Portal de investigación
Home Blood Pressure Self-monitoring plus Self-titration of Antihypertensive Medication for Poorly Controlled Hypertension in Primary Care: the ADAMPA Randomized Clinical Trial
Fecha de publicación:
Fecha Ahead of Print:
Autores de INCLIVA
Participantes ajenos a INCLIVA
- Martinez-Ibanez, P
- Marco-Moreno, I
- Peiro, S
- Martinez-Ibanez, L
- Barreira-Franch, I
- Avelino-Hidalgo, E
- Boveda-Garcia, M
- Ferrero-Gregori, A
- Iftimi, AA
- Hurtado, I
- Garcia-Sempere, A
- Rodriguez-Bernal, CL
- Sanfelix-Gimeno, G
- Sanfelix-Genoves, J
- ADAMPA Res Grp
Grupos y Plataformas de I+D+i
Abstract
BACKGROUND: Patient empowerment through pharmacological self-management is a common strategy in some chronic diseases such as diabetes, but it is rarely used for controlling blood pressure. OBJECTIVE : This study aimed to assess self-monitoring plus self-titration of antihypertensive medication versus usual care for reducing systolic blood pressure (SBP) at 12 months in poorly controlled hypertensive patients. DESIGN: The ADAMPA study was a pragmatic, controlled, randomized, non-masked clinical trial with two parallel arms in Valencia, Spain. PARTICIPANTS: Hypertensive patients older than 40 years, with SBP over 145 mmHg and/or diastolic blood pressure (DBP) over 90 mmHg, were recruited from July 2017 to June 2018. INTERVENTION: Participants were randomized 1:1 to usual care versus an individualized, pre-arranged plan based on self-monitoring plus self-titration. MAIN MEASURE: The primary outcome was the adjusted mean difference (AMD) in SBP between groups at 12 months. KEY RESULTS: Primary outcome data were available for 312 patients (intervention n=156, control n=156) of the 366 who were initially recruited. The AMD in SBP at 12 months (main analysis) was -2.9 mmHg (95% CI, -5.9 to 0.1, p=0.061), while the AMD in DBP was -1.9 mmHg (95% CI, -3.7 to 0.0, p=0.052). The results of the subgroup analysis were consistent with these for the main outcome measures. More patients in the intervention group achieved good blood pressure control (<140/90 mmHg) at 12 months than in the control group (55.8% vs 42.3%, difference 13.5%, 95% CI, 2.5 to 24.5%, p=0.017). At 12 months, no differences were observed in behavior, quality of life, use of health services, or adverse events. CONCLUSION: Self-monitoring plus self-titration of antihypertensive medication based on an individualized prearranged plan used in primary care may be a promising strategy for reducing blood pressure at 12 months compared to usual care, without increasing healthcare utilization or adverse events.
© 2022. The Author(s).
Datos de la publicación
- ISSN/ISSNe:
- 0884-8734, 1525-1497
- Tipo:
- Article
- Páginas:
- 81-89
- PubMed:
- 36219303
JOURNAL OF GENERAL INTERNAL MEDICINE SPRINGER
Citas Recibidas en Web of Science: 7
Documentos
Filiaciones
Keywords
- patient empowerment; blood pressure self-monitoring; blood pressure self-management; primary care; randomized clinical trial
Financiación
Proyectos y Estudios Clínicos
Plataforma de Unidades de Investigación Clínica y Ensayos Clinicos.
Investigador Principal: ANDRÉS CERVANTES RUIPEREZ
PT13/0002/0031 . INSTITUTO SALUD CARLOS III . 2014
Cita
Martinez P,Marco I,Peiro S,Martinez L,Barreira I,Bellot L,Avelino E,Escrig M,Boveda M,Calleja M,Ferrero A,Iftimi AA,Hurtado I,Garcia A,Rodriguez CL,Gimenez M,Sanfelix G,Sanfelix J,ADAMPA GRP. Home Blood Pressure Self-monitoring plus Self-titration of Antihypertensive Medication for Poorly Controlled Hypertension in Primary Care: the ADAMPA Randomized Clinical Trial. J Gen Intern Med. 2023. 38. (1):p. 81-89. IF:4,300. (1).
Home Blood Pressure Self-monitoring plus Self-titration of Antihypertensive Medication for Poorly Controlled Hypertension in Primary Care: the ADAMPA Randomized Clinical Trial. Martinez P, Marco I, Peiro S, Martinez L, Barreira I, Bellot L, Avelino E et al. JOURNAL OF GENERAL INTERNAL MEDICINE. 2023 enero 01. 38 (1):81-89. DOI:10.1007/s11606-022-07791-z. PMID:36219303.
