Title:	OPtimising Treatment for MIld Systolic hypertension in the Elderly: a randomised controlled trial
Project Description:	The OPTiMISE trial is a multi-disciplinary and multi-institution programme of work on optimising treatment for mild systolic hypertension in the elderly. Due an ageing population and consequent increase in the number of people living with multiple chronic conditions, the proportion of the population taking multiple medications is on the rise. Hypertension is the number one co-morbid condition in older patients, and up to half of those aged 80 years or over are prescribed two or more antihypertensive medications. However, previous evidence suggests there is uncertainty as to whether large reductions in blood pressure in this age group are associated with benefit or harm. In our multi-centre, non-inferiority trial we will investigate the safety of antihypertensive medication reduction in 540 older patients (>80 years) with controlled blood pressure (systolic blood pressure <150mmHg). The trial will compare the proportion of patients with controlled blood pressure at follow-up in those randomised to a strategy of medication reduction with self-monitoring versus usual care (continued treatment). The proportion of patients having their medication reintroduced due to unsafe change in blood pressure and any changes in quality of life, functional independence, frailty or adverse events will be monitored as secondary outcomes. An important component of this work involves the use of qualitative approaches to explore key issues alongside the conduct of the trial, including what the barriers and facilitators are to medication reduction from the perspectives of patients and doctors, and how information is presented within recruitment appointments in the trial, and how this might impact on consent to participate. Overall, it is hoped that this work will establish whether medication reduction in older patients can be achieved safely and enable us to understand how the drivers of quality of life including medication burden and side effects balance any potential risks from changes in blood pressure.
Project organisation
Start date:	1st October 2016
End date:	1st May 2019
Contact person:	Dr Jenni Burt
Contact Details:	Primary Care Unit Institute of Public Health University Forvie Site, Robinson Way Cambridge Cambs CB2 0SR UK Telephone: 01223 330329 Fax: 01223 762515 E-mail: jab35@medschl.cam.ac.uk
Collaborative:	Dr James Sheppard, Prof Richard McManus, Prof Richard Hobbs, Prof Carl Heneghan, Dr Emma Ogburn, Dr Ly-Mee Yu, Prof Gary Ford (University of Oxford) Dr Jenni Burt, Prof Jonathan Mant, Dr John Benson (University of Cambridge) Dr Mark Lown, Prof Paul Little (University of Southampton) Dr Rupert Payne (University of Bristol, Bristol) Prof Richard Lindley (University of Sydney) Marney Williams, Lay patient advisor.
Funding information
Funding Organisation:	School for Primary Care Research
Funding Reference:
Funding Amount:	£534,382
Further Information, References and Publications