Telemonitoring and/or self-monitoring of blood pressure in hypertension
Pragmatic un-blinded randomised controlled trial to evaluate the management of hypertension in primary care using self-monitored blood pressure, with or without telemonitoring compared to standard care.
Hypertension is a key risk factor for cardiovascular disease. National and international surveys suggest that despite significant improvements in recent years, blood pressure (BP) within the population remains sub-optimal. Factors responsible for suboptimal BP control include those due to patients, physicians and the health system. Self-monitoring as an intervention has been shown to reduce BP, improve adherence to antihypertensive medication, and reduce primary care consultation rates at no additional cost.
The current system, relying on clinic based measurement, is not suited to appropriate management of those currently at risk with inadequate treatment. Self-monitoring of hypertension might be a solution: it is simple, leads to reduced BP and is already practiced by around 30% of patients with hypertension in the UK. Compared to clinic readings, it provides a better estimate of both underlying BP and BP variability and is better correlated with clinically relevant outcomes such as stroke and coronary disease. Due to lack of a strong evidence base, self-monitoring is not recommended in current guidelines (NICE 2011) to guide routine management of hypertension in the UK.
This trial is part of a programme of work that aims to provide such evidence and is aligned with current policy objectives namely “putting patients first, improving healthcare outcomes and improving efficiency”.
|Study design:||Pragmatic un-blinded individual patient randomised controlled trial – three arm parallel groups.|
|Sponsor:||University of Oxford|
|Chief Investigator:||Professor Richard McManus, University of Oxford|
|Ethical approval:||Ethics Ref 14/SC/0218|