Does a colour-coded blood pressure diary improve blood pressure control for patients in general practice: the CoCo trial.
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 (Home Blood Pressure Measurement, 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.


RESULTS



METHODS
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
Randomised controlled study.


METHODS
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 <or= 140/<or= 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.


BACKGROUND
ClinicalTrials.gov ID NCT01013467.
Steurer-Stey
Claudia
C
Institute for General Practice, University of Zurich, Sonneggstrasse 6, 8091 Zurich, Switzerland. claudia.stey@usz.ch
Zoller
Marco
M
Chmiel Moshinsky
Corinne
C
Senn
Oliver
O
Rosemann
Thomas
T
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001364:Awareness; D001794:Blood Pressure / Q000187:drug effects; D001795:Blood Pressure Determination / Q000379:methods*; D005194:Family Practice; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D010349:Patient Compliance; D010465:Perception; D010817:Physician-Patient Relations; D011237:Predictive Value of Tests; D012107:Research Design; D012648:Self Care; D013997:Time Factors
D000959:Antihypertensive Agents
BMJ. 2004 Jul 17;329(7458):145
15194600
Schweiz Rundsch Med Prax. 1994 Aug 16;83(33):889-94
8091061
Hypertension. 2004 Jan;43(1):10-7
14638619
Cochrane Database Syst Rev. 2004;(2):CD004804
15106262
Diabetes Care. 2001 Oct;24(10):1821-33
11574449
JAMA. 2004 Mar 17;291(11):1342-9
15026401
Circulation. 1997 Feb 18;95(4):1085-90
9054774
J Hypertens. 2003 Jun;21(6):1011-53
12777938
J Hypertens. 2006 Jan;24(1):169-75
16331115
N Engl J Med. 2005 Aug 4;353(5):487-97
16079372
J Am Coll Cardiol. 2005 Sep 6;46(5):743-51
16139119
Arch Intern Med. 2004 Apr 12;164(7):722-32
15078641
JAMA. 2003 May 21;289(19):2560-72
12748199
Schweiz Rundsch Med Prax. 1994 Aug 2;83(31):841-5
8091050
Hypertens Res. 2000 Jan;23(1):21-4
10737131
J Allergy Clin Immunol. 2003 Sep;112(3):489-94
13679805