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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)

Identifieur interne : 000458 ( Main/Exploration ); précédent : 000457; suivant : 000459

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)

Auteurs : Gianfranco Parati [Italie] ; Stefano Omboni [Italie] ; Angelo Compare [Italie] ; Enzo Grossi [Italie] ; Edward Callus [Italie] ; Achille Venco [Italie] ; Maurizio Destro [Italie] ; Giuseppe Villa [Italie] ; Paolo Palatini [Italie] ; Enrico Agabiti Rosei [Italie] ; Simonetta Scalvini [Italie] ; Stefano Taddei [Italie] ; Dario Manfellotto [Italie] ; Stefano Favale [Italie] ; Carmine De Matteis [Italie] ; Michele Guglielmi [Italie]

Source :

RBID : PMC:3576326

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


Url:
DOI: 10.1186/1745-6215-14-22
PubMed: 23343138
PubMed Central: 3576326


Affiliations:


Links toward previous steps (curation, corpus...)


Le document en format XML

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<name sortKey="Guglielmi, Michele" sort="Guglielmi, Michele" uniqKey="Guglielmi M" first="Michele" last="Guglielmi">Michele Guglielmi</name>
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. conventional management and assessment of psychological determinants of adherence (TELEBPMET Study)</title>
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<name sortKey="Scalvini, Simonetta" sort="Scalvini, Simonetta" uniqKey="Scalvini S" first="Simonetta" last="Scalvini">Simonetta Scalvini</name>
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</author>
<author>
<name sortKey="Guglielmi, Michele" sort="Guglielmi, Michele" uniqKey="Guglielmi M" first="Michele" last="Guglielmi">Michele Guglielmi</name>
<affiliation wicri:level="1">
<nlm:aff id="I16">Casa di Cura Tortorella, Salerno, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Casa di Cura Tortorella, Salerno</wicri:regionArea>
<wicri:noRegion>Salerno</wicri:noRegion>
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</author>
</analytic>
<series>
<title level="j">Trials</title>
<idno type="eISSN">1745-6215</idno>
<imprint>
<date when="2013">2013</date>
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</series>
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</sourceDesc>
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<front>
<div type="abstract" xml:lang="en">
<sec>
<title>Background</title>
<p>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.</p>
</sec>
<sec>
<title>Methods/design</title>
<p>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 (
<italic>n</italic>
=84) or HBPT (
<italic>n</italic>
=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).</p>
</sec>
<sec>
<title>Discussion</title>
<p>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.</p>
</sec>
<sec>
<title>Trial registration</title>
<p>Clinical Trials.gov: NCT01541566</p>
</sec>
</div>
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<list>
<country>
<li>Italie</li>
</country>
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<li>Latium</li>
<li>Lombardie</li>
<li>Toscane</li>
</region>
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<li>Milan</li>
<li>Pise</li>
<li>Rome</li>
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<name sortKey="Favale, Stefano" sort="Favale, Stefano" uniqKey="Favale S" first="Stefano" last="Favale">Stefano Favale</name>
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<name sortKey="Guglielmi, Michele" sort="Guglielmi, Michele" uniqKey="Guglielmi M" first="Michele" last="Guglielmi">Michele Guglielmi</name>
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<name sortKey="Palatini, Paolo" sort="Palatini, Paolo" uniqKey="Palatini P" first="Paolo" last="Palatini">Paolo Palatini</name>
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<name sortKey="Scalvini, Simonetta" sort="Scalvini, Simonetta" uniqKey="Scalvini S" first="Simonetta" last="Scalvini">Simonetta Scalvini</name>
<name sortKey="Taddei, Stefano" sort="Taddei, Stefano" uniqKey="Taddei S" first="Stefano" last="Taddei">Stefano Taddei</name>
<name sortKey="Venco, Achille" sort="Venco, Achille" uniqKey="Venco A" first="Achille" last="Venco">Achille Venco</name>
<name sortKey="Villa, Giuseppe" sort="Villa, Giuseppe" uniqKey="Villa G" first="Giuseppe" last="Villa">Giuseppe Villa</name>
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