scholarly journals Rationale and design of a pragmatic clinical trial to assess the impact of self-monitoring blood pressure at home and self-titration of antihypertensive medication in poorly controlled hypertension: the ADAMPA study protocol

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
José Sanfélix-Genovés ◽  
◽  
Clara L. Rodríguez-Bernal ◽  
Irene Marco-Moreno ◽  
Patricia Martinez-Ibañez ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Study Protocol ◽  
Antihypertensive Medication ◽  
Self Monitoring ◽  
Pragmatic Clinical Trial ◽  
The Impact ◽  
At Home

scholarly journals Patient experience of home and waiting room blood pressure measurement: a qualitative study of patients with recently diagnosed hypertension

2018 ◽  
Vol 68 (677) ◽  
pp. e835-e843 ◽  
Author(s):  
Alice C Tompson ◽  
Claire L Schwartz ◽  
Susannah Fleming ◽  
Alison M Ward ◽  
Sheila M Greenfield ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Qualitative Study ◽  
Patient Experience ◽  
Blood Pressure Measurement ◽  
Lifestyle Changes ◽  
Waiting Room ◽  
Cross Sectional ◽  
Self Monitoring ◽  
The Impact ◽  
At Home

BackgroundOut-of-office blood pressure (BP) measurement is advocated to confirm hypertension diagnosis. However, little is known about how primary care patients view and use such measurement.AimTo investigate patient experience of out-of-office BP monitoring, particularly home and practice waiting room BP measurement, before, during, and after diagnosis.Design and settingA cross-sectional, qualitative study with patients from two UK GP surgeries participating in a feasibility study of waiting room BP measurement.MethodInterviewees were identified from recent additions to the practice hypertension register. Interviews were recorded, transcribed, and coded thematically.ResultsOf 29 interviewees, 9 (31%) and 22 (76%) had used the waiting room monitor and/or monitored at home respectively. Out-of-office monitoring was used by patients as evidence of control or the lack of need for medication, with the printed results slips from the waiting room monitor perceived to improve ‘trustworthiness’. The waiting room monitor enabled those experiencing uncertainty about their equipment or technique to double-check readings. Monitoring at home allowed a more intensive and/or flexible schedule to investigate BP fluctuations and the impact of medication and lifestyle changes. A minority used self-monitoring to inform drug holidays. Reduced intensity of monitoring was reported with both modalities following diagnosis as initial anxiety or patient and GP interest decreased.ConclusionHome and practice waiting room measurements have overlapping but differing roles for patients. Waiting room BP monitors may be a useful out-of-office measurement modality for patients unwilling and/or unable to measure and record their BP at home.

Self-monitoring of blood pressure at home

1998 ◽  
Vol 16 (6) ◽  
pp. 725-731 ◽  
Author(s):  
George S. Stergiou ◽  
Irini I. Skeva ◽  
Andromachi S. Zourbaki ◽  
Theodore D. Mountokalakis
Keyword(s):  
Blood Pressure ◽  
Self Monitoring ◽  
At Home

scholarly journals Impact of Patient Beliefs on Blood Pressure Control in the General Population: Findings from the Population-Based STAAB Cohort Study

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Theresa Tiffe ◽  
Caroline Morbach ◽  
Viktoria Rücker ◽  
Götz Gelbrich ◽  
Martin Wagner ◽  
...  
Keyword(s):  
Blood Pressure ◽  
General Population ◽  
Blood Pressure Control ◽  
Antihypertensive Medication ◽  
Pressure Control ◽  
Population Based ◽  
Blood Pressure Target ◽  
Successful Implementation ◽  
Inverse Association ◽  
The Impact

Background. Effective antihypertensive treatment depends on patient compliance regarding prescribed medications. We assessed the impact of beliefs related towards antihypertensive medication on blood pressure control in a population-based sample treated for hypertension. Methods. We used data from the Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) study investigating 5000 inhabitants aged 30 to 79 years from the general population of Würzburg, Germany. The Beliefs about Medicines Questionnaire German Version (BMQ-D) was provided in a subsample without established cardiovascular diseases (CVD) treated for hypertension. We evaluated the association between inadequately controlled hypertension (systolic RR >140/90 mmHg; >140/85 mmHg in diabetics) and reported concerns about and necessity of antihypertensive medication. Results. Data from 293 participants (49.5% women, median age 64 years [quartiles 56.0; 69.0]) entered the analysis. Despite medication, half of the participants (49.8%) were above the recommended blood pressure target. Stratified for sex, inadequately controlled hypertension was less frequent in women reporting higher levels of concerns (OR 0.36; 95%CI 0.17-0.74), whereas no such association was apparent in men. We found no association for specific-necessity in any model. Conclusion. Beliefs regarding the necessity of prescribed medication did not affect hypertension control. An inverse association between concerns about medication and inappropriately controlled hypertension was found for women only. Our findings highlight that medication-related beliefs constitute a serious barrier of successful implementation of treatment guidelines and underline the role of educational interventions taking into account sex-related differences.

scholarly journals Design of the Pregnancy REmote MOnitoring II study (PREMOM II): a multicenter, randomized controlled trial of remote monitoring for gestational hypertensive disorders

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Dorien Lanssens ◽  
◽  
Inge M. Thijs ◽  
Wilfried Gyselaers
Keyword(s):  
Blood Pressure ◽  
Remote Monitoring ◽  
Antihypertensive Medication ◽  
Neonatal Outcomes ◽  
Self Monitoring ◽  
Link Type ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Multicenter Randomized Controlled Trial ◽  
Patient Reported

Abstract Background Observational data from the retrospective, non-randomized Pregnancy REmote MOnitoring I (PREMOM I) study showed that remote monitoring (RM) may be beneficial for prenatal observation of women at risk for gestational hypertensive disorders (GHD) in terms of clinical outcomes, health economics, and stakeholder perceptions. PREMOM II is a prospective, randomized, multicenter follow-up study that was performed to explore these promising results. Methods After providing written consent, 3922 pregnant women aged ≥18 years who are at increased risk of developing GHD will be randomized (1:1:1 ratio) to (a) conventional care (control group), (b) a patient self-monitoring group, and (c) a midwife-assisted RM group. The women in each group will be further divided (1:1 ratio) to evaluate the outcomes of targeted or non-targeted (conventional) antihypertensive medication. Women will be recruited in five hospitals in Flanders, Belgium: Ziekenhuis Oost-Limburg, Universitaire Ziekenhuis Antwerpen, Universitaire Ziekenhuis Leuven, AZ Sint Jan Brugge–Oostende, and AZ Sint Lucas Brugge. The primary outcomes are: (1) numbers and types of prenatal visits; (2) maternal outcomes; (3) neonatal outcomes; (4) the applicability and performance of RM; and (5) compliance with RM and self-monitoring. The secondary outcomes are: (1) cost-effectiveness and willingness to pay; (2) patient-reported outcome measures (PROMS) questionnaires on the experiences of the participants; and (3) the maternal and perinatal outcomes according to the type of antihypertensive medication. Demographic, and maternal and neonatal outcomes are collected from the patients’ electronic records. Blood pressure and compliance rate will be obtained from an online digital coordination platform for remote data handling. Information about the healthcare-related costs will be obtained from the National Coordination Committee of Belgian Health Insurance Companies (Intermutualistisch Agentschap). PROMS will be assessed using validated questionnaires. Discussion To our knowledge, this is the first randomized trial comparing midwife-assisted RM and self-monitoring of prenatal blood pressure versus conventional management among women at increased risk of GHD. Positive results of this study may lead to a practical framework for caregivers, hospital management, and payers to introduce RM into the prenatal care programs of high-risk pregnancies. Trial registration This study was registered on clinicaltrials.gov, identification number NCT04031430. Registered 24 July 2019, https://clinicaltrials.gov/ct2/show/NCT04031430?cond=premom+ii&draw=2&rank=1.

scholarly journals The Japanese Society of Hypertension Guidelines for Self-monitoring of Blood Pressure at Home (Second Edition)

2012 ◽  
Vol 35 (8) ◽  
pp. 777-795 ◽  
Author(s):  
Yutaka Imai ◽  
◽  
Kazuomi Kario ◽  
Kazuyuki Shimada ◽  
Yuhei Kawano ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Japanese Society ◽  
Self Monitoring ◽  
Hypertension Guidelines ◽  
At Home

scholarly journals Assessing the impact of the COVID-19 pandemic on pragmatic clinical trial participants

2021 ◽  
pp. 106619
Author(s):  
Brian C. Coleman ◽  
Natalie Purcell ◽  
Mary Geda ◽  
Stephen L. Luther ◽  
Peter Peduzzi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Pragmatic Clinical Trial ◽  
The Impact ◽  
Trial Participants

scholarly journals A pragmatic clinical trial examining the impact of a resilience program on college student mental health

2019 ◽  
Vol 37 (3) ◽  
pp. 202-213 ◽  
Author(s):  
Elisabeth Akeman ◽  
Namik Kirlic ◽  
Ashley N. Clausen ◽  
Kelly T. Cosgrove ◽  
Timothy J. McDermott ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Trial ◽  
College Student ◽  
Pragmatic Clinical Trial ◽  
Student Mental Health ◽  
College Student Mental Health ◽  
The Impact

The Journey of Recovery—Caregivers’ Perspectives From a Hip Fracture Telerehabilitation Clinical Trial

2020 ◽  
Author(s):  
Patrocinio Ariza-Vega ◽  
Herminia Castillo-Pérez ◽  
Mariana Ortiz-Piña ◽  
Lena Ziden ◽  
Jerónimo Palomino-Vidal ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Clinical Trial ◽  
Hip Fracture ◽  
Family Member ◽  
Family Caregivers ◽  
Public Health Care ◽  
Control Group ◽  
The Impact ◽  
At Home

Abstract Objective To explore family caregivers’ perspectives of the recovery process of older adults with hip fracture, and describe experiences from caregivers who (i) used the online intervention or (ii) received home-based care provided by the Andalusian Public Health Care System. Methods This was an exploratory secondary study with informal family caregivers who had an older adult family member with hip fracture enrolled in a novel telerehabilitation (telerehab) clinical trial. Forty-four caregivers of older adults with hip fracture were interviewed at 6 to 9 months after their family member’s hip fracture. Results Caregivers shared concerns of family members’ survival and recovery; they recounted increased stress and anxiety due to the uncertainty of new tasks associated with providing care and the impact on their lifestyle. Although most caregivers were satisfied with the health care received, they made suggestions for better organization of hospital discharge, and requests for home support. The main reasons why caregivers and their family member chose the telerehab program were to, enhance recovery after fracture, gain knowledge for managing at home, and the convenience of completing the exercises at home. There were more family caregivers in the control group who expressed a high level of stress and anxiety, and they also requested more social and health services compared with caregivers whose family member received telerehab. Conclusions Family caregivers are an essential component of recovery after hip fracture by providing emotional and physical support. However, future clinical interventions should evaluate person-centered interventions to mitigate possible stress and anxiety experienced by family caregivers. Impact Family caregivers’ perspectives are necessary in the co-design of management strategies for older adults after hip fracture.

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