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June 24, 2016JMIR Research ProtocolsOpen Access

Telemonitoring and Protocolized Case Management for Hypertensive Community-Dwelling Seniors With Diabetes: Protocol of the TECHNOMED Randomized Controlled Trial

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Why the study?

Does home blood pressure telemonitoring, with or without protocolized pharmacist case management, improve blood pressure control in community-dwelling seniors with diabetes and hypertension compared to enhanced usual care?

Population

300 community-dwelling seniors with documented diabetes and hypertension living independently in seniors'…

Comparison

Home blood pressure telemonitoring alone OR home… vs Enhanced usual care.

Design

RCT, 1:1:1 computer-generated randomization performed centrally and…

Follow-up

12 months

Authors

RPRaj PadwalFMFinlay A. McAlisterPWPeter W. Wood

Discussion

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Overview

This trial protocol describes a pragmatic randomized controlled trial to evaluate whether home blood pressure telemonitoring, with or without pharmacist case management, safely and cost-effectively improves blood pressure control in high-risk seniors with diabetes and hypertension.

Structured PICO

Does home blood pressure telemonitoring, with or without protocolized pharmacist case management, improve blood pressure control in community-dwelling seniors with diabetes and hypertension compared to enhanced usual care?

P
Population
300 community-dwelling seniors (age ≥65 years) with documented diabetes and hypertension living independently in seniors' residences in greater Edmonton, Canada. Key exclusions: SBP >220 mmHg or DBP >110 mmHg, heart failure, severe cognitive impairment, severe depression, foreshortened life expectancy (<1 year), or currently receiving case management services.
I
Intervention
Home blood pressure telemonitoring alone OR home blood pressure telemonitoring plus protocolized pharmacist case management. Patients receive an electronic upper arm oscillometric BP device and a set top box for wireless teletransmission of BP readings to a health portal for provider use.
C
Comparator
Enhanced usual care (patients receive a home BP monitor and are taught how to measure BP, but neither they nor their providers have access to teletransmitted data, and no case management is provided).
O
Outcome
Proportion of subjects with a mean 24-hour ambulatory systolic BP in the optimal range (110-129 mmHg in patients 65-79 years and 110-139 mmHg in those ≥80 years) at 6 and 12 months.surrogate

This trial protocol describes a pragmatic randomized controlled trial to evaluate whether home blood pressure telemonitoring, with or without pharmacist case management, safely and cost-effectively improves blood pressure control in high-risk seniors with diabetes and hypertension.

Cite This Study

Padwal et al. (2016) studied this question.

synapsesocial.com/papers/6a83844b3965fa42e1c94f22https://doi.org/10.2196/resprot.5775
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Implementing Home Blood Glucose and Blood Pressure Telemonitoring in Primary Care Practices for Patients with Diabetes: Lessons Learned2013 · 49 citations
  2. 2Role of Home Blood Pressure Monitoring in Overcoming Therapeutic Inertia and Improving Hypertension Control2010 · 431 citations
  3. 3Case management for blood pressure and lipid level control after minor stroke: PREVENTION randomized controlled trial2014 · 93 citations
  4. 4Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study2000 · 2,158 citations
  5. 5Computer Modeling of Diabetes and Its Complications2007 · 185 citations