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PERson-centredness in Hypertension management using Information Technology : a randomized controlled trial in primary care

Andersson, Ulrika LU orcid ; Nilsson, Peter M LU ; Kjellgren, Karin LU ; Hoffmann, Mikael ; Wennersten, André LU and Midlöv, Patrik LU orcid (2023) In Journal of Hypertension 41(2). p.246-253
Abstract

OBJECTIVES: To increase the proportion of individuals with hypertension obtaining a blood pressure (BP) of less than 140/90 mmHg by improving the management of hypertension in daily life from a person-centred perspective.

METHODS: In this unblinded randomized controlled trial, we tested an interactive web-based self-management system for hypertension. A total of 949 patients with hypertension from 31 primary healthcare centres (PHCCs) in Sweden were randomized 1 : 1 to either the intervention or usual care group. The intervention included daily measurement - via the participant's mobile phone - of BP and pulse and reports of well being, symptoms, lifestyle, medication intake and side effects for eight consecutive weeks. It also... (More)

OBJECTIVES: To increase the proportion of individuals with hypertension obtaining a blood pressure (BP) of less than 140/90 mmHg by improving the management of hypertension in daily life from a person-centred perspective.

METHODS: In this unblinded randomized controlled trial, we tested an interactive web-based self-management system for hypertension. A total of 949 patients with hypertension from 31 primary healthcare centres (PHCCs) in Sweden were randomized 1 : 1 to either the intervention or usual care group. The intervention included daily measurement - via the participant's mobile phone - of BP and pulse and reports of well being, symptoms, lifestyle, medication intake and side effects for eight consecutive weeks. It also included reminders and optional motivational messages. The primary outcome was the proportion of participants obtaining BP of less than 140/90 mmHg at 8 weeks and 12 months. Significance was tested by Pearson's chi2-test.

RESULTS: A total of 862 patients completed the trial, 442 in the intervention group and 420 in the control group. The primary outcome (BP <140/90 mmHg) at 8 weeks was achieved by 48.8% in the intervention group and 39.9% in the control group (P = 0.006). At 12 months, 47.1% (intervention) and 41.0% (control group) had a BP less than 140/90 mmHg (P = 0.071).

CONCLUSION: The proportion of participants with a controlled BP of less than 140/90 mmHg increased after using the interactive system for self-management of hypertension for 8 weeks compared with usual care. Although the trend continued, there was no significant difference after 12 months. The results indicate that the effect of the intervention is significant, but the long-term effect is uncertain.

TRIAL REGISTRATION: The study was registered with ClinicalTrials.gov (NCT03554382).

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Hypertension
volume
41
issue
2
pages
246 - 253
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:36394295
  • scopus:85145242301
ISSN
1473-5598
DOI
10.1097/HJH.0000000000003322
language
English
LU publication?
yes
additional info
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
id
4412cf90-b2ce-488c-a3cc-7b5ae6602b6c
date added to LUP
2022-11-22 14:40:15
date last changed
2024-06-13 15:02:32
@article{4412cf90-b2ce-488c-a3cc-7b5ae6602b6c,
  abstract     = {{<p>OBJECTIVES: To increase the proportion of individuals with hypertension obtaining a blood pressure (BP) of less than 140/90 mmHg by improving the management of hypertension in daily life from a person-centred perspective.</p><p>METHODS: In this unblinded randomized controlled trial, we tested an interactive web-based self-management system for hypertension. A total of 949 patients with hypertension from 31 primary healthcare centres (PHCCs) in Sweden were randomized 1 : 1 to either the intervention or usual care group. The intervention included daily measurement - via the participant's mobile phone - of BP and pulse and reports of well being, symptoms, lifestyle, medication intake and side effects for eight consecutive weeks. It also included reminders and optional motivational messages. The primary outcome was the proportion of participants obtaining BP of less than 140/90 mmHg at 8 weeks and 12 months. Significance was tested by Pearson's chi2-test.</p><p>RESULTS: A total of 862 patients completed the trial, 442 in the intervention group and 420 in the control group. The primary outcome (BP &lt;140/90 mmHg) at 8 weeks was achieved by 48.8% in the intervention group and 39.9% in the control group (P = 0.006). At 12 months, 47.1% (intervention) and 41.0% (control group) had a BP less than 140/90 mmHg (P = 0.071).</p><p>CONCLUSION: The proportion of participants with a controlled BP of less than 140/90 mmHg increased after using the interactive system for self-management of hypertension for 8 weeks compared with usual care. Although the trend continued, there was no significant difference after 12 months. The results indicate that the effect of the intervention is significant, but the long-term effect is uncertain.</p><p>TRIAL REGISTRATION: The study was registered with ClinicalTrials.gov (NCT03554382).</p>}},
  author       = {{Andersson, Ulrika and Nilsson, Peter M and Kjellgren, Karin and Hoffmann, Mikael and Wennersten, André and Midlöv, Patrik}},
  issn         = {{1473-5598}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{246--253}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Journal of Hypertension}},
  title        = {{PERson-centredness in Hypertension management using Information Technology : a randomized controlled trial in primary care}},
  url          = {{http://dx.doi.org/10.1097/HJH.0000000000003322}},
  doi          = {{10.1097/HJH.0000000000003322}},
  volume       = {{41}},
  year         = {{2023}},
}