Evidence map›Paper›PMID 23709583›Full record

Trial reportBMJ (Clinical research ed.)2013

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

Brian McKinstry, Janet Hanley, Sarah Wild, Claudia Pagliari, Mary Paterson, Steff Lewis, Aziz Sheikh, Ashma Krishan, Andrew Stoddart, Paul Padfield

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 99 papers, 30 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
99citing papers in PubMed, 30 pooled it
10.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

99 citing papers in PubMed, 30 syntheses or guidelines pooled it, 199 citations in OpenAlex.

  1. Pooled it
  2. Impact of patient care teams on blood pressure control in patients with hypertension: a systematic review and meta-analysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
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  18. Guideline
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  20. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019).Hypertension research : official journal of the Japanese Society of Hypertension · 2019
    Guideline

39 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Brian McKinstryCentre for Population Health Sciences, Medical School, University of Edinburgh, Edinburgh EH8 9AG, UK. brian.mckinstry@ed.ac.uk
Janet Hanley
Sarah Wild
Claudia Pagliari
Mary Paterson
Steff Lewis
Aziz Sheikh
Ashma Krishan
Andrew Stoddart
Paul Padfield
University of Edinburgh · GBEdinburgh Napier University · GBScottish Government · GB

Funding

Chief Scientist Office ARPG/07/03
6 · The paper itself

Abstract

objectiveTo 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.

designMulticentre randomised controlled trial.

setting20 primary care practices in south east Scotland.

participants401 people aged 29-95 years with uncontrolled blood pressure (mean daytime ambulatory measurement ≥ 135/85 mm Hg but ≤ 210/135 mm Hg).

interventionSelf 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 measuresBlinded assessment of mean daytime systolic ambulatory blood pressure six months after randomisation.

results200 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.

conclusionsSupported 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.

trial registrationCurrent Controlled Trials ISRCTN72614272.

Indexed as

AdultAgedAged, 80 and overAnalysis of VarianceAntihypertensive AgentsBlood Pressure Monitoring, AmbulatoryDecision Support Systems, ClinicalDisease ManagementFemaleHumansHypertensionMaleMiddle AgedPrimary Health CareProgram EvaluationSelf CareAntihypertensive Agents

Identifiers

PMID23709583
PMCPMC3663293
OpenAlexW2084930541

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.