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Protocol for a randomised controlled trial of telemonitoring and self-management in the control of hypertension: telemonitoring and self-management in hypertension. [ISRCTN17585681]

Protocol for a randomised controlled trial of telemonitoring and self-management in the control of hypertension: telemonitoring and self-management in hypertension. [ISRCTN17585681]
Protocol for a randomised controlled trial of telemonitoring and self-management in the control of hypertension: telemonitoring and self-management in hypertension. [ISRCTN17585681]
Background: controlling blood pressure with drugs is a key aspect of cardiovascular disease prevention, but until recently has been the sole preserve of health professionals. Self-management of hypertension is an under researched area in which potential benefits for both patients and professionals are great.

Methods and design: the telemonitoring and self-management in hypertension trial (TASMINH2) will be a primary care based randomised controlled trial with embedded economic and qualitative analyses in order to evaluate the costs and effects of increasing patient involvement in blood pressure management, specifically with respect to home monitoring and self titration of antihypertensive medication compared to usual care. Provision of remote monitoring results to participating practices will ensure that practice staff are able to engage with self management and provide assistance where required. 478 patients will be recruited from general practices in the West Midlands, which is sufficient to detect clinically significant differences in systolic blood pressure between self-management and usual care of 5 mmHg with 90% power. Patients will be excluded if they demonstrate an inability to self monitor, their blood pressure is below 140/90 or above 200/100, they are on three or more antihypertensive medications, have a terminal disease or their blood pressure is not managed by their general practitioner.

The primary end point is change in mean systolic blood pressure (mmHg) between baseline and each follow up point (6 months and 12 months). Secondary outcomes will include change in mean diastolic blood pressure, costs, adverse events, health behaviours, illness perceptions, beliefs about medication, medication compliance and anxiety. Modelling will evaluate the impact of costs and effects on a system wide basis. The qualitative analysis will draw upon the views of users, informal carers and professionals regarding the acceptability of self-management and prerequisites for future widespread implementation should the trial show this approach to be efficacious.

Discussion: the TASMINH2 trial will provide important new evidence regarding the costs and effects of self monitoring with telemonitoring in a representative primary care hypertensive population
1471-2261
1-9
McManus, Richard J.
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Bray, Emma P.
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Mant, Jonathan
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Holder, Roger
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Greenfield, Sheila
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Bryan, Stirling
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Jones, Miren I.
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Little, Paul
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Williams, Bryan
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Hobbs, F.D. Richard
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McManus, Richard J.
481f6284-d599-4c77-8869-d1c6b63b9b02
Bray, Emma P.
a4338352-cb2e-4589-a0f7-33c1e80b7b39
Mant, Jonathan
0d1a0061-0f04-45c7-b20a-15798b1f465c
Holder, Roger
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Greenfield, Sheila
a983610e-aa36-442b-9f11-9af5721d7542
Bryan, Stirling
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Jones, Miren I.
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Little, Paul
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Williams, Bryan
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Hobbs, F.D. Richard
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McManus, Richard J., Bray, Emma P., Mant, Jonathan, Holder, Roger, Greenfield, Sheila, Bryan, Stirling, Jones, Miren I., Little, Paul, Williams, Bryan and Hobbs, F.D. Richard (2009) Protocol for a randomised controlled trial of telemonitoring and self-management in the control of hypertension: telemonitoring and self-management in hypertension. [ISRCTN17585681]. BMC Cardiovascular Disorders, 9 (6), 1-9. (doi:10.1186/1471-2261-9-6).

Record type: Article

Abstract

Background: controlling blood pressure with drugs is a key aspect of cardiovascular disease prevention, but until recently has been the sole preserve of health professionals. Self-management of hypertension is an under researched area in which potential benefits for both patients and professionals are great.

Methods and design: the telemonitoring and self-management in hypertension trial (TASMINH2) will be a primary care based randomised controlled trial with embedded economic and qualitative analyses in order to evaluate the costs and effects of increasing patient involvement in blood pressure management, specifically with respect to home monitoring and self titration of antihypertensive medication compared to usual care. Provision of remote monitoring results to participating practices will ensure that practice staff are able to engage with self management and provide assistance where required. 478 patients will be recruited from general practices in the West Midlands, which is sufficient to detect clinically significant differences in systolic blood pressure between self-management and usual care of 5 mmHg with 90% power. Patients will be excluded if they demonstrate an inability to self monitor, their blood pressure is below 140/90 or above 200/100, they are on three or more antihypertensive medications, have a terminal disease or their blood pressure is not managed by their general practitioner.

The primary end point is change in mean systolic blood pressure (mmHg) between baseline and each follow up point (6 months and 12 months). Secondary outcomes will include change in mean diastolic blood pressure, costs, adverse events, health behaviours, illness perceptions, beliefs about medication, medication compliance and anxiety. Modelling will evaluate the impact of costs and effects on a system wide basis. The qualitative analysis will draw upon the views of users, informal carers and professionals regarding the acceptability of self-management and prerequisites for future widespread implementation should the trial show this approach to be efficacious.

Discussion: the TASMINH2 trial will provide important new evidence regarding the costs and effects of self monitoring with telemonitoring in a representative primary care hypertensive population

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Published date: 16 February 2009
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 350031
URI: https://eprints.soton.ac.uk/id/eprint/350031
ISSN: 1471-2261
PURE UUID: a81f8dce-7208-424f-aa8d-3784cbc8b519

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Date deposited: 15 Mar 2013 15:07
Last modified: 16 Jul 2019 21:41

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