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CoCo trial: Color-coded blood pressure Control, a randomized controlled study.

Chmiel C, Senn O, Rosemann T, Del Prete V, Steurer-Stey C - Patient Prefer Adherence (2014)

Bottom Line: After 6 months, a significant decrease in systolic and diastolic BP was achieved in both groups, with no significant difference between the groups (16.1/7.9 mmHg in the intervention group versus 13.1/8.6 mmHg in the control group, P=0.3/0.7).BP control (treatment target <140/90 mmHg) was achieved significantly more often in the intervention group (43% versus 25%; P=0.037; number needed to treat of 5).Color-coded BP self-monitoring significantly improved BP control (number needed to treat of 5, meaning that every fifth patient utilizing color-coded self-monitoring achieved better BP control after 6 months), but no significant between-group difference was observed in BP change.

View Article: PubMed Central - PubMed

Affiliation: Institute of General Practice and Health Services Research, University of Zurich, Zürich, Switzerland.

ABSTRACT

Background: Inadequate blood pressure (BP) control is a frequent challenge in general practice. The objective of this study was to determine whether a color-coded BP booklet using a traffic light scheme (red, >180 mmHg systolic BP and/or >110 mmHg diastolic BP; yellow, >140-180 mmHg systolic BP or >90-110 mmHg diastolic BP; green, ≤140 mmHg systolic BP and ≤90 mmHg diastolic BP) improves BP control and adherence with home BP measurement.

Methods: In this two-group, randomized controlled trial, general practitioners recruited adult patients with a BP >140 mmHg systolic and/or >90 mmHg diastolic. Patients in the control group received a standard BP booklet and the intervention group used a color-coded booklet for daily home BP measurement. The main outcomes were changes in BP, BP control (treatment goal <140/90 mmHg), and adherence with home BP measurement after 6 months.

Results: One hundred and twenty-one of 137 included patients qualified for analysis. After 6 months, a significant decrease in systolic and diastolic BP was achieved in both groups, with no significant difference between the groups (16.1/7.9 mmHg in the intervention group versus 13.1/8.6 mmHg in the control group, P=0.3/0.7). BP control (treatment target <140/90 mmHg) was achieved significantly more often in the intervention group (43% versus 25%; P=0.037; number needed to treat of 5). Adherence with home BP measurement overall was high, with a trend in favor of the intervention group (98.6% versus 96.2%; P=0.1).

Conclusion: Color-coded BP self-monitoring significantly improved BP control (number needed to treat of 5, meaning that every fifth patient utilizing color-coded self-monitoring achieved better BP control after 6 months), but no significant between-group difference was observed in BP change. A markedly higher percentage of patients achieved BP values in the normal range. This simple, inexpensive approach of color-coded BP self-monitoring is user-friendly and applicable in primary care, and should be implemented in the care of patients with arterial hypertension.

No MeSH data available.


Related in: MedlinePlus

(A) Color-coded and (B) standard blood pressure booklet.
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f1-ppa-8-1383: (A) Color-coded and (B) standard blood pressure booklet.

Mentions: Clinical and demographic data upon inclusion and at follow-up were collected by the GPs (Tables 1 and 2). Patients in the intervention group received the color-coded booklet (Figure 1A), with a scheme divided into three measuring zones (green, yellow, red) following a traffic light scheme. BP measurements within the target values of up to 140 mmHg systolic and 90 mmHg diastolic were entered into the green area. BP measurements above 140 mmHg but below 180 mmHg systolic and/or above 90 mmHg but below 110 mmHg diastolic were entered into the yellow area, and measurements above 180 mmHg systolic and above 110 mmHg diastolic in the red area. The colored areas had the goal to improve patients’ understanding and interpretation of BP control by visualizing target and elevated values. Pulse rate was also recorded but without any designated color coding. Patients in the control group used the usual standard booklet (Figure 1B) without color coding. In both booklets, the exact time and date of readings were recorded.


CoCo trial: Color-coded blood pressure Control, a randomized controlled study.

Chmiel C, Senn O, Rosemann T, Del Prete V, Steurer-Stey C - Patient Prefer Adherence (2014)

(A) Color-coded and (B) standard blood pressure booklet.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4206524&req=5

f1-ppa-8-1383: (A) Color-coded and (B) standard blood pressure booklet.
Mentions: Clinical and demographic data upon inclusion and at follow-up were collected by the GPs (Tables 1 and 2). Patients in the intervention group received the color-coded booklet (Figure 1A), with a scheme divided into three measuring zones (green, yellow, red) following a traffic light scheme. BP measurements within the target values of up to 140 mmHg systolic and 90 mmHg diastolic were entered into the green area. BP measurements above 140 mmHg but below 180 mmHg systolic and/or above 90 mmHg but below 110 mmHg diastolic were entered into the yellow area, and measurements above 180 mmHg systolic and above 110 mmHg diastolic in the red area. The colored areas had the goal to improve patients’ understanding and interpretation of BP control by visualizing target and elevated values. Pulse rate was also recorded but without any designated color coding. Patients in the control group used the usual standard booklet (Figure 1B) without color coding. In both booklets, the exact time and date of readings were recorded.

Bottom Line: After 6 months, a significant decrease in systolic and diastolic BP was achieved in both groups, with no significant difference between the groups (16.1/7.9 mmHg in the intervention group versus 13.1/8.6 mmHg in the control group, P=0.3/0.7).BP control (treatment target <140/90 mmHg) was achieved significantly more often in the intervention group (43% versus 25%; P=0.037; number needed to treat of 5).Color-coded BP self-monitoring significantly improved BP control (number needed to treat of 5, meaning that every fifth patient utilizing color-coded self-monitoring achieved better BP control after 6 months), but no significant between-group difference was observed in BP change.

View Article: PubMed Central - PubMed

Affiliation: Institute of General Practice and Health Services Research, University of Zurich, Zürich, Switzerland.

ABSTRACT

Background: Inadequate blood pressure (BP) control is a frequent challenge in general practice. The objective of this study was to determine whether a color-coded BP booklet using a traffic light scheme (red, >180 mmHg systolic BP and/or >110 mmHg diastolic BP; yellow, >140-180 mmHg systolic BP or >90-110 mmHg diastolic BP; green, ≤140 mmHg systolic BP and ≤90 mmHg diastolic BP) improves BP control and adherence with home BP measurement.

Methods: In this two-group, randomized controlled trial, general practitioners recruited adult patients with a BP >140 mmHg systolic and/or >90 mmHg diastolic. Patients in the control group received a standard BP booklet and the intervention group used a color-coded booklet for daily home BP measurement. The main outcomes were changes in BP, BP control (treatment goal <140/90 mmHg), and adherence with home BP measurement after 6 months.

Results: One hundred and twenty-one of 137 included patients qualified for analysis. After 6 months, a significant decrease in systolic and diastolic BP was achieved in both groups, with no significant difference between the groups (16.1/7.9 mmHg in the intervention group versus 13.1/8.6 mmHg in the control group, P=0.3/0.7). BP control (treatment target <140/90 mmHg) was achieved significantly more often in the intervention group (43% versus 25%; P=0.037; number needed to treat of 5). Adherence with home BP measurement overall was high, with a trend in favor of the intervention group (98.6% versus 96.2%; P=0.1).

Conclusion: Color-coded BP self-monitoring significantly improved BP control (number needed to treat of 5, meaning that every fifth patient utilizing color-coded self-monitoring achieved better BP control after 6 months), but no significant between-group difference was observed in BP change. A markedly higher percentage of patients achieved BP values in the normal range. This simple, inexpensive approach of color-coded BP self-monitoring is user-friendly and applicable in primary care, and should be implemented in the care of patients with arterial hypertension.

No MeSH data available.


Related in: MedlinePlus