Skip to main content
release_alert
Welcome to the new Scholars 3.0! Read about new features and let us know what you think.
cancel

Home blood pressure management and improved blood pressure control: results from a randomized controlled trial.

Publication ,  Journal Article
Bosworth, HB; Powers, BJ; Olsen, MK; McCant, F; Grubber, J; Smith, V; Gentry, PW; Rose, C; Van Houtven, C; Wang, V; Goldstein, MK; Oddone, EZ
Published in: Arch Intern Med
July 11, 2011

BACKGROUND: To determine which of 3 interventions was most effective in improving blood pressure (BP) control, we performed a 4-arm randomized trial with 18-month follow-up at the primary care clinics at a Veterans Affairs Medical Center. METHODS: Eligible patients were randomized to either usual care or 1 of 3 telephone-based intervention groups: (1) nurse-administered behavioral management, (2) nurse- and physician-administered medication management, or (3) a combination of both. Of the 1551 eligible patients, 593 individuals were randomized; 48% were African American. The intervention telephone calls were triggered based on home BP values transmitted via telemonitoring devices. Behavioral management involved promotion of health behaviors. Medication management involved adjustment of medications by a study physician and nurse based on hypertension treatment guidelines. RESULTS: The primary outcome was change in BP control measured at 6-month intervals over 18 months. Both the behavioral management and medication management alone showed significant improvements at 12 months-12.8% (95% confidence interval [CI], 1.6%-24.1%) and 12.5% (95% CI, 1.3%-23.6%), respectively-but not at 18 months. In subgroup analyses, among those with poor baseline BP control, systolic BP decreased in the combined intervention group by 14.8 mm Hg (95% CI, -21.8 to -7.8 mm Hg) at 12 months and 8.0 mm Hg (95% CI, -15.5 to -0.5 mm Hg) at 18 months, relative to usual care. CONCLUSIONS: Overall intervention effects were moderate, but among individuals with poor BP control at baseline, the effects were larger. This study indicates the importance of identifying individuals most likely to benefit from potentially resource intensive programs. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00237692.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Arch Intern Med

DOI

EISSN

1538-3679

Publication Date

July 11, 2011

Volume

171

Issue

13

Start / End Page

1173 / 1180

Location

United States

Related Subject Headings

  • White People
  • United States Department of Veterans Affairs
  • United States
  • Treatment Outcome
  • Time Factors
  • Telephone
  • Telenursing
  • Telemedicine
  • Research Design
  • Quality of Health Care
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bosworth, H. B., Powers, B. J., Olsen, M. K., McCant, F., Grubber, J., Smith, V., … Oddone, E. Z. (2011). Home blood pressure management and improved blood pressure control: results from a randomized controlled trial. Arch Intern Med, 171(13), 1173–1180. https://doi.org/10.1001/archinternmed.2011.276
Bosworth, Hayden B., Benjamin J. Powers, Maren K. Olsen, Felicia McCant, Janet Grubber, Valerie Smith, Pamela W. Gentry, et al. “Home blood pressure management and improved blood pressure control: results from a randomized controlled trial.Arch Intern Med 171, no. 13 (July 11, 2011): 1173–80. https://doi.org/10.1001/archinternmed.2011.276.
Bosworth HB, Powers BJ, Olsen MK, McCant F, Grubber J, Smith V, et al. Home blood pressure management and improved blood pressure control: results from a randomized controlled trial. Arch Intern Med. 2011 Jul 11;171(13):1173–80.
Bosworth, Hayden B., et al. “Home blood pressure management and improved blood pressure control: results from a randomized controlled trial.Arch Intern Med, vol. 171, no. 13, July 2011, pp. 1173–80. Pubmed, doi:10.1001/archinternmed.2011.276.
Bosworth HB, Powers BJ, Olsen MK, McCant F, Grubber J, Smith V, Gentry PW, Rose C, Van Houtven C, Wang V, Goldstein MK, Oddone EZ. Home blood pressure management and improved blood pressure control: results from a randomized controlled trial. Arch Intern Med. 2011 Jul 11;171(13):1173–1180.

Published In

Arch Intern Med

DOI

EISSN

1538-3679

Publication Date

July 11, 2011

Volume

171

Issue

13

Start / End Page

1173 / 1180

Location

United States

Related Subject Headings

  • White People
  • United States Department of Veterans Affairs
  • United States
  • Treatment Outcome
  • Time Factors
  • Telephone
  • Telenursing
  • Telemedicine
  • Research Design
  • Quality of Health Care