Six monthly follow-up is as effective as 3 monthly follow-up for people with hypertension - 24/08/11

Doi : 10.1016/j.ehbc.2004.05.020

Mark R Nelson, MBBS(Hons), MFM, FRACGP, PhD, FAFPHM : Commentary Author
Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia

Abstract

Question

In people with treated hypertension, how effective is 3 month follow-up by a family physician compared with 6 month follow-up, in terms of blood pressure control, patient satisfaction and adherence to drug treatment over 3 years?

Study design

Randomised controlled trial.

Main results

At 36 months, mean blood pressure, patient satisfaction and adherence to treatment was equivalent between treatment groups (see Table 1).

Table 1 Outcome measures at 36 months for people receiving 3 or 6 month follow-up by a family practitioner.
	3 months (N=302)	6 months (N=307)	Difference (SE)	Equivalence 90% CI^†
% Participants with out of control blood pressure^*	18%	16%	Not stated
Mean systolic blood pressure	133.50	135.84	−2.35 (1.52)	−4.84 to 0.15
Mean diastolic blood pressure	81.70	81.45	0.25 (1.12)	−1.61 to 2.11
General satisfaction with clinical care	73%	75%	−2.69	−5.76 to 0.38
% of participants answering ‘yes’ to the question: ‘Did I ever forget to take my pills?’	78/263 (30%)	71/263 (27%)	2.96 (3.92)	−3.48 to 9.41
^*As assessed by doctor; authors state no significant difference between groups, but statistics not presented.
^†If the 90% CI falls entirely within the predefined equivalence range (±5mmHg for both systolic and diastolic blood pressure and ±10% for patient satisfaction and adherence), the groups are considered equivalent.

Authors’ conclusions

In people with controlled hypertension, 6 monthly follow-up is as effective as 3 monthly follow-up over 3 years for control of blood pressure, patient satisfaction and adherence to treatment, and has no effect on the proportion of participants with out of control blood pressure.

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Keywords : Hypertension, Monitoring, Family practice, Randomised controlled trial

Plan

Commentary

Study parameters

Abstracted from: Birtwhistle RV, Godwin MS, Delva MD et al. Randomised equivalence trial comparing three and six months follow up of patients with hypertension by family practitioners. BMJ 2004; 328: 204–206.