A randomised controlled trial of telemonitoring and self management in the control of hypertension: Telemonitoring and self-management in hypertension
527 patients, aged 35-85 with treated hypertension but whose BP was not controlled below 140/90, were recruited from 24 practices in the West Midlands. Participants were randomised to self-management of BP (self-monitoring of BP and self-titration of antihypertensive medication) or to usual care. Intervention patients were given a home BP monitor and training on how to measure their BP and when and how to adjust their medication. At 12 months, the reduction in BP was significantly greater in the self-management group compared to usual care (5.4/2.7mmHg). Patients who self-managed increased their antihypertensive medication more, but were no more anxious and had no more side effects, than those following usual care.
An interview study of 23 intervention participants found that they were generally pleased to gain greater control of their own medication and more involvement in their care. They were generally confident about implementing a medication change when their BP was consistently above target levels, but many chose not to implement a change when their BP was borderline/raised. Giving patients the ability to measure their own blood pressure and the knowledge to interpret their readings enabled them to make an informed choice over whether to increase their medication.
The study was completed in May 2009
Final Report published in the Lancet 2010
McManus RJ, Mant J, Bray EP, Holder R, Jones MI, Greenfield S, Kwaamba B, Banting M, Bryan S, Little P, Williams B, Hobbs FDR. A Randomised Controlled Trial Of Telemonitoring And Self-Management In The Control Of Hypertension: Telemonitoring And Self-Management In Hypertension (TASMINH2). Lancet 2010; 76: 163-172 DOI:10.1016/S0140-6736(10)60964-6
McManus RJ, Bray EP, Mant J, Holder R, Greenfield S, Bryan S, Jones MI, Little P, Williams B, Hobbs FDR. Protocol for a randomised controlled trial of telemonitoring and self-management in the control of hypertension: Telemonitoring and self-management in hypertension. [ISRCTN17585681] BMC Cardiovascular Disorders 2009, 9:6 doi:10.1186/1471-2261-9-6
MI Jones, SM Greenfield, EP Bray, J Mant, P Little, FDR Hobbs, R Holder, B Williams, S Baral-Grant, S Virdee, RJ McManus. Can self-management overcome the barriers to the successful control of blood pressure? A qualitative study of patients in the TASMINH2 trial of blood pressure self-monitoring and titration of medication. BJGP 2011 accepted for publication
Professor Richard McManus (firstname.lastname@example.org)
Dr Emma Bray (email@example.com)