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1. Effect of PCI on Health Status in Ischemic Left Ventricular Dysfunction: Insights From REVIVED-BCIS2

Author

Perera, Divaka, Chiribiri, Amedeo, Carr-White, Gerry, Pavlidis, Antonis, Redwood, Simon, Clapp, Brian, Rinaldi, Aldo, Rahman, Haseeb, Briceno, Natalia, Arnold, Sophie, Raynsford, Amy, Wilson, Karen, Clack, Lucy, Petrie, Mark, McEntegart, Margaret, Watkins, Stuart, Shaukat, Aadil, Rocchiccioli, Paul, McAdam, Marion, McPherson, Elizabeth, Cowan, Louise, Wood, Marie, Weerackody, Roshan, Davies, Ceri, Smith, Elliot, Modi, Bhavik, Mathew, Bindu, Mitchelmore, Oliver, Adrego, Rita, Andiapen, Mervyn, O’Kane, Peter, Din, Jehangir, Kennard, Sarah, Orr, Sarah, Purnell, Cathie, Greenwood, John, Blaxill, Jonathan, Mozid, Abdul, Anderson, Michelle, Somers, Kathryn, Dixon, Lana, Walsh, Simon, Spence, Mark, Glover, Patricia, Brown, Caroline, Edwards, Richard, McDiarmid, Adam, Egred, Mohaned, Narytnyk, Alla, Wealleans, Vera, Amin-Youssef, George, Shah, Ajay, McDonagh, Theresa, Byrne, Jonathan, Pareek, Nilesh, Breeze, Jonathan, Antao, Catherine, De Silva, Kalpa, Strange, Julian, Johnson, Tom, Nightingale, Angus, Gallego, Laura, Medina, Cristina, Gershlick, Anthony, McCann, Gerald, Ladwiniec, Andrew, Squire, Iain, Davison, Joanna, Kenmuir-Hogg, Kris, Spratt, James, Cosgrove, Claudia, Williams, Rupert, Firoozi, Sam, Lim, Pitt, Bonato, Giovanna, Sookhoo, Vennessa, Conway, Dwayne, Brooksby, Paul, Wright, Judith, Exley, Donna, Cotton, James, Horton, Richard, Metherell, Stella, Smallwood, Andrew, Hogrefe, Kai, Cheng, Adrian, Beirnes, Charmaine, Sidgwick, Sian, Lockie, Tim, Patel, Niket, Rakhit, Roby, Davies, Nina, Smit, Angelique, Ahmed, Fozia, Hendry, Cara, Fath-Odoubadi, Farzin, Fraser, Douglas, Mamas, Mamas, Oommen, Anu, Charles, Thabitha, Behan, Miles, Japp, Alan, Rif, Belinda, Jenkins, Nicholas, McClure, Sam, Oates, Pauline, Martin, Karen, Abdelaal, Eltigani, Sarma, Jaydeep, Shastri, Sanjay, Riley, Jo, Giannopoulou, Sarra, Quinn, Sophie, Magapu, Pradeep, Stables, Rod, Wright, David, Barton, Janet, Clarkson, Nichola, Mahmoudi, Michael, Flett, Andrew, Curzen, Nick, Radmore, Judith, Gough, Sam, Ludman, Andrew, Kurdi, Hibba, Keenan, Samantha, Banerjee, Prithwish, Tapp, Luke, Edwards, Nigel, Gibson, Catherine, Kukreja, Neville, Lynch, Mary, Barratt, Claire, de Belder, Mark, Thambyrajah, Jeet, Swanson, Neil, Richardson, Cath, Atkinson, Bev, Viswanathan, Girish, Waugh, Darren, Routledge, Helen, Trevelyan, Jasper, Doughty, Angela, Pegge, Nick, Dhamrait, Sukhbir, Moore, Sally, Galasko, Gavin, Cassidy, Christopher, Waddington, Natalia, Edwards, Tim, Iqbal, Javed, Witherow, Fraser, Birch, Jenny, Munro, Melanie, Wells, Tim, Sinha, Manas, Frost, Linda, Lee, Kaeng, Beattie, James, Pitt, Mike, Chung, Alan, Ramcharitar, Steve, McCafferty, Laura, Martin, Thomas, Irving, John, Iskandar, Zaid, Hutcheon, Anita, Gunn, Julian, Al-Mohammad, Abdallah, Agyemang, Michael, Griffiths, Huw, Kalra, Paul, Howe, Serena, Gray, Tim, Sobolewska, Jolanta, Morby, Louise, Glover, Jason, Beynon, James, Knight, Janet, Das, Paul, Bellamy, Chris, Harman, Emily, Pye, Maurice, Megarry, Simon, McGill, Yvonne, Redfearn, Heidi, Ryan, Matthew, Taylor, Dylan, Dodd, Matthew, Spertus, John A., Kosiborod, Mikhail N., Docherty, Kieran F., Clayton, Tim, and Petrie, Mark C.

Published
2024
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2. Arrhythmia and Death Following Percutaneous Revascularization in Ischemic Left Ventricular Dysfunction: Prespecified Analyses From the REVIVED-BCIS2 Trial

Author

Perera, Divaka, Morgan, Holly P., Ryan, Matthew, Dodd, Matthew, Clayton, Tim, O’Kane, Peter D., Greenwood, John P., Walsh, Simon J., Weerackody, Roshan, McDiarmid, Adam, Amin-Youssef, George, Strange, Julian, Modi, Bhavik, Lockie, Timothy, Hogrefe, Kai, Ahmed, Fozia Z., Behan, Miles, Jenkins, Nicholas, Abdelaal, Eltigani, Anderson, Michelle, Watkins, Stuart, Evans, Richard, Rinaldi, Christopher A., Petrie, Mark C., Perera, Divaka, Chiribiri, Amedeo, Carr-White, Gerry, Pavlidis, Antonis, Redwood, Simon, Clapp, Brian, Rinaldi, Aldo, Rahman, Haseeb, Briceno, Natalia, Arnold, Sophie, Raynsford, Amy, Wilson, Karen, Clack, Lucy, Petrie, Mark, McEntegart, Margaret, Watkins, Stuart, Shaukat, Aadil, Rocchiccioli, Paul, McAdam, Marion, McPherson, Elizabeth, Cowan, Louise, Wood, Marie, Weerackody, Roshan, Davies, Ceri, Smith, Elliot, Modi, Bhavik, Mathew, Bindu, Mitchelmore, Oliver, Adrego, Rita, Andiapen, Mervyn, O’Kane, Peter, Din, Jehangir, Kennard, Sarah, Orr, Sarah, Purnell, Cathie, Greenwood, John, Blaxill, Jonathan, Mozid, Abdul, Anderson, Michelle, Somers, Kathryn, Dixon, Lana, Walsh, Simon, Spence, Mark, Glover, Patricia, Brown, Caroline, Edwards, Richard, McDiarmid, Adam, Egred, Mohaned, Narytnyk, Alla, Wealleans, Vera, Amin-Youssef, George, Shah, Ajay, McDonagh, Theresa, Byrne, Jonathan, Pareek, Nilesh, Breeze, Jonathan, Antao, Catherine, De Silva, Kalpa, Strange, Julian, Johnson, Tom, Nightingale, Angus, Gallego, Laura, Medina, Cristina, Gershlick, Anthony, McCann, Gerald, Ladwiniec, Andrew, Squire, Iain, Davison, Joanna, Kenmuir-Hogg, Kris, Spratt, James, Cosgrove, Claudia, Williams, Rupert, Firoozi, Sam, Lim, Pitt, Bonato, Giovanna, Sookhoo, Vennessa, Conway, Dwayne, Brooksby, Paul, Wright, Judith, Exley, Donna, Cotton, James, Horton, Richard, Metherell, Stella, Smallwood, Andrew, Hogrefe, Kai, Cheng, Adrian, Beirnes, Charmaine, Sidgwick, Sian, Lockie, Tim, Patel, Niket, Rakhit, Roby, Davies, Nina, Smit, Angelique, Ahmed, Fozia, Hendry, Cara, Fath-Odoubadi, Farzin, Fraser, Douglas, Mamas, Mamas, Oommen, Anu, Charles, Thabitha, Behan, Miles, Japp, Alan, Rif, Belinda, Jenkins, Nicholas, McClure, Sam, Oates, Pauline, Martin, Karen, Abdelaal, Eltigani, Sarma, Jaydeep, Shastri, Sanjay, Riley, Jo, Giannopoulou, Sarra, Quinn, Sophie, Magapu, Pradeep, Stables, Rod, Wright, David, Barton, Janet, Clarkson, Nichola, Mahmoudi, Michael, Flett, Andrew, Curzen, Nick, Radmore, Judith, Gough, Sam, Ludman, Andrew, Kurdi, Hibba, Keenan, Samantha, Banerjee, Prithwish, Tapp, Luke, Edwards, Nigel, Gibson, Catherine, Kukreja, Neville, Lynch, Mary, Barratt, Claire, de Belder, Mark, Thambyrajah, Jeet, Swanson, Neil, Richardson, Cath, Atkinson, Bev, Viswanathan, Girish, Waugh, Darren, Routledge, Helen, Trevelyan, Jasper, Doughty, Angela, Pegge, Nick, Dhamrait, Sukhbir, Moore, Sally, Galasko, Gavin, Cassidy, Christopher, Waddington, Natalia, Edwards, Tim, Iqbal, Javed, Witherow, Fraser, Birch, Jenny, Munro, Melanie, Wells, Tim, Sinha, Manas, Frost, Linda, Lee, Kaeng, Beattie, James, Pitt, Mike, Chung, Alan, Ramcharitar, Steve, McCafferty, Laura, Martin, Thomas, Irving, John, Iskandar, Zaid, Hutcheon, Anita, Gunn, Julian, Al-Mohammad, Abdallah, Agyemang, Michael, Griffiths, Huw, Kalra, Paul, Howe, Serena, Gray, Tim, Sobolewska, Jolanta, Morby, Louise, Glover, Jason, Beynon, James, Knight, Janet, Das, Paul, Bellamy, Chris, Harman, Emily, Pye, Maurice, Megarry, Simon, McGill, Yvonne, and Redfearn, Heidi

Published
2023
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3. Effect of PCI on Health Status in Ischemic Left Ventricular Dysfunction

Author

Ryan, Matthew, Taylor, Dylan, Dodd, Matthew, Spertus, John A., Kosiborod, Mikhail N., Shaukat, Aadil, Docherty, Kieran F., Clayton, Tim, Perera, Divaka, Petrie, Mark C., Perera, Divaka, Chiribiri, Amedeo, Carr-White, Gerry, Pavlidis, Antonis, Redwood, Simon, Clapp, Brian, Rinaldi, Aldo, Rahman, Haseeb, Briceno, Natalia, Arnold, Sophie, Raynsford, Amy, Wilson, Karen, Clack, Lucy, Petrie, Mark, McEntegart, Margaret, Watkins, Stuart, Shaukat, Aadil, Rocchiccioli, Paul, McAdam, Marion, McPherson, Elizabeth, Cowan, Louise, Wood, Marie, Weerackody, Roshan, Davies, Ceri, Smith, Elliot, Modi, Bhavik, Mathew, Bindu, Mitchelmore, Oliver, Adrego, Rita, Andiapen, Mervyn, O’Kane, Peter, Din, Jehangir, Kennard, Sarah, Orr, Sarah, Purnell, Cathie, Greenwood, John, Blaxill, Jonathan, Mozid, Abdul, Anderson, Michelle, Somers, Kathryn, Dixon, Lana, Walsh, Simon, Spence, Mark, Glover, Patricia, Brown, Caroline, Edwards, Richard, McDiarmid, Adam, Egred, Mohaned, Narytnyk, Alla, Wealleans, Vera, Amin-Youssef, George, Shah, Ajay, McDonagh, Theresa, Byrne, Jonathan, Pareek, Nilesh, Breeze, Jonathan, Antao, Catherine, De Silva, Kalpa, Strange, Julian, Johnson, Tom, Nightingale, Angus, Gallego, Laura, Medina, Cristina, Gershlick, Anthony, McCann, Gerald, Ladwiniec, Andrew, Squire, Iain, Davison, Joanna, Kenmuir-Hogg, Kris, Spratt, James, Cosgrove, Claudia, Williams, Rupert, Firoozi, Sam, Lim, Pitt, Bonato, Giovanna, Sookhoo, Vennessa, Conway, Dwayne, Brooksby, Paul, Wright, Judith, Exley, Donna, Cotton, James, Horton, Richard, Metherell, Stella, Smallwood, Andrew, Hogrefe, Kai, Cheng, Adrian, Beirnes, Charmaine, Sidgwick, Sian, Lockie, Tim, Patel, Niket, Rakhit, Roby, Davies, Nina, Smit, Angelique, Ahmed, Fozia, Hendry, Cara, Fath-Odoubadi, Farzin, Fraser, Douglas, Mamas, Mamas, Oommen, Anu, Charles, Thabitha, Behan, Miles, Japp, Alan, Rif, Belinda, Jenkins, Nicholas, McClure, Sam, Oates, Pauline, Martin, Karen, Abdelaal, Eltigani, Sarma, Jaydeep, Shastri, Sanjay, Riley, Jo, Giannopoulou, Sarra, Quinn, Sophie, Magapu, Pradeep, Stables, Rod, Wright, David, Barton, Janet, Clarkson, Nichola, Mahmoudi, Michael, Flett, Andrew, Curzen, Nick, Radmore, Judith, Gough, Sam, Ludman, Andrew, Kurdi, Hibba, Keenan, Samantha, Banerjee, Prithwish, Tapp, Luke, Edwards, Nigel, Gibson, Catherine, Kukreja, Neville, Lynch, Mary, Barratt, Claire, de Belder, Mark, Thambyrajah, Jeet, Swanson, Neil, Richardson, Cath, Atkinson, Bev, Viswanathan, Girish, Waugh, Darren, Routledge, Helen, Trevelyan, Jasper, Doughty, Angela, Pegge, Nick, Dhamrait, Sukhbir, Moore, Sally, Galasko, Gavin, Cassidy, Christopher, Waddington, Natalia, Edwards, Tim, Iqbal, Javed, Witherow, Fraser, Birch, Jenny, Munro, Melanie, Wells, Tim, Sinha, Manas, Frost, Linda, Lee, Kaeng, Beattie, James, Pitt, Mike, Chung, Alan, Ramcharitar, Steve, McCafferty, Laura, Martin, Thomas, Irving, John, Iskandar, Zaid, Hutcheon, Anita, Gunn, Julian, Al-Mohammad, Abdallah, Agyemang, Michael, Griffiths, Huw, Kalra, Paul, Howe, Serena, Gray, Tim, Sobolewska, Jolanta, Morby, Louise, Glover, Jason, Beynon, James, Knight, Janet, Das, Paul, Bellamy, Chris, Harman, Emily, Pye, Maurice, Megarry, Simon, McGill, Yvonne, and Redfearn, Heidi

Abstract

In the REVIVED-BCIS2 (Revascularization for Ischemic Ventricular Dysfunction) trial, percutaneous coronary intervention (PCI) did not reduce the incidence of death or hospitalization for heart failure (HHF).

Published
2024
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4. Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial

Author

McManus, Richard J., Little, Paul, Stuart, Beth, Morton, Katherine, Raftery, James, Kelly, Jo, Bradbury, Katherine, Zhang, Jin, Zhu, Shihua, Murray, Elizabeth, May, Carl R., Mair, Frances S., Michie, Susan, Smith, Peter, Band, Rebecca, Ogburn, Emma, Allen, Julie, Rice, Cathy, Nuttall, Jacqui, Williams, Bryan, Yardley, Lucy, HOME BP investigators, Jones, Adam, Hussain, Ajmal, McHardy, Alistair, Harrison, Anna, LaLonde, Anna, Malik, Asim, Hernandez-Diaz, Basilio, Cranfield, Ben, Nicholson, Brian, Anandan, Carl, Neden, Catherine, Bobrow, Cathy, Evans, Chloe, Keast, Christopher, Henderson, Clare, Sutherland, Corrine, Kyte, Craig, Henderson, Dan, Noble, Debbie, Capo-Bianco, Ed, Williams, Edward, Shaw, Elizabeth, Mohri, Fatima, Asal, Gaurav, Dougall, Greig, Bhupal, Hardeep, Luckhurst, Heidi, Dosanjh, Hergeven, Nowell, Hilary, Brown, Jan, Flett, Jennifer, Barber, Julian, Rutter, Heather, Thompson, Julian, Ramanan, Kanjhana, Madronal, Karen, Malone, Karen, Etherington, Katie, Tsoi, Kenney, Knox, Kyle, Amin, Laila, Hirst, Lisa, Allen, Lucy, Skellern, Luke, Flynn, Lynne, McEwan, Lorne, Pugsley, Mark, Frassen, Marloes, Gaw, Matthew, Prendergast, Matthew, Wallard, Matthew, Faisal, Muhammad, Wooding, Nick, Lees, Nienke, Wainman, Paul, Nanda, Nithya, Moore, Patrick, Conley, Paul, Johnson, Paul, Wilson, Penny, Jacobs, Phillip, Whitbred, Pippa, Zamir, Rebecca, Reed, Richard, Tribley, Richard, Woof, Richard, Danson, Ruth, Lawes, Ruth, Gallagher, Sarah, Wadsworth, Sarah, Macanovic, Serge, Cartwright, Simon, Pettitt, Simon, Tucker, Simon, Doggett, Stephen, Sevenoaks, Tamsin, Watson, Tara, Talbot, Tess, Imrie, Ruth, Herbert, Thomas, Crockett, Tony, Wright, Tony, Sharma, Vanshika, Telford, Vicki, Almashta, Zaid, Cheng, Zelda, Ali, Zishan, Grube, Alice, Claxton, Andy, Asante, Barbara, Weare, Becki, McKee, Eleanor, Werrett, Bertha, Barwell, Carmel, Mulvihill, Carole, Sherwood, Caroline, MacDonald, Clare, Tabor, Dadirayi, Denning, Dawn, Roberts, Debbie, Adshead, Diane, Clarke, Gemma, Huntley, Heather, Pinder, Heather, Qasim, Irene, Merrison, Jane, King, Jill, Allison, Julie, Johal, Kam, Terry, Karen, Wood, Karine, Balmford, Kathryn, Barnes, Katie, Post, Katie, Bowden, Kelly-Marie, Edmunds, Kirsty, Whittle, Klaire, Peniket, Lara, Carnegie, Leann, Neale, Linda, Davey, Lisa, Bartlett, Liz, Smith, Louise, Clack, Lucy, Brown, Martina, McKenna, Naomi, Kay, Pam, Jacobs, Polly, Cutts, Rebecca, Pearse, Robert, Atkinson, Ruth, Barter, Sally, Mackie, Sally, Norris, Sam, Cook, Sandra, Elderfield, Sarah, Nzante, Sarah, Cronin, Sharon, Maslen, Sophie, Marchant, Stephanie, Wright, Stephanie, Keene, Sue, Smith, Sue, Cimelli, Suzie, Stone, Tracy, Joyce, Tricia, Le Marechal, Trudie, Kettle, Vicky, Osborne, Victoria, Cubiss, Wendy, Marsden, Wendy, Kowalczyk-Williams, Wioletta, and Bailey, Zoe

Abstract

Objective: The HOME BP (Home and Online Management and Evaluation of Blood Pressure) trial aimed to test a digital intervention for hypertension management in primary care by combining self-monitoring of blood pressure with guided self-management. Design: Unmasked randomised controlled trial with automated ascertainment of primary endpoint. Setting: 76 general practices in the United Kingdom. Participants: 622 people with treated but poorly controlled hypertension (>140/90 mm Hg) and access to the internet. Interventions: Participants were randomised by using a minimisation algorithm to self-monitoring of blood pressure with a digital intervention (305 participants) or usual care (routine hypertension care, with appointments and drug changes made at the discretion of the general practitioner; 317 participants). The digital intervention provided feedback of blood pressure results to patients and professionals with optional lifestyle advice and motivational support. Target blood pressure for hypertension, diabetes, and people aged 80 or older followed UK national guidelines. Main outcome measures: The primary outcome was the difference in systolic blood pressure (mean of second and third readings) after one year, adjusted for baseline blood pressure, blood pressure target, age, and practice, with multiple imputation for missing values. Results: After one year, data were available from 552 participants (88.6%) with imputation for the remaining 70 participants (11.4%). Mean blood pressure dropped from 151.7/86.4 to 138.4/80.2 mm Hg in the intervention group and from 151.6/85.3 to 141.8/79.8 mm Hg in the usual care group, giving a mean difference in systolic blood pressure of −3.4 mm Hg (95% confidence interval −6.1 to −0.8 mm Hg) and a mean difference in diastolic blood pressure of −0.5 mm Hg (−1.9 to 0.9 mm Hg). Results were comparable in the complete case analysis and adverse effects were similar between groups. Within trial costs showed an incremental cost effectiveness ratio of £11 ($15, €12; 95% confidence interval £6 to £29) per mm Hg reduction. Conclusions: The HOME BP digital intervention for the management of hypertension by using self-monitored blood pressure led to better control of systolic blood pressure after one year than usual care, with low incremental costs. Implementation in primary care will require integration into clinical workflows and consideration of people who are digitally excluded. Trial registration: ISRCTN13790648.

Published
2021

5. Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial

Author

McManus, Richard J, Little, Paul, Stuart, Beth, Morton, Katherine, Raftery, James, Kelly, Jo, Bradbury, Katherine, Zhang, Jin, Zhu, Shihua, Murray, Elizabeth, May, Carl R, Mair, Frances S, Michie, Susan, Smith, Peter, Band, Rebecca, Ogburn, Emma, Allen, Julie, Rice, Cathy, Nuttall, Jacqui, Williams, Bryan, Yardley, Lucy, Jones, Adam, Hussain, Ajmal, McHardy, Alistair, Harrison, Anna, LaLonde, Anna, Malik, Asim, Hernandez-Diaz, Basilio, Cranfield, Ben, Nicholson, Brian, Anandan, Carl, Neden, Catherine, Bobrow, Cathy, Evans, Chloe, Keast, Christopher, Henderson, Clare, Sutherland, Corrine, Kyte, Craig, Henderson, Dan, Noble, Debbie, Capo-Bianco, Ed, Williams, Edward, Shaw, Elizabeth, Mohri, Fatima, Asal, Gaurav, Dougall, Greig, Bhupal, Hardeep, Luckhurst, Heidi, Dosanjh, Hergeven, Nowell, Hilary, Brown, Jan, Flett, Jennifer, Barber, Julian, Rutter, Heather, Thompson, Julian, Ramanan, Kanjhana, Madronal, Karen, Malone, Karen, Etherington, Katie, Tsoi, Kenney, Knox, Kyle, Amin, Laila, Hirst, Lisa, Allen, Lucy, Skellern, Luke, Flynn, Lynne, McEwan, Lorne, Pugsley, Mark, Frassen, Marloes, Gaw, Matthew, Prendergast, Matthew, Wallard, Matthew, Faisal, Muhammad, Wooding, Nick, Lees, Nienke, Wainman, Paul, Nanda, Nithya, Moore, Patrick, Conley, Paul, Johnson, Paul, Wilson, Penny, Jacobs, Phillip, Whitbred, Pippa, Zamir, Rebecca, Reed, Richard, Tribley, Richard, Woof, Richard, Danson, Ruth, Lawes, Ruth, Gallagher, Sarah, Wadsworth, Sarah, Macanovic, Serge, Cartwright, Simon, Pettitt, Simon, Tucker, Simon, Doggett, Stephen, Sevenoaks, Tamsin, Watson, Tara, Talbot, Tess, Imrie, Ruth, Herbert, Thomas, Crockett, Tony, Wright, Tony, Sharma, Vanshika, Telford, Vicki, Almashta, Zaid, Cheng, Zelda, Ali, Zishan, Grube, Alice, Claxton, Andy, Asante, Barbara, Weare, Becki, McKee, Eleanor, Werrett, Bertha, Barwell, Carmel, Mulvihill, Carole, Sherwood, Caroline, MacDonald, Clare, Tabor, Dadirayi, Denning, Dawn, Roberts, Debbie, Adshead, Diane, Clarke, Gemma, Huntley, Heather, Pinder, Heather, Qasim, Irene, Merrison, Jane, King, Jill, Allison, Julie, Johal, Kam, Terry, Karen, Wood, Karine, Balmford, Kathryn, Barnes, Katie, Post, Katie, Bowden, Kelly-Marie, Edmunds, Kirsty, Whittle, Klaire, Peniket, Lara, Carnegie, Leann, Neale, Linda, Davey, Lisa, Bartlett, Liz, Smith, Louise, Clack, Lucy, Brown, Martina, McKenna, Naomi, Kay, Pam, Jacobs, Polly, Cutts, Rebecca, Pearse, Robert, Atkinson, Ruth, Barter, Sally, Mackie, Sally, Norris, Sam, Cook, Sandra, Elderfield, Sarah, Nzante, Sarah, Cronin, Sharon, Maslen, Sophie, Marchant, Stephanie, Wright, Stephanie, Keene, Sue, Smith, Sue, Cimelli, Suzie, Stone, Tracy, Joyce, Tricia, Le Marechal, Trudie, Kettle, Vicky, Osborne, Victoria, Cubiss, Wendy, Marsden, Wendy, Kowalczyk-Williams, Wioletta, and Bailey, Zoe

Subjects
Male, medicine.medical_specialty, General Practice, Psychological intervention, Blood Pressure, law.invention, Randomized controlled trial, law, Diabetes mellitus, Clinical endpoint, Humans, Medicine, Antihypertensive Agents, Aged, business.industry, Research, Self-Management, General Medicine, Blood Pressure Monitoring, Ambulatory, Middle Aged, medicine.disease, Telemedicine, United Kingdom, Confidence interval, Mean blood pressure, Blood pressure, Hypertension, Physical therapy, Female, Physical and Mental Health, business, Incremental cost-effectiveness ratio
Abstract

Objective The HOME BP (Home and Online Management and Evaluation of Blood Pressure) trial aimed to test a digital intervention for hypertension management in primary care by combining self-monitoring of blood pressure with guided self-management. Design Unmasked randomised controlled trial with automated ascertainment of primary endpoint. Setting 76 general practices in the United Kingdom. Participants 622 people with treated but poorly controlled hypertension (>140/90 mm Hg) and access to the internet. Interventions Participants were randomised by using a minimisation algorithm to self-monitoring of blood pressure with a digital intervention (305 participants) or usual care (routine hypertension care, with appointments and drug changes made at the discretion of the general practitioner; 317 participants). The digital intervention provided feedback of blood pressure results to patients and professionals with optional lifestyle advice and motivational support. Target blood pressure for hypertension, diabetes, and people aged 80 or older followed UK national guidelines. Main outcome measures The primary outcome was the difference in systolic blood pressure (mean of second and third readings) after one year, adjusted for baseline blood pressure, blood pressure target, age, and practice, with multiple imputation for missing values. Results After one year, data were available from 552 participants (88.6%) with imputation for the remaining 70 participants (11.4%). Mean blood pressure dropped from 151.7/86.4 to 138.4/80.2 mm Hg in the intervention group and from 151.6/85.3 to 141.8/79.8 mm Hg in the usual care group, giving a mean difference in systolic blood pressure of −3.4 mm Hg (95% confidence interval −6.1 to −0.8 mm Hg) and a mean difference in diastolic blood pressure of −0.5 mm Hg (−1.9 to 0.9 mm Hg). Results were comparable in the complete case analysis and adverse effects were similar between groups. Within trial costs showed an incremental cost effectiveness ratio of £11 ($15, €12; 95% confidence interval £6 to £29) per mm Hg reduction. Conclusions The HOME BP digital intervention for the management of hypertension by using self-monitored blood pressure led to better control of systolic blood pressure after one year than usual care, with low incremental costs. Implementation in primary care will require integration into clinical workflows and consideration of people who are digitally excluded. Trial registration ISRCTN13790648 .

Published
2020

6. The effect of coronary artery disease defined by quantitative coronary angiography and SYNTAX score upon outcome after transcatheter aortic valve implantation (TAVI) using the Edwards bioprosthesis

Author

Khawaja, Muhammed Zeeshan, primary, Asrress, Kaleab N., additional, Haran, Hari, additional, Arri, Saptal, additional, Nadra, Imad, additional, Bolter, Kirsty, additional, Wilson, Karen, additional, Clack, Lucy, additional, Hancock, Jane, additional, Young, Christopher P., additional, Bapat, Vinayak, additional, Thomas, Martyn, additional, and Redwood, Simon, additional

Published
2015
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