Efficient Self-management of Chronic Disease Using Health Information Technology - a Study on Hypertension

NCT ID: NCT03554382

Last Updated: 2025-02-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

971 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-10-01

Study Completion Date

2021-04-18

Brief Summary

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Background:

Hypertension is an increasing global problem and measures are needed against the emerging hypertensive burden. Management of the risk factor hypertension consists of medical treatment in conjunction with lifestyle adjustment, whereby lifestyle adjustment is the preventive cornerstone but has also been proven to contribute to BP reduction among those already receiving medical drug treatments. Non-adherence is a significant barrier to successful hypertension management.

Goal:

To improve management of hypertension in daily life from a person-centred perspective, utilizing information and communication technology, and further to decrease complications of hypertension. To increase the proportion of persons with hypertension obtaining a BP goal =\<140/90 mmHg and to conduct a health economic evaluation of our intervention.

Plan:

The investigators will conduct a multi-centre randomized controlled trial in 36 primary care centres in three counties in Sweden. There will be approximaely 430 patients in each group. BP will be measured in a standardized manner, laboratory tests taken and questionnaires answered at baseline, after eight weeks and after a year in both the intervention and the control group. Register data on health care resource one year before baseline and for the full study period will be retrieved for participants in both study groups.

Singificance:

The intervention is expected to improve adherence to treatment and a significant lowering of the blood pressure. Hospitalization rates are lower among persons with hypertension that adheres to their medication. By improving treatment of hypertension the hope is to decrease complications and morbidity due to hypertension and thereby hospitalization and health care costs. Due to the generic nature of the technology involved, the self-management system can easily be adapted to monitor other chronic conditions.

Detailed Description

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Conditions

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Hypertension High Blood Pressure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomization to study groups occurs after completion of informed consent, baseline assessments and questionnaires. Patients are randomly assigned in a 1:1 ratio to either the intervention group or the control group. The CONSORT-EHEALTH checklist will be followed.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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intervention

Daily use of interactive mobile phone-based system to support self-management of hypertension: a) relevant items on drug side effects related to patient's drug regimen; and b) blood pressure.

Group Type EXPERIMENTAL

system to support self-management of hypertension

Intervention Type OTHER

The patients are provided with a home BP monitor. Thereafter they will be asked to use the self-management support system and self-report, once daily in the evening, via their own mobile phone during eight weeks. At each occasion, the patients first answer the questions on wellbeing, symptoms, lifestyle, medication intake and side effects and then measure their BP and pulse, and when these data (mean of three readings) are input into the mobile phone, they automatically register in the database. During intervention the paient has regular access to self-reported data via graphs

Control

No study intervention will be made in the control group; they will receive "treatment as usual".

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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system to support self-management of hypertension

The patients are provided with a home BP monitor. Thereafter they will be asked to use the self-management support system and self-report, once daily in the evening, via their own mobile phone during eight weeks. At each occasion, the patients first answer the questions on wellbeing, symptoms, lifestyle, medication intake and side effects and then measure their BP and pulse, and when these data (mean of three readings) are input into the mobile phone, they automatically register in the database. During intervention the paient has regular access to self-reported data via graphs

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age 18 years or older
* Diagnosis of hypertension
* On treatment with at least one antihypertensive drug
* Understanding of Swedish in order to be able to provide informed consent and to make use of the mobile phone based self-management support system.
* Mobile phone (patients will use their own mobile, but have the possibility to borrow one if needed)
* Patient at a primary healthcare centre in any of four participating healthcare regions in Sweden (Skåne, Västra Götaland, Östergötland, and Jönköping)

Exclusion Criteria

* Secondary hypertension
* Terminal illness
* Pregnancy-induced hypertension
* Cognitive impairment
* Impaired vision (not able to read messages on mobile phone)
* Psychotic disease
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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the Kamprad Family Foundation

UNKNOWN

Sponsor Role collaborator

Swedish Heart Lung Foundation

OTHER

Sponsor Role collaborator

Clinical Studies Sweden - Forum South

UNKNOWN

Sponsor Role collaborator

Region Skane

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Patrik Midlöv, MD

Role: PRINCIPAL_INVESTIGATOR

Lund University

Locations

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Solklart vård i Bjuv

Bjuv, , Sweden

Site Status

Wetterhälsan

Jönköping, , Sweden

Site Status

Vårdcentralen Kärna

Linköping, , Sweden

Site Status

Adina Hälsans Vårdcentral Nol

Nol, , Sweden

Site Status

Countries

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Sweden

References

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Ekholm M, Andersson U, Nilsson PM, Kjellgren K, Midlov P. Evaluation of self-monitoring of blood pressure in the PERHIT study and the impact on glomerular function. Blood Press. 2024 Dec;33(1):2399565. doi: 10.1080/08037051.2024.2399565. Epub 2024 Sep 9.

Reference Type DERIVED
PMID: 39250514 (View on PubMed)

Vestala H, Bendtsen M, Midlov P, Kjellgren K, Eldh AC. Is patient participation in hypertension care based on patients' preferences? A cross-sectional study in primary healthcare. Eur J Cardiovasc Nurs. 2024 Dec 16;23(8):903-911. doi: 10.1093/eurjcn/zvae085.

Reference Type DERIVED
PMID: 38805264 (View on PubMed)

Andersson U, Nilsson PM, Kjellgren K, Harris K, Chalmers J, Ekholm M, Midlov P. Variability in home blood pressure and its association with renal function and pulse pressure in patients with treated hypertension in primary care. J Hum Hypertens. 2024 Mar;38(3):212-220. doi: 10.1038/s41371-023-00874-2. Epub 2023 Nov 15.

Reference Type DERIVED
PMID: 37968455 (View on PubMed)

Andersson U, Nilsson PM, Kjellgren K, Hoffmann M, Wennersten A, Midlov P. PERson-centredness in Hypertension management using Information Technology: a randomized controlled trial in primary care. J Hypertens. 2023 Feb 1;41(2):246-253. doi: 10.1097/HJH.0000000000003322. Epub 2022 Nov 18.

Reference Type DERIVED
PMID: 36394295 (View on PubMed)

Andersson U, Bengtsson U, Ranerup A, Midlov P, Kjellgren K. Patients and Professionals as Partners in Hypertension Care: Qualitative Substudy of a Randomized Controlled Trial Using an Interactive Web-Based System Via Mobile Phone. J Med Internet Res. 2021 Jun 3;23(6):e26143. doi: 10.2196/26143.

Reference Type DERIVED
PMID: 34081021 (View on PubMed)

Other Identifiers

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PERHIT

Identifier Type: -

Identifier Source: org_study_id

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