Behavioral Study to Control Blood Pressure
Effect of a Novel Behavioral Intervention on Blood Pressure Control in Hypertension Patients
調査の概要
状態
条件
詳細な説明
According to the National Health and Nutrition Examination Survey, more than 31% of adults in the U.S. population have hypertension (HTN). HTN is a major risk factor for heart disease and stroke, which are the 1st and 3rd leading causes of death in the U.S. and impose an enormous financial and social burden on Americans with more than $352 billion spent in direct and indirect costs. Behavioral interventions to control blood pressure (BP) have exhibited, on average, positive but relatively modest effects on blood pressure control. We and others have studied the effects of one such intervention - home BP monitoring - on BP control in hypertensive patients, and found reliable, albeit modest effects. We have found similar effects for another behavioral intervention, Motivational Interviewing, on BP control. We hypothesize that the effects of such interventions will be augmented when accompanied by a systematic approach to patient education concerning their illness and its treatment. The literature suggests that patient education is "necessary but not sufficient"(an implicit interaction) to produce behavioral changes; however, the "necessary" part tends to be ignored by interventionalists. The implication of the interaction is that when patients lack the necessary knowledge, any intervention is likely to be less effective (as any value multiplied by zero - i.e., no knowledge - is zero). In spite of this, we have found no trials that have tested the interaction between patient knowledge and a lifestyle or drug intervention.
We propose to test an intervention to increase patients' understanding of the causes, consequences, and the rationale for treatment, of their HTN, as a strategy for increasing BP control. The focus is on the interaction between a behavioral intervention to reduce BP - home BP monitoring (HBPM) - and patient knowledge, which, we propose, moderates the effect of the HBPM intervention. We hypothesize that patients who have a better understanding of their illness and its prescribed treatment will be more adherent to the treatment regimen, and thus will exhibit improved outcomes compared to those who have been exposed to the same intervention, but who do not have a clear understanding of these elements.
We propose to pilot test the effect of the HBPM intervention using a 2 X 2 independent groups randomized design, to allow us to compare the effects of Usual Care (UC) + Printed Materials (PM) compared to Usual Care (UC) and Self-Paced Programmed Instruction (SPPI) compared to Home Blood Pressure Monitoring (HBPM) + Printed Materials (PM) compared to Home Blood Pressure Monitoring (HBPM) + Self-Paced Programmed Instruction (SPPI).
Our primary hypothesis is:
Decreased ABP at 3 months will be ordered thusly:
HBPM+SPPI > HBPM+PM > UC+SPPI > UC+PM
研究の種類
入学 (実際)
段階
- フェーズ2
- フェーズ 3
連絡先と場所
研究場所
-
-
Pennsylvania
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Hershey、Pennsylvania、アメリカ、17033
- Penn State Hershey Medical Center
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- English speaking
- Has been diagnosed by physician has having hypertension/high blood pressure
- Has been prescribed medications to treat hypertension
- Has a blood pressure reading at the Screening Visit of either above 140/90
- If previously diagnosed with cancer, must be in remission
- Not currently pregnant or trying to become pregnant within next three months
- No major kidney, heart, liver failure
- Ages 21-80
- Must be able to travel to Hershey Medical Center (Hershey, PA)
Exclusion Criteria:
- Cannot read and speak English fluently
- Has not been diagnosed with hypertension
- Is not currently taking medications for hypertension
- Has blood pressure that is below 140 and 90
- Has blood pressure that is above 180 or 120
- Has cancer that is not in remission
- Is currently pregnant of plans to become pregnant in the next 3 months
- Has had major kidney, heart or liver failure
- Is less than 21 or greater than 80 years old
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:独身
武器と介入
参加者グループ / アーム |
介入・治療 |
---|---|
アクティブコンパレータ:Usual Care (UC) + Printed Materials (PM)
If the participant is assigned to UC, they will receive standard care.
They will not receive a HBPM to use for the study, but will be given one to keep at the 3 month Follow-Up Visit.
If they are also assigned to PM, they will then be given written materials (pamphlets from the NIH) and will be asked to review the information in its entirety.
The coordinator will be available to answer any questions they might have.
|
標準治療
National Institutes of Health Printed Materials on hypertension
他の名前:
|
実験的:UC + Self-Paced Program Instruction (SPPI)
If the participant is assigned to UC, they will receive standard care.
They will not receive a HBPM to use for the study, but will be given one to keep at the 3 month Follow-Up Visit.
If they are also assigned to SPPI, they will be asked to complete a series of educational modules at their own pace on the laptop that is provided.
They will be informed that there is no grading and that the program is set up so that they can go at their own pace.
The SPPI modules will be designed directly from the information provided on the Printed Materials from the National Institutes of Health.
|
標準治療
If participants are assigned to SPPI, they will be asked to complete a series of educational modules at their own pace on the laptop that is provided.
They will be informed that there is no grading and that the program is set up so that they can go at their own pace.
The SPPI modules will be designed directly from the information provided on the Printed Materials (PM) from the National Institutes of Health.
|
実験的:Home Blood Pressure Monitor (HBPM) + PM
If the participant is assigned to HBPM, they will be asked to use the monitor once a day in the morning and once before they go to bed any 3 days of the week, each week of the study (total = 12 weeks).
They will be asked to record their BP values in diaries they will be given to take home with them.
If they are also assigned to PM, they will then be given written materials (pamphlets from the NIH) regarding hypertension education and will be asked to review the information in its entirety.
The coordinator will be available to answer any questions they might have.
|
National Institutes of Health Printed Materials on hypertension
他の名前:
The home blood pressure monitor will allow the participant to measure their blood pressure anytime and anywhere precisely, quickly and easily on their upper arm.
他の名前:
|
実験的:HBPM + SPPI
If the participant is assigned to HBPM, they will be asked to use the monitor once a day in the morning and once before they go to bed any 3 days of the week, each week of the study (total = 12 weeks). They will be asked to record their BP values in diaries they will be given to take home with them. If they are also assigned to SPPI, they will be asked to complete a series of educational modules at their own pace on the laptop that is provided. They will be informed that there is no grading and that the program is set up so that they can go at their own pace. The SPPI modules will be designed directly from the information provided on the PM from the National Institutes of Health. |
If participants are assigned to SPPI, they will be asked to complete a series of educational modules at their own pace on the laptop that is provided.
They will be informed that there is no grading and that the program is set up so that they can go at their own pace.
The SPPI modules will be designed directly from the information provided on the Printed Materials (PM) from the National Institutes of Health.
The home blood pressure monitor will allow the participant to measure their blood pressure anytime and anywhere precisely, quickly and easily on their upper arm.
他の名前:
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
---|---|
Decreased Arterial Blood Pressure
時間枠:3 months
|
3 months
|
協力者と研究者
捜査官
- 主任研究者:Christopher Sciamanna, MD, MPH、Milton S. Hershey Medical Center
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
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