Evidence map›Paper›PMID 36639797›Full record

ArticlePilot and feasibility studies2023

Towards an integrated blood pressure self-monitoring solution for stroke/TIA in Ireland: a mixed methods feasibility study for the TASMIN5S IRL randomised controlled trial.

R Doogue, P Hayes, R Hebert, A Sheikhi, T Rai, K Morton, C Roman, R J McManus, L G Glynn

Abstract read
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In one paragraph

Article in Pilot and feasibility studies, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

3 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
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

9 authors.

R DoogueSchool of Medicine, University of Limerick, Limerick, Ireland. roisin.doogue@ul.ie.ORCID http://orcid.org/0000-0002-4539-3982
P HayesSchool of Medicine, University of Limerick, Limerick, Ireland.
R HebertSchool of Medicine, University of Limerick, Limerick, Ireland.
A SheikhiHealth Research Institute, University of Limerick, Limerick, Ireland.
T RaiNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
K MortonCentre for Clinical and Community Applications of Health Psychology, School of Psychology, University of Southampton, Southampton, SO17 1BJ, UK.
C RomanInstitute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK.
R J McManusNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
L G GlynnSchool of Medicine, University of Limerick, Limerick, Ireland.

Funding

The Identification of Tangier Disease &HSN-1 GenesK08NS002017 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI O'NEILL, GILMORE · 1997 to 2002
$260k
Health Research Board Ireland ScholarshipStroke Association UK TSA BHF 2017/01
6 · The paper itself

Abstract

backgroundOptimising blood pressure (BP) control is one of the most important modifiable risk factors in preventing subsequent stroke where the risk increases by one-third for every 10 mmHg rise in systolic BP. This study evaluated the feasibility and potential effectiveness of blood pressure self-monitoring with planned medication titration, to inform a definitive trial of the intervention, in patients with a previous stroke or transient ischaemic attack (TIA).

methodsPatients with a history of stroke/TIA and sub-optimal BP control were invited to take part in a mixed methods feasibility study for a randomised controlled trial. Those meeting the inclusion criteria with systolic BP >130 mmHg were randomised to a self-monitoring intervention group or usual care group. The intervention involved self-monitoring BP twice a day for 3 days within a 7-day period, every month, following text message reminders. Treatment escalation, based on a pre-agreed plan by the general practitioner (GP) and patient, was initiated according to the results of these readings. Semi-structured interviews were carried out with patients and clinicians and analysed thematically.

resultsOf those identified, 47% (32/68) attended for assessment. Of those assessed, 15 were eligible for recruitment and were consented and randomised to the intervention or control group on a 2:1 basis. Of those randomised, 93% (14/15) completed the study and there were no adverse events. Systolic BP was lower in the intervention group at 3 months. Participants found the intervention acceptable and easy to use. GPs found it easy to incorporate into their practice activity without increasing workload.

conclusionsTASMIN5S, an integrated blood pressure self-monitoring intervention in patients with a previous stroke/TIA, is feasible and safe to deliver in primary care. A pre-agreed three-step medication titration plan was easily implemented, increased patient involvement in their care, and had no adverse effects. This feasibility study provides important information to inform a definitive trial to determine the potential effectiveness of the intervention in patients post-stroke or TIA.

trial registrationISRCTN57946500 . Registered on 12/08/2019.

Indexed as

Blood pressureFeasibility studiesQualitative researchRandomised controlled trialSelf-monitoringStroke

Identifiers

PMID36639797
PMCPMC9837752

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Registered trials

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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.