Blood pressure control and treatment adherence in hypertensive patients with metabolic syndrome: protocol of a randomized controlled study based on home blood pressure telemonitoring vs. conventional management and assessment of psychological determinants of adherence (TELEBPMET Study)
Year: 2013
Type: article
Study design: Study Protocol
Abstract: BACKGROUND: Inadequate blood pressure control and poor adherence to treatment remain among the major limitations in the management of hypertensive patients, particularly of those at high risk of cardiovascular events. Preliminary evidence suggests that home blood pressure telemonitoring (HBPT) might help increasing the chance of achieving blood pressure targets and improve patient's therapeutic adherence. However, all these potential advantages of HBPT have not yet been fully investigated. METHODS/DESIGN: The purpose of this open label, parallel group, randomized, controlled study is to assess whether, in patients with high cardiovascular risk (treated or untreated essential arterial hypertension--both in the office and in ambulatory conditions over 24 h--and metabolic syndrome), long-term (48 weeks) blood pressure control is more effective when based on HBPT and on the feedback to patients by their doctor between visits, or when based exclusively on blood pressure determination during quarterly office visits (conventional management (CM)). A total of 252 patients will be enrolled and randomized to usual care (n = 84) or HBPT (n = 168). The primary study endpoint will be the rate of subjects achieving normal daytime ambulatory blood pressure targets (< 135/85 mmHg) 24 weeks and 48 weeks after randomization. In addition, the study will assess the psychological determinants of adherence and persistence to drug therapy, through specific psychological tests administered during the course of the study. Other secondary study endpoints will be related to the impact of HBPT on additional clinical and economic outcomes (number of additional medical visits, direct costs of patient management, number of antihypertensive drugs prescribed, level of cardiovascular risk, degree of target organ damage and rate of cardiovascular events, regression of the metabolic syndrome). DISCUSSION: The TELEBPMET Study will show whether HBPT is effective in improving blood pressure control and related medical and economic outcomes in hypertensive patients with metabolic syndrome. It will also provide a comprehensive understanding of the psychological determinants of medication adherence and blood pressure control of these patients. TRIAL REGISTRATION: Clinical Trials.gov: NCT01541566.
Source: Trials
Authors: Gianfranco Parati, Stefano Omboni, Angelo Compare, Enzo Grossi, Edward Callus, Achille Venco, Maurizio Destro, Giuseppe Villa, Paolo Palatini, Enrico Agabiti Rosei, Simonetta Scalvini, Stefano Taddei, Dario Manfellotto, Stefano Favale, Carmine De Matteis, Michele Guglielmi, on behalf of the TELEBPMET Study Group
Institutions: IRCCS Istituto Auxologico Italiano, University of Milano-Bicocca, Italian Institute of Telemedicine, University of Bergamo, Centro Diagnostico Italiano, IRCCS Policlinico San Donato, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Azienda Ospedaliera Treviglio, Istituti Clinici Scientifici Maugeri, Fondazione Salvatore Maugeri, University of Padua, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, University of Brescia, University of Pisa, Fatebenefratelli Hospital, Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari, University of Bari Aldo Moro
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,790
OpenAlex ID: W2169065879