Is blood pressure self-monitoring for the management of pre-hypertension feasible and acceptable: the REVERSE study?

Conference:

SAPC ASM 2024 - Bristol

Talk Code:

6D.2

Presenter:

Emma Bray

Twitter:

@DrEmmaBray

Co-authors:

Emma Bray, Valerio Benedetto, Lucy Hives, Nefyn Williams, Paul Rutter, Andrew Clegg, Calvin Heal, Julie Cook, Clare Thetford, Paul Heyworth, Caroline Watkins

Author institutions:

University of Central Lancashire, University of Liverpool, University of Portsmouth, University of Manchester

Problem

Prehypertension (PHT) currently affects around 40% of UK adults and is directly associated with increased risk ofcardiovascular disease (CVD), as well as progression to hypertension itself. Lifestyle changes can reduce theserisks, but there is little evidence of what interventions are feasible, acceptable and effective. Previous research hasshown that self-monitoring of blood pressure (BP) is highly effective in managing hypertension. However, self-monitoring in PHT has not been systematically explored, nor do we know whether individuals in the PHT BP range, or healthcare professionals, would find self-monitoring BP feasible and acceptable for managing PHT.

Approach

A prospective, non-randomised , mixed-methods, feasibility study was conducted. Individuals with BP between 120-139/80-89mmHg identified from GP registers or pharmacy health checks were invited to participate. Participants home-monitored their BP for 6-months following a protocol. Outcome data were collected at baseline, 6- and 12-months. Semi-structured interviews were conducted with individuals and healthcare professionals (HCPs), and an evaluation survey sent to participants.

Findings

1501 people were invited to participate, 156 (10%) expressed an interest, 80 (80/156; 51%) were enrolled, and 75 (75/80; 94%) started self-monitoring. 66 (66/80; 83%) completed the 6-month follow-up. Although the overall recruitment target was not met, the GP target was exceeded. Despite acceptable levels of interest from pharmacies, their recruitment was poor.The sample lacked ethnic diversity (99% White) and most were well educated (56.4% >=degree-level) and from a high SES group (41%).Interview and survey data showed that HCPs and participants thought self-monitoring for PHT was feasible and acceptable. Minor concerns regarded future implementation. Valuable suggestions for future development were provided.

Consequences

REVERSE is feasible and acceptable in General Practice, but unlikely in pharmacy. Improvements to the diversity and inclusivity are vital. Useful information to inform a future effectiveness trial of self-monitoring of PHT was collected.

Submitted by:

Emma Bray

Funding acknowledgement:

This study is funded by the NIHR Research for Patent Benefit Programme (NIHR201028). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.