Research Output
Mixed methods feasibility study for a trial of blood pressure telemonitoring for people who have had stroke/transient ischaemic attack (TIA)
  Background
Good blood pressure (BP) control reduces the risk of recurrence of stroke/transient ischaemic
attack (TIA). Although there is strong evidence that BP telemonitoring helps achieve good
control, none of the major trials have considered the effectiveness in stroke/TIA survivors.
We therefore conducted a feasibility study for a trial of BP telemonitoring for stroke/ TIA
survivors with uncontrolled BP in primary care.
Method
Phase 1 was a pilot trial involving 55 patients stratified by stroke/TIA randomised 3:1 to BP
telemonitoring for 6 months or usual care. Phase 2 was a qualitative evaluation and
comprised semi-structured interviews with 16 trial participants who received telemonitoring
and 3 focus groups with 23 members of stroke support groups and 7 carers.
Results
Overall, 125 patients (60 stroke patients, 65 TIA patients) were approached and 55 (44%)
patients were randomised including 27 stroke patients and 28 TIA patients. Fifty-two
participants (95%) attended the 6-month follow-up appointment, but one declined the second
daytime ambulatory blood pressure monitoring (ABPM) measurement resulting in a 93%
completion rate for ABPM − the proposed primary outcome measure for a full trial.
Adherence to telemonitoring was good; of the 40 participants who were telemonitoring, 38
continued to provide readings throughout the 6 months. There was a mean reduction of 10.1
mmHg in systolic ABPM in the telemonitoring group compared with 3.8 mmHg in the
control group, which suggested the potential for a substantial effect from telemonitoring. Our
qualitative analysis found that many stroke patients were concerned about their BP and
telemonitoring increased their engagement, was easy, convenient and reassuring
Conclusions
A full-scale trial is feasible, likely to recruit well and have good rates of compliance and
follow-up.

  • Type:

    Article

  • Date:

    25 March 2015

  • Publication Status:

    Published

  • Publisher

    BioMed Central

  • DOI:

    10.1186/s13063-015-0628-y

  • Cross Ref:

    628

  • ISSN:

    1745-6215

  • Library of Congress:

    RT Nursing

  • Dewey Decimal Classification:

    610.73 Nursing

Citation

Hanley, J., Fairbrother, P., Krishan, A., McCloughan, L., Padfield, P., Paterson, M., …McKinstry, B. (2015). Mixed methods feasibility study for a trial of blood pressure telemonitoring for people who have had stroke/transient ischaemic attack (TIA). Trials, 16(1), 117. https://doi.org/10.1186/s13063-015-0628-y

Authors

Keywords

Hypertension; Stroke; Transient Ischaemic Attack; General Practice; Home monitoring; Telemonitoring; Pilot Randomised Controlled Trial; Qualitative Research;

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