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A randomised controlled trial of blood pressure self-monitoring in the management of hypertensive pregnancy. OPTIMUM-BP: A feasibility trial.

Authors
  • Pealing, Louise M1
  • Tucker, Katherine L2
  • Mackillop, Lucy H3
  • Crawford, Carole4
  • Wilson, Hannah5
  • Nickless, Alecia6
  • Temple, Eleanor7
  • Chappell, Lucy C8
  • McManus, Richard J9
  • 1 Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK. Electronic address: [email protected]
  • 2 Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK. Electronic address: [email protected]
  • 3 Women's Centre, Oxford University Hospitals NHS Foundation Trust, Level 6, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK. Electronic address: [email protected]
  • 4 Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK. Electronic address: [email protected]
  • 5 Department of Women and Children's Health, School of Life Course Sciences, King's College London, 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK. Electronic address: [email protected]
  • 6 Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK; Atmospheric Chemistry Research Group, School of Chemistry, University of Bristol, Cantock's Close BS8 1TS, UK. Electronic address: [email protected]
  • 7 Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK. Electronic address: [email protected]
  • 8 Department of Women and Children's Health, School of Life Course Sciences, King's College London, 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK. Electronic address: [email protected]
  • 9 Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK. Electronic address: [email protected]
Type
Published Article
Journal
Pregnancy hypertension
Publication Date
Oct 12, 2019
Volume
18
Pages
141–149
Identifiers
DOI: 10.1016/j.preghy.2019.09.018
PMID: 31618706
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To assess the feasibility of a blood pressure self-monitoring intervention for managing pregnancy hypertension. OPTIMUM-BP was an unmasked randomised controlled trial comparing a self-monitoring of blood pressure (SMBP) intervention versus usual care for the management of pregnancy hypertension. Women with chronic (CH) or gestational hypertension (GH) from 4 UK centres were randomised (2:1) intervention to control. Self-monitoring involved daily home blood pressure (BP) measurements, with recording via study diary or telemonitoring. Clinicians were invited to use the home readings in clinical and antihypertensive titration decisions. The primary outcomes were recruitment, retention, adherence and persistence with the intervention. Women from four UK centres were randomised: 158/222 (71%) of those approached agreed, comprising: 86 women with chronic hypertension (55 SMBP, 31 control) and 72 with gestational hypertension (49 SMBP, 23 control) of whom outcome data were available from 154 (97%) and were included in the analysis. The median (IQR) number of days with home BP readings per week were 5.5 (3.1-6.5) for those with chronic hypertension and 6.1 (4.5-6.7) with gestational hypertension. Participants persisted with the intervention for 80% or more of their time from enrolment until delivery in 86% (43/50) and 76% (38/49) of those with chronic and gestational hypertension respectively. Recorded clinic and study BPs were similar for both groups. This is the first randomised investigation of BP self-monitoring for the management of pregnancy hypertension and indicates that a large RCT would be feasible. Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.

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