Long-term maintenance interventions needed for sustained blood pressure control

Patients who had home blood pressure telemonitoring and regular telephone contact with a pharmacist had significantly improved outcomes up to 12 months after the end of the intervention

Home blood pressure monitoring

Research has shown that the benefits of an intensive telemonitoring protocol for blood pressure (BP) control lasted for up to a year after the end of the intervention[1]
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The findings came from a long-term follow-up of 326 patients with uncontrolled hypertension who took part in a telemonitoring trial. They had been randomly assigned to receive either home BP telemonitoring and regular telephone appointments with a pharmacist, or usual care for 12 months.

At a 54-month follow-up visit, the difference between the two groups in mean systolic BP was 2.5mmHg and the difference in mean diastolic BP was 1.0mmHg, neither of which were significant.

However, data from routine BP measurements in the patients’ electronic heath records suggested a significant improvement in systolic and diastolic BP for up to 12 months after the end of the intervention.

The results indicate that long-term maintenance interventions would be required to sustain the benefits of intensive interventions for blood-pressure control, the researchers said.

“More work is needed to determine the content, intensity and duration of reinforcement that are needed for maintaining intervention benefits over a longer period,” they concluded in JAMA Network Open (7 September 2018).

References

[1] Margolis K, Asche S, Dehmer S et al. Long-term outcomes of the effects of home blood pressure telemonitoring and pharmacist management on blood pressure among adults with uncontrolled hypertension: follow-up of a cluster randomized clinical trial. JAMA Network Open 2018; 1: e181617. doi: 10.1001/jamanetworkopen.2018.1617

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Citation
Clinical Pharmacist, CP, December 2018, Vol 10, No 12;10(12):DOI:10.1211/PJ.2018.20205715