# mGlide RCT: A Clinical Glide Path to Close the Guideline-to-Practice Gap in HTN Management

> **NIH NIH R01** · UNIVERSITY OF MINNESOTA · 2021 · $770,537

## Abstract

Abstract: This A1 application is in response to PAR-15-279, “Strategies to Increase Delivery of Guideline-
Based Care to Populations with Health Disparities.” Hypertension (HTN) is the most important stroke and
cardiovascular disease (CVD) risk factor. Unfortunately, there is substantial under-treatment of HTN. Of the 86
million adults with prevalent HTN in the U.S., 40 million (46%) have inadequately controlled blood pressure
(BP). This problem is worse among minority groups. In this study, we demonstrate how mHealth (mobile health
technology) can improve HTN control rates in stroke survivors and primary care patients without stroke, but
who are at a high risk of stroke and CVD. Our intervention is called mGlide. Intervention participants will self-
monitor their BP daily using a wireless BP monitor and a smart phone. The phone will transmit this BP to a
database automatically. We will use the framework of glide paths to manage the transmitted BP data. The glide
path, based on the concept of landing an airplane, establishes an expected trajectory of BP readings for each
patient with bounds set by guidelines and provider input. BP is monitored at home; the health care team is
alerted when patient BP deviates from expected bounds. Alerts are generated once a week for the health care
team with a list of patients with uncontrolled HTN. This facilitates early intervention while avoiding information
overload. In a pilot study (R21HS021794), we randomized 50 stroke survivors to mGlide (n=26) vs. usual care
(n=24). Our intervention team included a front-line coordinator who trained the patient on BP self-monitoring
and a pharmacist who co-managed the patient's HTN with the patient's physician. Our results confirm excellent
acceptability, high feasibility and promising efficacy of mGlide for achieving HTN control. Based upon this 4-
month pilot we propose a longer trial. Our partnering clinical centers include Federally Qualified Health Centers
that serve low income and minority (Latino, African American, Hmong) communities. In this RCT study, we will
randomize 450 participants with uncontrolled HTN to the mGlide intervention (n=225) vs. state-of-clinical-care
comparison (n=225). Aim 1 will examine how well HTN is controlled in the two groups at 6 months and 12
months after randomization. Aim 2 will examine mGlide usability for providers and provider experience and
satisfaction with mGlide. It will also examine whether medications are managed differently for participants in
the two groups. Aim 3 will examine whether patients are more satisfied with care in the mGlide group, whether
they are more “activated” and have a greater sense of self-efficacy in managing their HTN. Aim 4 will be a
cost-effectiveness analysis of providing mGlide care. Our long-term goal is to prevent stroke and improve
cardiovascular health in populations by increasing health system efficiency and effectiveness. The results from
our mGlide RCT will provide evidence for the use of re...

## Key facts

- **NIH application ID:** 10169495
- **Project number:** 5R01HL138332-04
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** KAMAKSHI LAKSHMINARAYAN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $770,537
- **Award type:** 5
- **Project period:** 2018-07-18 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10169495

## Citation

> US National Institutes of Health, RePORTER application 10169495, mGlide RCT: A Clinical Glide Path to Close the Guideline-to-Practice Gap in HTN Management (5R01HL138332-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10169495. Licensed CC0.

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