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Aims:

To understand if a web-based programme (Home BP) will assist in patient self-monitoring and management of hypertension, and will result in greater control of blood pressure after 12 months.

Why this is important:

Blood pressure is the key risk factor for cardiovascular disease and one the largest causes of morbidity and mortality across the world. The health survey of England identified that 31% of men and 27% of women in England have hypertension, yet over 1/3 of all treated patients fail to reach national guidelines for BP control. The key factors responsible for control of BP are patients, clinicians and the health system.

A web-based programme for helping people to manage their own blood pressure could enable patients to take their medication regularly as prescribed by their doctor. - Professor Richard McManus, University of Oxford.

There is evidence that self-monitoring of blood pressure at home can help patients to take their medication as prescribed by their GP and better control their blood pressure. There is also evidence that further reduction in blood pressure control can be achieved by additional behavioural support for self-monitoring.

Increase use of mobile phones and increased access to the internet means that more digital healthcare interventions are now accessible to the majority of patients - such interventions could be used to as a tool for patients to manage their blood pressure.

The Home BP programme aims to provide a suite of tools to patients to support self-monitoring, behavioural support and advice on lifestyle modifications. The study will follow them up for 12 months to understand if there is there is any reduction in blood pressure.

Methods:

The pilot trial for this intervention aims to recruit 60 participants over 4 primary care practices and is due to start in June 2015. The main trial will aim to start in Jan 2016 recruiting 574 patients and will end in June 2018.

Patients will be included in the trial if they have uncontrolled hypertension which is >140/90. Patient must also have access to the internet.

Patients will be excluded from the trial if they are do not have the ability to monitor themselves or are taking more than three different types of blood pressure medication.

Working with the research networks, we will identify suitable practices to will help us recruit patients by conducting database searches for patients who are eligible. The patient will register with the support provider of patient group at the baseline screening appointment. After the patient completes the baselines assessment the patients will be randomised to either receiving usual care or receiving the Home BP along with optional nurse support. 

How this could benefit patients:

We believe that embedding the HOME BP programme in clinical practice will lead to greater reduction in blood pressure, enabling patients to take their medication regularly as prescribed by their doctor. The programme could be used by patients all over the UK to improve management of hypertension.