Towards an integrated blood pressure self-monitoring solution for stroke/TIA in Ireland: a mixed methods feasibility study for the TASMIN5S IRL randomised controlled trial

Pilot and Feasibility Studies

Research

K. Morton¹  A. Sheikhi²  C. Roman³  R. J. McManus⁴  T. Rai⁴  R. Hebert⁵  R. Doogue⁵  L. G. Glynn⁶  P. Hayes⁷ 

[1] Centre for Clinical and Community Applications of Health Psychology, School of Psychology, University of Southampton, SO17 1BJ, Southampton, UK;Health Research Institute, University of Limerick, Limerick, Ireland;Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK;Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK;School of Medicine, University of Limerick, Limerick, Ireland;School of Medicine, University of Limerick, Limerick, Ireland;HRB Primary Care Clinical Trial Network Ireland, Galway, Ireland;School of Medicine, University of Limerick, Limerick, Ireland;Health Research Institute, University of Limerick, Limerick, Ireland;

关键词: Blood pressure;    Self-monitoring;    Stroke;    Feasibility studies;    Randomised controlled trial;    Qualitative research;   

DOI  :  10.1186/s40814-023-01240-2

 received in 2022-01-15, accepted in 2023-01-04,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundOptimising blood pressure (BP) control is one of the most important modifiable risk factors in preventing subsequent stroke where the risk increases by one-third for every 10 mmHg rise in systolic BP. This study evaluated the feasibility and potential effectiveness of blood pressure self-monitoring with planned medication titration, to inform a definitive trial of the intervention, in patients with a previous stroke or transient ischaemic attack (TIA).MethodsPatients with a history of stroke/TIA and sub-optimal BP control were invited to take part in a mixed methods feasibility study for a randomised controlled trial. Those meeting the inclusion criteria with systolic BP >130 mmHg were randomised to a self-monitoring intervention group or usual care group. The intervention involved self-monitoring BP twice a day for 3 days within a 7-day period, every month, following text message reminders. Treatment escalation, based on a pre-agreed plan by the general practitioner (GP) and patient, was initiated according to the results of these readings. Semi-structured interviews were carried out with patients and clinicians and analysed thematically.ResultsOf those identified, 47% (32/68) attended for assessment. Of those assessed, 15 were eligible for recruitment and were consented and randomised to the intervention or control group on a 2:1 basis. Of those randomised, 93% (14/15) completed the study and there were no adverse events. Systolic BP was lower in the intervention group at 3 months. Participants found the intervention acceptable and easy to use. GPs found it easy to incorporate into their practice activity without increasing workload.ConclusionsTASMIN5S, an integrated blood pressure self-monitoring intervention in patients with a previous stroke/TIA, is feasible and safe to deliver in primary care. A pre-agreed three-step medication titration plan was easily implemented, increased patient involvement in their care, and had no adverse effects. This feasibility study provides important information to inform a definitive trial to determine the potential effectiveness of the intervention in patients post-stroke or TIA.Trial registrationISRCTN57946500. Registered on 12/08/2019.

【 授权许可】

CC BY   
© The Author(s) 2023

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