An integrated blood pressure self-monitoring intervention with planned medication titration was feasible and acceptable in patients with a previous stroke or TIA, with 93% completing the 3-month trial.
RCT (n=15)
Open-label
2:1
Yes
Does blood pressure self-monitoring with planned medication titration improve blood pressure control and prove feasible in patients with a previous stroke or TIA?
An integrated blood pressure self-monitoring intervention with planned medication titration is feasible, acceptable, and safe to deliver in primary care for patients post-stroke or TIA.
Absolute Event Rate: 120.8% vs 140.5%
Abstract Background Optimising blood pressure (BP) control is one of the most important modifiable risk factors in preventing subsequent stroke where the risk increases by one-third for every 10 mmHg rise in systolic BP. This study evaluated the feasibility and potential effectiveness of blood pressure self-monitoring with planned medication titration, to inform a definitive trial of the intervention, in patients with a previous stroke or transient ischaemic attack (TIA). Methods Patients with a history of stroke/TIA and sub-optimal BP control were invited to take part in a mixed methods feasibility study for a randomised controlled trial. Those meeting the inclusion criteria with systolic BP >130 mmHg were randomised to a self-monitoring intervention group or usual care group. The intervention involved self-monitoring BP twice a day for 3 days within a 7-day period, every month, following text message reminders. Treatment escalation, based on a pre-agreed plan by the general practitioner (GP) and patient, was initiated according to the results of these readings. Semi-structured interviews were carried out with patients and clinicians and analysed thematically. Results Of those identified, 47% (32/68) attended for assessment. Of those assessed, 15 were eligible for recruitment and were consented and randomised to the intervention or control group on a 2:1 basis. Of those randomised, 93% (14/15) completed the study and there were no adverse events. Systolic BP was lower in the intervention group at 3 months. Participants found the intervention acceptable and easy to use. GPs found it easy to incorporate into their practice activity without increasing workload. Conclusions TASMIN5S, an integrated blood pressure self-monitoring intervention in patients with a previous stroke/TIA, is feasible and safe to deliver in primary care. A pre-agreed three-step medication titration plan was easily implemented, increased patient involvement in their care, and had no adverse effects. This feasibility study provides important information to inform a definitive trial to determine the potential effectiveness of the intervention in patients post-stroke or TIA. Trial registration ISRCTN57946500 . Registered on 12/08/2019.
Doogue et al. (Fri,) conducted a rct in Previous stroke or transient ischaemic attack (TIA) (n=15). Blood pressure self-monitoring with planned medication titration (TASMIN5S) vs. Usual care was evaluated on Post-trial systolic blood pressure at 3 months (mmHg). An integrated blood pressure self-monitoring intervention with planned medication titration was feasible and acceptable in patients with a previous stroke or TIA, with 93% completing the 3-month trial.