A Home-based Blood Pressure Monitoring Program to Promote Better Management of Hypertension
A Home-based Blood Pressure Measurement Program in Hypertensive Patients to Promote Medications Adherence and Blood Pressure Status.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Adherence to treatment is disappointingly low among patients with chronic health disorders especially after 6 month of initiating drug therapy. In hypertensive patients , as reported by WHO, 50% of non-adherence could be expected. Poor adherence to anti hypertensive medications results in increased morbidity, mortality and costs. One of the reasons that could implicate medications adherence can be attributed to seeing no physical sign of better controlling blood pressure. Self monitoring of blood pressure at home has been reported to improve patients adherence to their medications.
This study is a 2-arm randomized controlled trial. The investigators aim to evaluate the effect of home-based blood pressure measurement with an electronic device on medication adherence and blood pressure status.
One hundred ninety six hypertensive patients aged at least 18 years old are recruited in an ambulatory care setting and are evenly allocated to the study arms with balanced-block telephone randomization.
Appropriate medication is prescribed as preferred by the cardiologist (single daily dose medicines are recommended). Patients in both arms are followed for 24 weeks, each will be visited by the cardiologist four times during the study period. In each visit, patients' blood pressure will be measured twice by a nurse in the office.
In the intervention arm, electronic blood pressure device is provided for each patient and he/she will be trained to measure blood pressure at home once daily (same time each day). A logbook is also provided to document the daily blood pressure level.
Primary outcome of the study is the blood pressure measured at each office visit overtime. Medication adherence is measured by pill count method as the secondary outcome.
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
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Tehran, Iran (République islamique d
- Dr Mohagheghi's Office
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Ambulatory patients older than 18
- Patients newly diagnosed as hypertension stage 1
- Patients previously on antihypertensive treatment but uncontrolled hypertension
- Patients not possessing electronic self blood pressure measurement device
- Patients with functional ability to use the device
Exclusion Criteria:
- Patients requiring two or more antihypertensive drugs at the start of the study
- Patients with secondary hypertension
- Patients cardiovascular comorbidities and other interfering medical conditions
- Patients with drug contraindication or documented drug allergy
- Patients with serum creatinine > 150 microliters
Withdrawal criteria:
- Inadequate therapeutic effect requiring an increase of more than 20% in pre-established number of visits
- Emergence of adverse drug reactions requiring cessation of medication
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: Home-based blood pressure monitoring
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Electronic blood pressure device is provided for patients and he/she will be trained to measure blood pressure at home once daily(same time each day).
A logbook is also provided to document the daily blood pressure level.
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Comparateur actif: Soins habituels
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Four visits to the physician's office at 4th, 12th, 24th week in the study period with usual advice giving practice of the staff.
At the end of the trial period, an electronic blood pressure device will be given to each patient in this arm.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Blood pressure-24 weeks
Délai: Change from baseline(at the point of recruiting) blood pressure at 24 weeks.
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Blood pressure is measured twice by trained nurses using hand-cuff device at the physician office.
(in Hg millimeter)
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Change from baseline(at the point of recruiting) blood pressure at 24 weeks.
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Medication adherence-4 weeks
Délai: Change from baseline(at the point of recruiting) medication adherence at 4 weeks
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Change from baseline(at the point of recruiting) medication adherence at 4 weeks
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Blood pressure- 4 weeks
Délai: Change from baseline(at the point of recruiting) blood pressure at 4 weeks.
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Change from baseline(at the point of recruiting) blood pressure at 4 weeks.
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Blood pressure- 12 weeks
Délai: Change from baseline(at the point of recruiting) blood pressure at 12 weeks.
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Change from baseline(at the point of recruiting) blood pressure at 12 weeks.
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Medication adherence- 12 weeks
Délai: Change from baseline(at the point of recruiting) medication adherence at 12 weeks
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Change from baseline(at the point of recruiting) medication adherence at 12 weeks
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Medication adherence-24 weeks
Délai: Change from baseline(at the point of recruiting) medication adherence at 24 weeks
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Pill count method is employed.
At the time of each office visit, patients bring their medications with themselves and the researcher counts the unused pills.
Adherence is calculated as percentage of the pills used during previous weeks.
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Change from baseline(at the point of recruiting) medication adherence at 24 weeks
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Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Chaise d'étude: Kheirollah Gholami, M.Sc,PharmD, Tehran University of Medical Sciences
- Directeur d'études: Zahra Jahangard-Rafsanjani, PharmD, Tehran University of Medical Sciences
- Chercheur principal: Arash Rashidian, M.D, Ph.D, Tehran University of Medical Sciences
Publications et liens utiles
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 90-04-156-15281
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