July 11, 2011Archives of Internal Medicine
Home Blood Pressure Management and Improved Blood Pressure Control
Key result
Telephone-based behavioral and medication management improved BP control at 12 months (12.8% and 12.5% improvements, respectively), but these effects were not sustained at 18 months.
Why the study?
Do telephone-based behavioral and/or medication management interventions triggered by home blood pressure telemonitoring improve blood pressure control in primary care patients?
Population
593 patients at primary care clinics at a Veterans Affairs Medical Center, 48% African American.
Comparison
Telephone-based interventions triggered by home… vs Usual care
Design
RCT, 4-arm randomized trial
Follow-up
18 months
Authors
Discussion
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Member takes
Implication
Short-term BP gains from telephone interventions fade by 18 months; extends evidence that ongoing support is needed for durable control.
Study Design
Type
RCT (n=593)
Randomization
4-arm randomized
Multicenter
No
Structured PICO
Do telephone-based behavioral and/or medication management interventions triggered by home blood pressure telemonitoring improve blood pressure control in primary care patients?
P
Population
593 patients at primary care clinics at a Veterans Affairs Medical Center, 48% African American.
I
Intervention
Telephone-based interventions triggered by home blood pressure telemonitoring: (1) nurse-administered behavioral management, (2) nurse- and physician-administered medication management, or (3) a combination of both.
C
Comparator
Usual care
O
Outcome
Change in blood pressure control measured at 6-month intervals over 18 monthssurrogate
Main Result
Effect estimate: 12.8% improvement (behavioral) (95% CI 1.6%-24.1%)
Telephone-based home blood pressure management interventions provide moderate improvements in blood pressure control, with the greatest benefit seen in patients with poor baseline control.
Cite This Study
Hayden B. Bosworth (2011) conducted an RCT in Hypertension (n=593). Telephone-based behavioral management, medication management, or both vs. Usual care was evaluated on Change in BP control measured at 6-month intervals over 18 months (12.8% improvement (behavioral), 95% CI 1.6%-24.1%). Telephone-based behavioral and medication management improved BP control at 12 months (12.8% and 12.5% improvements, respectively), but these effects were not sustained at 18 months.