Doogue, R., Hayes, P., Hebert, R. et al. (6 more authors) (2023) Towards an integrated blood pressure self-monitoring solution for stroke/TIA in Ireland:a mixed methods feasibility study for the TASMIN5S IRL randomised controlled trial. Pilot and Feasibility Studies. 9. ISSN 2055-5784
Abstract
Background: Optimising blood pressure (BP) control is one of the most important modifiable risk factors in preventing subsequent stroke where the risk increases by one-third for every 10 mmHg rise in systolic BP. This study evaluated the feasibility and potential effectiveness of blood pressure self-monitoring with planned medication titration, to inform a definitive trial of the intervention, in patients with a previous stroke or transient ischaemic attack (TIA). Methods: Patients with a history of stroke/TIA and sub-optimal BP control were invited to take part in a mixed methods feasibility study for a randomised controlled trial. Those meeting the inclusion criteria with systolic BP >130 mmHg were randomised to a self-monitoring intervention group or usual care group. The intervention involved self-monitoring BP twice a day for 3 days within a 7-day period, every month, following text message reminders. Treatment escalation, based on a pre-agreed plan by the general practitioner (GP) and patient, was initiated according to the results of these readings. Semi-structured interviews were carried out with patients and clinicians and analysed thematically. Results: Of those identified, 47% (32/68) attended for assessment. Of those assessed, 15 were eligible for recruitment and were consented and randomised to the intervention or control group on a 2:1 basis. Of those randomised, 93% (14/15) completed the study and there were no adverse events. Systolic BP was lower in the intervention group at 3 months. Participants found the intervention acceptable and easy to use. GPs found it easy to incorporate into their practice activity without increasing workload. Conclusions: TASMIN5S, an integrated blood pressure self-monitoring intervention in patients with a previous stroke/TIA, is feasible and safe to deliver in primary care. A pre-agreed three-step medication titration plan was easily implemented, increased patient involvement in their care, and had no adverse effects. This feasibility study provides important information to inform a definitive trial to determine the potential effectiveness of the intervention in patients post-stroke or TIA. Trial registration: ISRCTN57946500. Registered on 12/08/2019.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | Funding Information: The intervention development and UK trial were supported by the Stroke Association, UK. The Irish trial was supported by the Health Research Board in Ireland. RD has received an Education and Health Science (Ireland) scholarship. Publisher Copyright: © 2023, The Author(s). |
Keywords: | Blood pressure,Feasibility studies,Qualitative research,Randomised controlled trial,Self-monitoring,Stroke |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Health Sciences (York) |
Depositing User: | Pure (York) |
Date Deposited: | 22 Jun 2023 09:20 |
Last Modified: | 16 Oct 2024 19:16 |
Published Version: | https://doi.org/10.1186/s40814-023-01240-2 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1186/s40814-023-01240-2 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:200722 |
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Filename: s40814_023_01240_2.pdf
Description: Towards an integrated blood pressure self-monitoring solution for stroke/TIA in Ireland: a mixed methods feasibility study for the TASMIN5S IRL randomised controlled trial
Licence: CC-BY 2.5