An interactive web-based self-management system significantly increased the proportion of patients achieving a blood pressure of less than 140/90 mmHg at 8 weeks to 48.8% compared to 39.9% with usual care.
RCT (n=949)
Unblinded
1:1 block randomization
Yes
Does an interactive web-based self-management system improve blood pressure control in adult patients with hypertension?
An interactive web-based self-management system significantly improved blood pressure control at 8 weeks, but the effect was not sustained at 12 months.
Absolute Event Rate: 48.8% vs 39.9%
p-value: p=0.006
OBJECTIVES: To increase the proportion of individuals with hypertension obtaining a blood pressure (BP) of less than 140/90 mmHg by improving the management of hypertension in daily life from a person-centred perspective. METHODS: In this unblinded randomized controlled trial, we tested an interactive web-based self-management system for hypertension. A total of 949 patients with hypertension from 31 primary healthcare centres (PHCCs) in Sweden were randomized 1 : 1 to either the intervention or usual care group. The intervention included daily measurement - via the participant's mobile phone - of BP and pulse and reports of well being, symptoms, lifestyle, medication intake and side effects for eight consecutive weeks. It also included reminders and optional motivational messages. The primary outcome was the proportion of participants obtaining BP of less than 140/90 mmHg at 8 weeks and 12 months. Significance was tested by Pearson's chi 2 -test. RESULTS: A total of 862 patients completed the trial, 442 in the intervention group and 420 in the control group. The primary outcome (BP <140/90 mmHg) at 8 weeks was achieved by 48.8% in the intervention group and 39.9% in the control group ( P = 0.006). At 12 months, 47.1% (intervention) and 41.0% (control group) had a BP less than 140/90 mmHg ( P = 0.071). CONCLUSION: The proportion of participants with a controlled BP of less than 140/90 mmHg increased after using the interactive system for self-management of hypertension for 8 weeks compared with usual care. Although the trend continued, there was no significant difference after 12 months. The results indicate that the effect of the intervention is significant, but the long-term effect is uncertain. TRIAL REGISTRATION: The study was registered with ClinicalTrials.gov (NCT03554382).
Andersson et al. (Thu,) conducted a rct in Hypertension (n=949). Interactive web-based self-management system via mobile phone vs. Usual care was evaluated on Proportion of participants obtaining blood pressure <140/90 mmHg at 8 weeks (p=0.006). An interactive web-based self-management system significantly increased the proportion of patients achieving a blood pressure of less than 140/90 mmHg at 8 weeks to 48.8% compared to 39.9% with usual care.