Intervention development of a new programme for managing high BP
Research type
Research Study
Full title
Developing and testing a programme for managing high blood pressure for people with stroke or TIA
IRAS ID
246177
Contact name
Richard McManus
Contact email
Sponsor organisation
University of Oxford / Clinical Trials and Research Governance
Duration of Study in the UK
1 years, 5 months, 1 days
Research summary
Research Summary:
This study aims to adapt a web-based intervention used in previous studies for self-monitoring (taking regular home blood pressure readings) and self-management (initiating medication titration, when required, according to pre-planned changes) of high blood pressure (hypertension) to ensure it is acceptable to patients with stroke/TIA, carers and healthcare practitioners (HCP). This intervention is called ‘An Integrated Self-Monitoring SolutIoN for Stroke/TIA’ and will include a) home monitoring of blood pressure with recommendations to change medication if blood pressure is high, b) support tools that patients can use to make lifestyle changes in order to lower their blood pressure (such as weight loss, increased physical activity, reduced salt and quitting smoking) and c) web pages for their healthcare professionals (HCP) to support patients taking part in the BP home management programme. During this initial phase we will develop the intervention and materials by seeking feedback from this population group to ensure they are as effective and accessible as possible. This will include talking to patients and showing the study materials (app, information sheets, text messages, etc) to a diverse sample of participants with stroke/TIA (including men and women differing in terms of education and level and type of disability), carers of stroke/TIA patients and GPs, nurses, health care assistants and practice administrative staff. We will then modify the intervention until feedback indicates that there are no serious barriers to accessibility and implementation. The effectiveness and value-for-money of this new way to manage blood pressure in stroke/TIA patients will later be tested in a planned trial (for which we will submit a further ethics application once we have developed this new intervention).Summary of Results:
Having a stroke increases the risk of another one, especially with high blood pressure. Home-based blood pressure management can be effective at maintaining optimal blood pressure.We developed a digital intervention for stroke patients to manage their blood pressure. Stroke patients were recruited from general practices and community settings. Three linked qualitative studies were conducted with patients and general practitioners to help develop an intervention that was user-friendly and attractive.
The BP: Together intervention was adapted from existing self-monitoring interventions. It is delivered via mobile phone or a website to support self-monitoring of blood pressure at home. It alerts patients and their clinicians when a change in blood pressure medication is needed.
Feedback from a diverse range of participants identified potential barriers, which were addressed to make the intervention more accessible, feasible and persuasive. Easy-to-read materials were developed to improve usability. The importance of including family members who support patient care was also highlighted. Feedback messages regarding medication change were refined to ensure usefulness for patients and clinicians.
Input from patient contributors, and research participants from a diverse study sample allowed the creation of a simple and equitable blood pressure management intervention for stroke patients.
REC name
HSC REC B
REC reference
18/NI/0134
Date of REC Opinion
17 Jul 2018
REC opinion
Favourable Opinion