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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT03005470
Other study ID # CAAE: 31423214.0.0000.5327
Secondary ID
Status Active, not recruiting
Phase Phase 3
First received December 23, 2016
Last updated April 24, 2018
Start date January 2017
Est. completion date February 2019

Study information

Verified date April 2018
Source Hospital de Clinicas de Porto Alegre
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

National and international guidelines that guide evidence-based clinical practice advocate an effort to improve blood pressure control based on changing lifestyle and use of blood pressure lowering medication. However, the effectiveness of the approach usually depends on patient adherence to both types of interventions - pharmacological and behavioral. Lack of success on blood pressure control has increased the scope of interventions to improve adherence and to reduce cardiovascular risk factors without overburdening the public health system. The use of technologies - mobile or smart phones, games, blogs, internet and video conferencing - to implement interventions can reduce costs and increase coverage.

Interactive interventions have been associated with a reduction in systolic blood pressure of 3-8 mmHg in patients with hypertension. These interventions were individually tailored to patient specificities and involved self-monitoring of blood pressure and lifestyle changes, including regular physical activity, DASH diet, restriction of dietary salt intake, and weight control. However, the effectiviness of these interventions may have short half-lives without periodic reinforcement, either to adhere to pharmacological treatment or behavioral changes. Innovative technologies can be used to achieve lasting effect and even greater blood pressure reduction.

Therefore, the purpose of this study is to compare effectiveness of four strategies to reduce blood pressure and improve lifestyle.


Description:

This is a factorial randomized controlled trial of comparative effectiveness and precision medicine. Participants will be randomly assigned in a ratio of 1:1:2:1 to one of four arms: telemonitoring of blood pressure by smart phone, text message for lifestyle changes, both interventions (telemonitoring and messages) or usual clinical care. At randomization, all participants will receive a printed booklet with lifestyle modification guidelines. The standardized recommendation to adhere to the pharmacological treatment prescribed by the attending physician will also be implemented. These types of interventions do not allow the research assistant responsible for monitoring to be blinded, but the researcher resposible for the assessment of the outcome will be blinded to the allocated arm and the results will be evaluated through objective measurements.


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 231
Est. completion date February 2019
Est. primary completion date February 2019
Accepts healthy volunteers No
Gender All
Age group 30 Years to 75 Years
Eligibility Inclusion Criteria:

- Office blood pressure: systolic blood pressure greater or equal to 135 mmHg and below 180 mmHg or diastolic blood pressure greater or equal to 85 mmhg and below 110 mmhg

- Ambulatory Blood Pressure Monitoring (ABPM): 24h-SBP =130 mmHg or 24h-DBP =80 mmHg

- Use of one or two blood pressure lowering drugs

- Have a smartphone

Exclusion Criteria:

- Cardiovascular event in the last 6 months (eg myocardial infarction, stroke, pacemaker or other use)

- Life threatening conditions, low life expectancy

- Inability to measure blood pressure;

- Previous diagnosis of secondary hypertension;

- IF WOMAN: lactating, pregnancy or who intend to become pregnant within the next 6 months.

- Unable to understand the interventions

Study Design


Related Conditions & MeSH terms


Intervention

Device:
TELEM
Participants in the telemonitoring home blood pressure (TELEM) group will receive an oscillometric monitor to measure blood pressure at home for six months. Measurements will be made early in the morning (5:00 to 10:00) and in the evening (18:00 to 21:00) for at least five days a week (including one day during the weekend). Each blood pressure measure will be sent to the center of the study coordination center through software downloaded on the participant's smartphone.
TELEMEV
In the lifestyle telemonitoring group (TELEMEV), participants will receive customized standardized text messages to stimulate lifestyle changes and adherence to blood pressure lowering medication. The messages will be focused on the adoption of DASH diet, sodium restriction, increase of physical activity, weight control and adherence to drug treatment. They will be sent out on four of the five days of the week at random times. The messages will be sent to the smarphones through a software developed for this study.
TELEM-TELEMEV
Participants in the TELEM plus TELEMEV (TELEM-TELEMEV) will receive both interventions as previously described.
Other:
UCT
Participants in the control group will receive usual clinical treatment (UCT) on pre-scheduled visits, but will not receive any technological tool to stimulate blood pressure control or lifestyle modification.

Locations

Country Name City State
Brazil Hospital de Clinicas de Porto Alegre Porto Alegre RS

Sponsors (2)

Lead Sponsor Collaborator
Hospital de Clinicas de Porto Alegre Federal University of Rio Grande do Sul

Country where clinical trial is conducted

Brazil, 

Outcome

Type Measure Description Time frame Safety issue
Primary Ambulatory blood pressure monitoring (ABPM) Reduction in 24h-systolic blood pressure Change at six months (end of the trial)
Secondary ABPM Reduction in 24h-diastolic blood pressure Change at six months (end of the trial)
Secondary Other ABPM measurements Reduction in daytime and nighttime systolic blood pressure Change from baseline to end of the trial
Secondary Office blood pressure Office blood pressure control rate: <130/80 mmHg At six months (end of the trial)
Secondary Reduction in sodium urinary excretion Reduction in sodium urinary excretion in a urinary spot Change at six months (end of the trial)
Secondary Improvement of lifestyle: increase of regular physical activity, intake of DASH-type diet, or weight reduction Increase in average steps taken during 7 days, using pedometer; reported dietary intake using 24h recall of food groups; reduction of reported intake, using a quantitative questionnaire; or reduction of at least 3 kg or the average reduction Change at six months (end of the trial)
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