AFFECT Education
Research type
Research Study
Full title
A randomised controlled feasibility trial evaluating the impact of an educational intervention regarding the treatment of hypertension for people with vascular cognitive impairment (AFFECT EDUCATION) and their carers on blood pressure and treatment adherence
IRAS ID
215642
Contact name
Carol Bannister
Contact email
Sponsor organisation
Kings College London
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Worldwide there are approximately 35.6 million people with dementia, (ADI World Alzheimer’s Report 2010). Vascular dementia (VaD) is the second most common cause of dementia affecting approximately 20% of people. Importantly, the number of individuals in whom cerebrovascular disease makes a significant contribution is substantially higher since the majority of people with Alzheimer’s disease (AD) have concurrent vascular pathology, particularly with older ages of onset, which has an impact on disease expression (Snowdon et al. 1997). There are currently no effective pharmacological treatments for VaD in any jurisdiction worldwide.
The link between vascular cognitive impairment and hypertension is well described and treatment of hypertension is believed to be one of the most important and modifiable risk factors in the development and progression of dementia. (Sharp et al . 2010)
Effective management of hypertension relies on patients’ compliance with drug therapy. (Burnier . 2006) However, studies suggest that patient adherence to their medication regimes is between 60-78% (Morrissey E et al . 2016)
In patients with hypertension and vascular dementia there is the added issue of cognitive impairment and there is a scarcity of research around treatment adherence in this patient group. (Arlt S . 2008) Given this situation and the potential benefits in improving patient adherence with antihypertensive treatment, this is a key area where improvements in treatment may be possible.
There is also vast epidemiological literature demonstrating the apparent relationship between lifestyle factors and hypertension. (Dickinson . 2006) The current NICE guidelines recommend increasing physical activity, stopping smoking and adopting healthier diets with restricted salt and alcohol consumption to help manage and treat hypertension. (NICE . 2011) These lifestyle factors are also associated with lower risk of dementia, however further exploration is needed to evidence their potential impact on cognitive decline. (Smith PJ & Blumenthal JA . 2016)
Patient participation and empowerment strategies have been shown to have a positive impact on the efficacy of self-directed disease management and patients mental health as well as reducing dependence on health care professionals. (McKillop . 2004; Barr PJ et al . 2015)
AFFECT Education is seeking to understand whether an empowerment programme of information and support tools offered to patients with dementia and hypertension can lead to improved blood pressure management and to explore the potential for it to affect other lifestyle outcomes.REC name
London - London Bridge Research Ethics Committee
REC reference
17/LO/0246
Date of REC Opinion
27 Feb 2017
REC opinion
Unfavourable Opinion