in the METHODS section of the ABSTRACT "(1) Intervention Condition – patients used a fully-automated website each month to receive tailored messages that suggested questions to ask their PCP to improve blood pressure control; (2) Control Condition – a similar tool that suggested questions to ask about preventive services (e.g., cancer screening)." 1b-ii) Level of human involvement in the METHODS section of the ABSTRACT “patients used a fully-automated web-based tool” 1b-iii) Open vs. closed, web-based (self-assessment) vs. face-to-face assessments in the METHODS section of the ABSTRACT “Primary care providers and their patients with hypertension were recruited by letter” 1b-iv) RESULTS section in abstract must contain use data “Of 500 enrolled patients (282 intervention and 218 control), 415 (83.0%) completed the 1-year follow up visit. At baseline, 294 (62.3%) of subjects had controlled blood pressure. 411 (82.2%) participants utilized the intervention during at least 6 of 12 months and 222 (62.5%) reported asking questions directly from the web-based tool. There were no group differences, however, in asking about medication intensification. And, after 12 months, there were no differences in blood pressure control between the intervention and control conditions (172 [72.6%] v. 121 [68.0%]; p=.31). More intervention subjects discussed having a creatinine (92 [52.6%] v. 49 [35.5%]; p=.003) and urine protein (81 [44.8%] v. 21 [14.6%]; p <.001) test, but no group differences were observed in the rate of testing, based on chart reviews at 12 months. Control subjects reported more frequent discussions about tetanus and pneumonia vaccines and, after 12 months, reported more frequently receiving both tetanus (30 [13.8%] v. 15 [5.3%]; p= .001) and pneumonia (25 [11.5%] v. 16 [5.7%]; p=.02) vaccination.” 1b-v) CONCLUSIONS/DISCUSSION in abstract for negative trials “The use of a patient activation intervention designed to overcome clinical inertia for hypertension care did not lead to improvements in blood pressure control or greater use of blood pressure medications. Participant adherence to the intervention was high;” “participants were likely to discuss the questions with PCPs. These discussions did not, however, lead to improvements in blood pressure control.” INTRODUCTION 2a-i) Problem and the type of system/solution “The purpose of this RCT (randomized controlled trial) was to determine whether web-based tailored messages that prompted patients to ask specific questions during visits would improve blood pressure control. The intervention was designed to help participants overcome clinical inertia in their hypertension care.” 2a-ii) Scientific background, rationale: What is known about the (type of) system “Engaging patients in their own care, also known as patient activation, has been increasingly described as a strategy to improve self-management of chronic diseases such as hypertension. Positive changes in measures of patient activation have been associated with improved patient selfmanagement activities among patients with chronic conditions [5]. One important way for patients to be involved in their care is to ask questions during physician visits. Kravitz and colleagues observed that standardized patients who asked for a treatment for depression were more than twice as likely to receive a prescription for an antidepressant medication as standardized patients who made no request [6]. This is consistent with many studies that report that prompting patients to ask their providers specific questions leads to changes in care [7-9]. Reminders, given to patients, about questions they should ask at the point of care have been widely successful in improving preventive care [7,10,11]. What has not been shown, however, is whether these reminders have an impact on the control of chronic illnesses.” METHODS 3a) CONSORT: Description of trial design (such as parallel, factorial) including allocation ratio “By activating participants to become involved in their own care, we hypothesized that the intervention would increase medication intensification among patients whose blood pressure was not at target, which would thereby increase the percentage of patients who achieved standard blood pressure goals after one year” 3b) CONSORT: Important changes to methods after trial commencement (such as eligibility criteria), with reasons This item not relevant to the study as there were no changes made and no unexpected events occurred 3b-i) Bug fixes, Downtimes, Content Changes 4a) CONSORT: Eligibility criteria for participants Exclusion criteria included “Patient did not have personal access to the Internet at home or at work” and “Patient did not have a personal email account” 4a-i) Computer / Internet literacy 4a-ii) Open vs. closed, web-based vs. face-to-face assessments: