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Sanfélix-Genovés J, Rodríguez-Bernal CL, Marco-Moreno I, Martinez-Ibañez P, Martinez-Ibañez L, Bóveda-García M, Barreira-Franch I, Calleja-Del Ser M, Borrás-Moreno G, Avelino-Hidalgo E, Escrig-Veses M, Lauriano M, Giménez-Loreiro M, Bellot-Pujalte L, García-Sempere A, Peiró S, Sanfélix-Gimeno G. Rationale and design of a pragmatic clinical trial to assess the impact of self-monitoring blood pressure at home and self-titration of antihypertensive medication in poorly controlled hypertension: the ADAMPA study protocol. BMC Fam Pract 2018; 19:160. [PMID: 30249203 PMCID: PMC6154875 DOI: 10.1186/s12875-018-0846-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 09/03/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Lack of control of hypertension is one of the most prevalent problems encountered by general practitioners (GPs). Self-measured blood pressure monitoring at home (SMBP) and self-titration of medication could be a good strategy to improve hypertension management, however, evidence is limited and not conclusive. We aimed to assess the effectiveness, in the primary care setting, of an intervention that includes educational components, SMBP and self-titration of antihypertensive medication to decrease systolic blood pressure compared to usual care, in a population with poorly controlled hypertension, during a 12-month period. METHODS Pragmatic, controlled, randomized, unblinded clinical trial with two parallel groups assigned in a ratio of 1:1 to self-management (which includes educational components, SBMP and self-titration of antihypertensive medication based on a patient's GP's pre-established adjustment plan) or to usual care (with educational components too). DISCUSSION If the data from this trial show positive results, the study may contribute to a change of strategy in the treatment of hypertension, focusing on the patient as the main actor to achieve blood pressure control. Furthermore, this approach might contribute to the financial sustainability of the National Health Service. TRIAL REGISTRATION This trial has been registered in the database with reference number EudraCT: 2016-003986-25. Registered 05 May 2017, https://www.clinicaltrialsregister.eu/ctr-search/search?query=2016-003986-25.
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Affiliation(s)
- José Sanfélix-Genovés
- Centro de Salud de Nazaret, Departamento de Salud de Valencia Clínic-La Malvarrosa, Valencia, Spain
- Health Services Research Unit, FISABIO, Valencia, Spain
- Spanish Network of Chronic Care and Health Services Research (REDISSEC), Valencia, Spain
- Health Research Institute (INCLIVA), Valencia, Spain
| | - Clara L. Rodríguez-Bernal
- Health Services Research Unit, FISABIO, Valencia, Spain
- Spanish Network of Chronic Care and Health Services Research (REDISSEC), Valencia, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | - Aníbal García-Sempere
- Health Services Research Unit, FISABIO, Valencia, Spain
- Spanish Network of Chronic Care and Health Services Research (REDISSEC), Valencia, Spain
| | - Salvador Peiró
- Health Services Research Unit, FISABIO, Valencia, Spain
- Spanish Network of Chronic Care and Health Services Research (REDISSEC), Valencia, Spain
| | - Gabriel Sanfélix-Gimeno
- Health Services Research Unit, FISABIO, Valencia, Spain
- Spanish Network of Chronic Care and Health Services Research (REDISSEC), Valencia, Spain
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