Skip to main content
Top
Published in: Trials 1/2010

Open Access 01-12-2010 | Study protocol

Does a colour-coded blood pressure diary improve blood pressure control for patients in general practice: The CoCo trial

Authors: Claudia Steurer-Stey, Marco Zoller, Corinne Chmiel Moshinsky, Oliver Senn, Thomas Rosemann

Published in: Trials | Issue 1/2010

Login to get access

Abstract

Background

Insufficient blood pressure control is a frequent problem despite the existence of effective treatment. Insufficient adherence to self-monitoring as well as to therapy is a common reason. Blood pressure self-measurement at home (H ome B lood P ressure M easurement, HBPM) has positive effects on treatment adherence and is helpful in achieving the target blood pressure. Only a few studies have investigated whether adherence to HBPM can be improved through simple measures resulting also in better blood pressure control.

Objective

Improvement of self-monitoring and improved blood pressure control by using a new colour-coded blood pressure diary.

Outcome

Primary outcome: Change in systolic and/or diastolic blood pressure 6 months after using the new colour-coded blood pressure diary.
Secondary outcome: Adherence to blood pressure self-measurement (number of measurements/entries).

Methods/Design

Randomised controlled study.
Population: 138 adult patients in primary care with uncontrolled hypertension despite therapy. The control group uses a conventional blood pressure diary; the intervention group uses the new colour-coded blood pressure diary (green, yellow, red according a traffic light system).

Expected results/conclusion

The visual separation and entries in three colour-coded areas reflecting risk (green: blood pressure in the target range ≤ 140/≤ 90 mmHg, yellow: blood pressure >140/>90 mmHg, red: blood pressure in danger zone > 180 mmHg/>110 mmHg) lead to better self-monitoring compared with the conventional (non-colour-coded) blood pressure booklet. The colour-coded, visualised information supports improved perception (awareness and interpretation) of blood pressure and triggers correct behaviour, in the means of improved adherence to the recommended treatment as well as better communication between patients and doctors resulting in improved blood pressure control.

Trial registration

ClinicalTrials.gov ID NCT01013467
Appendix
Available only for authorised users
Literature
1.
go back to reference Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, Roccella EJ, National Heart, and Lung, Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, National High Blood Pressure Education Program Coordinating Committee: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003, 289 (19): 2560-2572. 10.1001/jama.289.19.2560.CrossRefPubMed Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, Roccella EJ, National Heart, and Lung, Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, National High Blood Pressure Education Program Coordinating Committee: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003, 289 (19): 2560-2572. 10.1001/jama.289.19.2560.CrossRefPubMed
2.
go back to reference 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens. 2003, 21 (6): 1011-1053. 10.1097/00004872-200306000-00001. 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens. 2003, 21 (6): 1011-1053. 10.1097/00004872-200306000-00001.
3.
go back to reference Wolf-Maier K, Cooper RS, Kramer H, Banegas JR, Giampaoli S, Joffres MR, Poulter N, Primatesta P, Stegmayr B, Thamm M: Hypertension treatment and control in five European countries, Canada, and the United States. Hypertension. 2004, 43 (1): 10-17. 10.1161/01.HYP.0000103630.72812.10.CrossRefPubMed Wolf-Maier K, Cooper RS, Kramer H, Banegas JR, Giampaoli S, Joffres MR, Poulter N, Primatesta P, Stegmayr B, Thamm M: Hypertension treatment and control in five European countries, Canada, and the United States. Hypertension. 2004, 43 (1): 10-17. 10.1161/01.HYP.0000103630.72812.10.CrossRefPubMed
6.
go back to reference Schroeder K, Fahey T, Ebrahim S: How can we improve adherence to blood pressure-lowering medication in ambulatory care? Systematic review of randomized controlled trials. Archives of Internal Medicine. 2004, 164 (7): 722-732. 10.1001/archinte.164.7.722.CrossRefPubMed Schroeder K, Fahey T, Ebrahim S: How can we improve adherence to blood pressure-lowering medication in ambulatory care? Systematic review of randomized controlled trials. Archives of Internal Medicine. 2004, 164 (7): 722-732. 10.1001/archinte.164.7.722.CrossRefPubMed
7.
go back to reference Patienten-Adherence - Möglichkeiten zur Verbesserung. Schweizerische Rundschau fur Medizin Praxis. 1995, 3: 58-62. Patienten-Adherence - Möglichkeiten zur Verbesserung. Schweizerische Rundschau fur Medizin Praxis. 1995, 3: 58-62.
8.
go back to reference Bender B, Milgrom H, Apter A: Adherence intervention research: What have we learned and what do we do next?. Journal of Allergy and Clinical Immunology. 2003, 112 (3): 489-494. 10.1016/S0091-6749(03)01718-4.CrossRefPubMed Bender B, Milgrom H, Apter A: Adherence intervention research: What have we learned and what do we do next?. Journal of Allergy and Clinical Immunology. 2003, 112 (3): 489-494. 10.1016/S0091-6749(03)01718-4.CrossRefPubMed
9.
go back to reference Osterberg L, Blaschke T: Adherence to medication. New England Journal of Medicine. 2005, 353 (5): 487-497. 10.1056/NEJMra050100.CrossRefPubMed Osterberg L, Blaschke T: Adherence to medication. New England Journal of Medicine. 2005, 353 (5): 487-497. 10.1056/NEJMra050100.CrossRefPubMed
10.
go back to reference Schroeder K, Fahey T, Ebrahim S: Interventions for improving adherence to treatment in patients with high blood pressure in ambulatory settings. Cochrane Database of Systematic Reviews. 2004, CD004804-2 Schroeder K, Fahey T, Ebrahim S: Interventions for improving adherence to treatment in patients with high blood pressure in ambulatory settings. Cochrane Database of Systematic Reviews. 2004, CD004804-2
11.
go back to reference Steiner A, Vetter W: Patienten-Compliance/-Non-Compliance, bestimmende Faktoren, Arzt-Patient-Interaktion. Schweizerische Rundschau fur Medizin Praxis. 1994, 83 (33): 889-894.PubMed Steiner A, Vetter W: Patienten-Compliance/-Non-Compliance, bestimmende Faktoren, Arzt-Patient-Interaktion. Schweizerische Rundschau fur Medizin Praxis. 1994, 83 (33): 889-894.PubMed
12.
go back to reference Steiner A, Vetter W: Patientencompliance - Begriffsbestimmung, Messmethoden. Schweizerische Rundschau fur Medizin Praxis. 1994, 83 (31): 841-845.PubMed Steiner A, Vetter W: Patientencompliance - Begriffsbestimmung, Messmethoden. Schweizerische Rundschau fur Medizin Praxis. 1994, 83 (31): 841-845.PubMed
13.
go back to reference Renders CM, Valk GD, Griffin SJ, Wagner EH, Eijk Van JT, Assendelft WJ: Interventions to improve the management of diabetes in primary care, outpatient, and community settings: a systematic review. Diabetes Care. 2001, 24 (10): 1821-1833. 10.2337/diacare.24.10.1821.CrossRefPubMed Renders CM, Valk GD, Griffin SJ, Wagner EH, Eijk Van JT, Assendelft WJ: Interventions to improve the management of diabetes in primary care, outpatient, and community settings: a systematic review. Diabetes Care. 2001, 24 (10): 1821-1833. 10.2337/diacare.24.10.1821.CrossRefPubMed
14.
go back to reference Houston Miller N, Hill M, Kottke T, Ockene IS: The multilevel compliance challenge: Recommendations for a call to action: A Statement for healthcare professionals. Circulation. 1997, 95 (4): 1085-1090.CrossRef Houston Miller N, Hill M, Kottke T, Ockene IS: The multilevel compliance challenge: Recommendations for a call to action: A Statement for healthcare professionals. Circulation. 1997, 95 (4): 1085-1090.CrossRef
15.
go back to reference Verberk WJ, Kroon AA, Kessels AGH, de Leeuw PW: Home blood pressure measurement: a systematic review. Journal of the American College of Cardiology. 2005, 46 (5): 743-751. 10.1016/j.jacc.2005.05.058.CrossRefPubMed Verberk WJ, Kroon AA, Kessels AGH, de Leeuw PW: Home blood pressure measurement: a systematic review. Journal of the American College of Cardiology. 2005, 46 (5): 743-751. 10.1016/j.jacc.2005.05.058.CrossRefPubMed
16.
go back to reference Cappuccio FP, Kerry SM, Forbes L, Donald A: Blood pressure control by home monitoring: meta-analysis of randomised trials. BMJ. 2004, 329 (7458): 145-10.1136/bmj.38121.684410.AE.CrossRefPubMedPubMedCentral Cappuccio FP, Kerry SM, Forbes L, Donald A: Blood pressure control by home monitoring: meta-analysis of randomised trials. BMJ. 2004, 329 (7458): 145-10.1136/bmj.38121.684410.AE.CrossRefPubMedPubMedCentral
17.
go back to reference Ashida T, Sugiyama T, Okuno S, Ebihara A, Fujii J: Relationship between home blood pressure measurement and medication compliance and name recognition of antihypertensive drugs. Hypertension Research - Clinical & Experimental. 2000, 23 (1): 21-24. 10.1291/hypres.23.21.CrossRef Ashida T, Sugiyama T, Okuno S, Ebihara A, Fujii J: Relationship between home blood pressure measurement and medication compliance and name recognition of antihypertensive drugs. Hypertension Research - Clinical & Experimental. 2000, 23 (1): 21-24. 10.1291/hypres.23.21.CrossRef
18.
go back to reference Bobrie G, Chatellier G, Genes N, Clerson P, Vaur L, Vaisse B, Menard J, Mallion J-M: Cardiovascular prognosis of "masked hypertension" detected by blood pressure self-measurement in elderly treated hypertensive patients. JAMA. 2004, 291 (11): 1342-1349. 10.1001/jama.291.11.1342.CrossRefPubMed Bobrie G, Chatellier G, Genes N, Clerson P, Vaur L, Vaisse B, Menard J, Mallion J-M: Cardiovascular prognosis of "masked hypertension" detected by blood pressure self-measurement in elderly treated hypertensive patients. JAMA. 2004, 291 (11): 1342-1349. 10.1001/jama.291.11.1342.CrossRefPubMed
19.
go back to reference Marquez-Contreras E, Martell-Claros N, Gil-Guillen V, de la Figuera-Von Wichmann M, Casado-Martinez JJ, Martin-de Pablos JL, Figueras M, Galera J, Serra A: Efficacy of a home blood pressure monitoring programme on therapeutic compliance in hypertension: the EAPACUM-HTA study. Journal of Hypertension. 2006, 24 (1): 169-175. 10.1097/01.hjh.0000198023.53859.a2.CrossRefPubMed Marquez-Contreras E, Martell-Claros N, Gil-Guillen V, de la Figuera-Von Wichmann M, Casado-Martinez JJ, Martin-de Pablos JL, Figueras M, Galera J, Serra A: Efficacy of a home blood pressure monitoring programme on therapeutic compliance in hypertension: the EAPACUM-HTA study. Journal of Hypertension. 2006, 24 (1): 169-175. 10.1097/01.hjh.0000198023.53859.a2.CrossRefPubMed
Metadata
Title
Does a colour-coded blood pressure diary improve blood pressure control for patients in general practice: The CoCo trial
Authors
Claudia Steurer-Stey
Marco Zoller
Corinne Chmiel Moshinsky
Oliver Senn
Thomas Rosemann
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Trials / Issue 1/2010
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-11-38

Other articles of this Issue 1/2010

Trials 1/2010 Go to the issue