title: Patient characteristics associated with greater blood pressure control in a randomized trial of home blood pressure telemonitoring and pharmacist management.
abstract: This paper reports subgroup analysis of a successful cluster-randomized trial to identify attributes of hypertensive patients who benefited more or less from an intervention combining blood pressure (BP) telemonitoring and pharmacist management. The end point was BP < 140/90 mm Hg at 6-month follow-up. Fourteen baseline patient characteristics were selected a priori as subgroup variables. Among the 351 trial participants, 44% were female, 84% non-Hispanic white, mean age was 60.9 years, and mean BP was 149/86 mm Hg. The overall adjusted odds ratio for BP control in the intervention versus usual care group was 3.64 (P < .001). The effect of the intervention was significantly larger in patients who were younger (interaction P = .02), did not have diabetes (P = .005), had high baseline diastolic BP (P = .02), added salt less than daily in food preparation (P = .007), and took 0-2 (rather than 3-6) antihypertensive medication classes at baseline (P = .02). These findings may help prioritize patients for whom the intervention is most effective.
authors.affiliation: HealthPartners Institute for Education and Research, Minneapolis, MN, USA.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Asche
authors.affiliation: HealthPartners Institute for Education and Research, Minneapolis, MN, USA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: O'Connor
authors.affiliation: HealthPartners Institute for Education and Research, Minneapolis, MN, USA.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Dehmer
authors.affiliation: Group Health Research Institute, Seattle, WA, USA.
authors.forename: Beverly B
authors.initials: BB
authors.lastname: Green
authors.affiliation: HealthPartners Institute for Education and Research, Minneapolis, MN, USA.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Bergdall
authors.affiliation: HealthPartners Institute for Education and Research, Minneapolis, MN, USA.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Maciosek
authors.affiliation: HealthPartners Institute for Education and Research, Minneapolis, MN, USA.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Nyboer
authors.affiliation: HealthPartners Institute for Education and Research, Minneapolis, MN, USA.
authors.forename: Pamala A
authors.initials: PA
authors.lastname: Pawloski
authors.affiliation: HealthPartners Institute for Education and Research, Minneapolis, MN, USA.
authors.forename: JoAnn M
authors.initials: JM
authors.lastname: Sperl-Hillen
authors.affiliation: HealthPartners Institute for Education and Research, Minneapolis, MN, USA.
authors.forename: Nicole K
authors.initials: NK
authors.lastname: Trower
authors.affiliation: HealthPartners Institute for Education and Research, Minneapolis, MN, USA. Electronic address: karen.l.margolis@healthpartners.com.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Margolis
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods*; D015924:Blood Pressure Monitors; D003920:Diabetes Mellitus / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010595:Pharmacists; D011320:Primary Health Care; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology; D017673:Sodium Chloride, Dietary / Q000009:adverse effects; D017216:Telemedicine
chemical_list: D000959:Antihypertensive Agents; D017673:Sodium Chloride, Dietary
keywords: Case management; hypertension; moderators; subgroups