Evidence map›Paper›PMID 33468518›Full record

Trial reportBMJ (Clinical research ed.)2021

Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial.

Richard J McManus, Paul Little, Beth Stuart, Katherine Morton, James Raftery, Jo Kelly, Katherine Bradbury, Jin Zhang, Shihua Zhu, Elizabeth Murray and 12 more

3 registry-linked trialsOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 143 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
143citing papers in PubMed, 14 pooled it
26.2field-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.

NCT06478732 nanot yet recruitingnot on this mapstarted 2024, after this paper: background citation

HeartMed-HF Digital Therapeutics Improves Exercise Capacity in Patients With Chronic Heart Failure After Acute Myocardial Infarction: an International, Multi-center, Randomized Controlled Clinical Trial

TypeinterventionalSponsorThe First Affiliated Hospital with Nanjing Medical UniversityRan2024 to 2026Enrolled710ConditionsHeart FailureArmshealth services
NCT07089290 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Effectiveness of Nurse-Led Telehealth Intervention for Hypertension Control in Nepal

TypeinterventionalSponsorKathmandu University School of Medical SciencesRan2025 to 2026Enrolled706ConditionsHypertension Combined Diastolic and SystolicArmsNurse-led Telehealth Intervention
NCT07397260 naenrolling by invitationnot on this mapstarted 2026, after this paper: background citation

Effects of Manually Recorded or Automatically Transmitted Home Blood Pressures With or Without Automated Patient Feedback on Hypertension Care

TypeinterventionalSponsorNorthwestern UniversityRan2026 to 2028Enrolled1,304ConditionsHypertension (HTN)ArmsSelf report of home measured blood pressure via patient EHR portal, Automated feedback about home blood pressure results, Automated Transmission of Remotely Measured Blood Pressure
3 · Its place in the literature

Who cites it

143 citing papers in PubMed, 14 syntheses or guidelines pooled it, 233 citations in OpenAlex.

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  18. Phone-based telemonitoring of arterial hypertension versus usual care: the HOROSCOPE study.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
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83 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

22 authors at 8 institutions in 1 country.

Richard J McManusNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK richard.mcmanus@phc.ox.ac.uk.ORCID 0000-0003-3638-028X
Paul LittlePrimary Care and Population Sciences Unit, University of Southampton, Southampton, UK.
Beth StuartPrimary Care and Population Sciences Unit, University of Southampton, Southampton, UK.
Katherine MortonSchool of Psychology, University of Southampton, Southampton, UK.
James RafteryPrimary Care and Population Sciences Unit, University of Southampton, Southampton, UK.
Jo KellyPrimary Care and Population Sciences Unit, University of Southampton, Southampton, UK.
Katherine BradburySchool of Psychology, University of Southampton, Southampton, UK.
Jin ZhangSchool of Psychology, University of Southampton, Southampton, UK.
Shihua ZhuPrimary Care and Population Sciences Unit, University of Southampton, Southampton, UK.
Elizabeth MurrayeHealth Unit, Research Department of Primary Care and Population Health Sciences, University College London, London, UK.
Carl R MayFaculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Frances S MairGeneral Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Susan MichieUCL Centre for Behaviour Change, University College London, London, UK.
Peter SmithPrimary Care and Population Sciences Unit, University of Southampton, Southampton, UK.
Rebecca BandSchool of Psychology, University of Southampton, Southampton, UK.
Emma OgburnNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.
Julie AllenNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.
Cathy RicePatient and Public Contributor, Bristol, UK.
Jacqui NuttallSouthampton Clinical Trials Unit, University of Southampton, Southampton, UK.
Bryan WilliamsInstitute of Cardiovascular Sciences, NIHR UCL Hospitals Biomedical Research Centre, University College London, London, UK.
Lucy YardleySchool of Psychology, University of Southampton, Southampton, UK.
HOME BP investigators
University of Southampton · GBUniversity of Oxford · GBUniversity College London · GBAt Bristol · GBLondon School of Hygiene & Tropical Medicine · GBUCL Biomedical Research Centre · GBUniversity of Bristol · GBUniversity of Glasgow · GB

Funding

Department of Health NIHR-RP-02-12-015Department of Health RP-PG-1211-20001Medical Research Council MC_PC_13090
6 · The paper itself

Abstract

objectiveThe HOME BP (Home and Online Management and Evaluation of Blood Pressure) trial aimed to test a digital intervention for hypertension management in primary care by combining self-monitoring of blood pressure with guided self-management.

designUnmasked randomised controlled trial with automated ascertainment of primary endpoint.

setting76 general practices in the United Kingdom.

participants622 people with treated but poorly controlled hypertension (>140/90 mm Hg) and access to the internet.

interventionsParticipants were randomised by using a minimisation algorithm to self-monitoring of blood pressure with a digital intervention (305 participants) or usual care (routine hypertension care, with appointments and drug changes made at the discretion of the general practitioner; 317 participants). The digital intervention provided feedback of blood pressure results to patients and professionals with optional lifestyle advice and motivational support. Target blood pressure for hypertension, diabetes, and people aged 80 or older followed UK national guidelines.

main outcome measuresThe primary outcome was the difference in systolic blood pressure (mean of second and third readings) after one year, adjusted for baseline blood pressure, blood pressure target, age, and practice, with multiple imputation for missing values.

resultsAfter one year, data were available from 552 participants (88.6%) with imputation for the remaining 70 participants (11.4%). Mean blood pressure dropped from 151.7/86.4 to 138.4/80.2 mm Hg in the intervention group and from 151.6/85.3 to 141.8/79.8 mm Hg in the usual care group, giving a mean difference in systolic blood pressure of -3.4 mm Hg (95% confidence interval -6.1 to -0.8 mm Hg) and a mean difference in diastolic blood pressure of -0.5 mm Hg (-1.9 to 0.9 mm Hg). Results were comparable in the complete case analysis and adverse effects were similar between groups. Within trial costs showed an incremental cost effectiveness ratio of £11 ($15, €12; 95% confidence interval £6 to £29) per mm Hg reduction.

conclusionsThe HOME BP digital intervention for the management of hypertension by using self-monitored blood pressure led to better control of systolic blood pressure after one year than usual care, with low incremental costs. Implementation in primary care will require integration into clinical workflows and consideration of people who are digitally excluded.

trial registrationISRCTN13790648.

Indexed as

Self-ManagementAgedAntihypertensive AgentsBlood PressureBlood Pressure Monitoring, AmbulatoryFemaleGeneral PracticeHumansHypertensionMaleMiddle AgedTelemedicineUnited KingdomAntihypertensive Agents

Identifiers

PMID33468518
PMCPMC7814507
OpenAlexW3048383434

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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.