|Title:||Trial of the Effectiveness and cost effectiveness of Self-monitoring and Treatment of Blood Pressure in secondary prevention following Stroke or Transient Ischaemic Attack (TIA)|
|Project Description:||We will conduct a randomised controlled trial, the best approach, to test the hypothesis that in stroke and TIA patients who require BP control, those who do self-monitoring with or without self-treatment using a previously agreed treatment plan will have a better BP control, compared to routine care.|
|Background:||Stroke is one of the leading causes of death and disability world wide. High blood pressure levels in stroke or TIA patients increases future risk of events including heart attack. Blood pressure (BP) reduction has been shown to reduce this risk but its control is still poor in this patient group. Furthermore, the BP shows considerable variation from time to time and this makes it almost impossible for doctors to treat BP based on the clinic BP alone. Therefore, there has been a considerable interest shown by both patients and doctors in self measurement, which gives values that are much closer to the gold standard measurement of 24 hour recordings. Self monitoring BP levels are also better predictors of further stroke and heart attack than clinic measurements. There is also the convenience to the patient of not having to attend clinic regularly for BP checks, which may be particularly difficult for stroke patients.
However, there is currently little supervision or consultation involved in the process. Whether self-monitoring of BP with some individually tailored treatment would improve the BP control and hence further reduce the risk of stroke in people who have had a TIA and milder stoke is not known.
|Methodology description:||We will recruit study participants from the stroke services in Norfolk and follow them up at 6 months. We will compare stroke and TIA rates and estimate the future risk of heart disease and stroke over the next 10 years, and the cost effectiveness of this intervention, between these groups.
This study will provide rigorous scientific evidence that can be directly translated into clinical practice for the benefit of patients.
|UK ISRCT Number:||86192648|
|Start date:||1st April 2012|
|End date:||31st August 2016|
|Contact person:||Dr Ed Wilson|
|Contact Details:||Primary Care Unit
Institute of Public Health
University Forvie Site, Robinson Way
Fax: 01223 762515
|Collaborative:||Led by Prof Phyo Myint, Aberdeen, economists from the HSR group are leading the economic evaluation component.|
|Further Information, References and Publications|