Telemonitoring and protocolized case management for hypertensive community dwelling older adults (TECHNOMED): a randomized controlled trial.
J Hypertens
; 40(9): 1702-1712, 2022 09 01.
Article
in English
| MEDLINE | ID: covidwho-1985146
ABSTRACT
BACKGROUND:
Home blood pressure (BP) telemonitoring combined with case management leads to BP reductions in individuals with hypertension. However, its benefits are less clear in older (age ≥ 65âyears) adults.METHODS:
Twelve-month, open-label, randomized trial of community-dwelling older adults comparing the combination of home BP telemonitoring (HBPM) and pharmacist-led case management, vs. enhanced usual care with HBPM alone. The primary outcome was the proportion achieving systolic BP targets on 24-h ambulatory BP monitoring (ABPM). Changes in HBPM were also examined. Logistic and linear regressions were used for analyses, adjusted for baseline BP.RESULTS:
Enrollment was stopped early due to coronavirus disease 2019. Participants randomized to intervention (n = 61) and control (nâ=â59) groups were mostly female (77%), with mean age 79.5âyears. The adjusted odds ratio for ABPM BP target achievement was 1.48 (95% confidence interval 0.87-2.52, Pâ=â0.15). At 12âmonths, the mean difference in BP changes between intervention and control groups was -1.6/-1.1 for ABPM (P-value 0.26 for systolic BP and 0.10 for diastolic BP), and -4.9/-3.1 for HBPM (P-value 0.04 for systolic BP and 0.01 for diastolic BP), favoring the intervention. Intervention group participants had hypotension (systolic BPâ<â110) more frequently (21% vs. 5%, Pâ=â0.009), but no differences in orthostatic symptoms, syncope, non-mechanical falls, or emergency department visits.CONCLUSIONS:
Home BP telemonitoring and pharmacist case management did not improve achievement of target range ambulatory BP, but did reduce home BP. It did not result in major adverse consequences.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
COVID-19
/
Hypertension
Type of study:
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
J Hypertens
Year:
2022
Document Type:
Article
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