Skip to main content

Research Repository

Advanced Search

Telemonitoring based service redesign for the management of uncontrolled hypertension: multicentre randomised controlled trial

McKinstry, B.; Wild, S.; Pagliari, C.; Paterson, M.; Lewis, S.; Sheikh, A.; Krishan, A.; Stoddart, A.; Padfield, P.; McKinstry, Brian; Hanley, J.; Wild, Sarah; Pagliari, Claudia; Paterson, Mary; Lewis, Steff; Sheikh, Aziz; Krishan, Ashma; Stoddart, Andrew; Padfield, Paul


B. McKinstry

S. Wild

C. Pagliari

M. Paterson

S. Lewis

A. Sheikh

A. Krishan

A. Stoddart

P. Padfield

Brian McKinstry

Sarah Wild

Claudia Pagliari

Steff Lewis

Aziz Sheikh

Ashma Krishan

Andrew Stoddart

Paul Padfield


Objective To determine if an intervention consisting of telemonitoring and supervision by usual primary care clinicians of home self measured blood pressure and optional patient decision support leads to clinically important reductions in daytime systolic and diastolic ambulatory blood pressure in patients with uncontrolled blood pressure.

Design Multicentre randomised controlled trial.

Setting 20 primary care practices in south east Scotland.

Participants 401 people aged 29-95 years with uncontrolled blood pressure (mean daytime ambulatory measurement ≥135/85 mm Hg but ≤210/135 mm Hg).

Intervention Self measurement and transmission of blood pressure readings to a secure website for review by the attending nurse or doctor and participant, with optional automated patient decision support by text or email for six months.

Main outcome measures Blinded assessment of mean daytime systolic ambulatory blood pressure six months after randomisation.

Results 200 participants were randomised to the intervention and 201 to usual care; primary outcome data were available for 90% of participants (182 and 177, respectively). The mean difference in daytime systolic ambulatory blood pressure adjusted for baseline and minimisation factors between intervention and usual care was 4.3 mm Hg (95% confidence interval 2.0 to 6.5; P=0.0002) and for daytime diastolic ambulatory blood pressure was 2.3 mm Hg (0.9 to 3.6; P=0.001), with higher values in the usual care group. The intervention was associated with a mean increase of one general practitioner (95% confidence interval 0.5 to 1.6; P=0.0002) and 0.6 (0.1 to 1.0; P=0.01) practice nurse consultations during the course of the study.

Conclusions Supported self monitoring by telemonitoring is an effective method for achieving clinically important reductions in blood pressure in patients with uncontrolled hypertension in primary care settings. However, it was associated with increase in use of National Health Service resources. Further research is required to determine if the reduction in blood pressure is maintained in the longer term and if the intervention is cost effective

Journal Article Type Article
Online Publication Date May 24, 2013
Publication Date May 24, 2013
Deposit Date Mar 27, 2014
Publicly Available Date Mar 27, 2014
Print ISSN 0959-8138
Electronic ISSN 1756-1833
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 346
Issue may24
Article Number f3030
Keywords Hypertension; General practice; family medicine; Clinical trials (epidemiology);
Public URL
Publisher URL
Contract Date Mar 27, 2014


Telemonitoring Based Service Redesign For The Management Of Uncontrolled Hypertension: Multicentre Randomised Controlled Trial (accepted manuscript) (686 Kb)

Publisher Licence URL

Copyright Statement
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

You might also like

Downloadable Citations