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January 1, 2022Canadian Journal of Kidney Health and DiseaseOpen Access

Telemonitoring and Case Management for Hypertensive and Remote-Dwelling Patients With Chronic Kidney Disease—The Telemonitoring for Improved Kidney Outcomes Study (TIKO): A Clinical Research Protocol

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Why the study?

Hypertension is a risk factor for kidney failure and CV morbidity, but the efficacy of HBPT combined with case management in remote-dwelling patients with hypertension and CKD remains unproven.

Does home blood pressure telemonitoring plus case management improve systolic blood pressure control compared to telemonitoring with usual care in remote-dwelling patients with hypertension and chronic kidney disease?

Population

Primary care patients with CKD and hypertension in Northern Alberta, Canada

Comparison

HBPT plus clinical case management vs HBPT plus usual care

Design

Pragmatic randomized controlled trial protocol

Follow-up

12 months

Authors

IOIkechi G. OkpechiDZDeenaz ZaidiFYFeng Ye

Discussion

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Overview

HBPT trial in remote CKD patients will test BP control gains; leaves open effects on kidney failure or CV events.

Structured PICO

Does home blood pressure telemonitoring plus case management improve systolic blood pressure control compared to telemonitoring with usual care in remote-dwelling patients with hypertension and chronic kidney disease?

P
Population
Remote-dwelling primary care patients with chronic kidney disease (CKD) and hypertension in Northern Alberta, Canada
I
Intervention
Home blood pressure telemonitoring (HBPT) plus clinical case management (BP measured 4 times daily for 1 week, medications titrated by case manager to target SBP <130 mmHg, repeated every 3 months for 1 year)
C
Comparator
Home blood pressure telemonitoring (HBPT) with usual care (same BP measurement protocol, but no case manager interaction; readings shared with primary care physicians or nurse practitioners)
O
Outcome
Mean difference in systolic blood pressure (SBP) at 12 months from baselinesurrogate

This protocol outlines a pragmatic randomized controlled trial to evaluate whether adding case management to home blood pressure telemonitoring improves systolic blood pressure control in remote-dwelling patients with hypertension and chronic kidney disease.

Limitations

  • relatively short duration of follow-up
  • possible technological pitfalls
  • need for patients to own a smartphone and have access to the internet

Cite This Study

Okpechi et al. (2022) studied this question.

synapsesocial.com/papers/6a7e0f40693a82ae6737ebd8https://doi.org/10.1177/20543581221077500
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