Feasibility of a randomized hypertension screening initiative in the perioperative setting

Sofia I Diaz; Luying Yan; Feng Dai; Bin Zhou; Matthew M Burg; Robert B Schonberger

doi:10.1186/s13741-021-00210-7

Feasibility of a randomized hypertension screening initiative in the perioperative setting

Perioper Med (Lond). 2021 Nov 22;10(1):39. doi: 10.1186/s13741-021-00210-7.

Authors

Sofia I Diaz¹, Luying Yan², Feng Dai^{2

3}, Bin Zhou^{2

3}, Matthew M Burg⁴, Robert B Schonberger²

Affiliations

¹ Department of Anesthesiology, Yale School of Medicine, 333 Cedar Street, TMP 3, New Haven, CT, 06520, USA. Sofia.diaz@yale.edu.
² Department of Anesthesiology, Yale School of Medicine, 333 Cedar Street, TMP 3, New Haven, CT, 06520, USA.
³ Yale Center for Analytical Sciences, Yale School of Public Health, 300 George Street, Ste 555, New Haven, CT, 06511, USA.
⁴ Department of Cardiovascular Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06520, USA.

Abstract

Objectives: This study sought to assess feasibility of a randomized trial of blood pressure intervention (home blood pressure monitoring vs. counseling) in the preoperative clinic and the baseline rates of primary care follow-up after such interventions.

Methods: A prospective randomized feasibility study was performed at Yale New Haven Hospital Preadmission Testing Clinic. A sample of 100 adults, with elevated blood pressure, were recruited during their preadmission visit, and randomized 1:1 to receive brief BP counseling and an educational brochure versus additionally receiving a home BP monitor (HBPM) with a mailed report of their home readings. At 60-day post-surgery telephone follow-up, investigators asked whether participants had primary-care follow-up; had new/adjusted hypertension treatment; and felt satisfied with the study.

Results: There were 51 patients in the counseling group and 49 in the HBPM group. Of 46 patients in the HBPM group who returned their monitors, 36 (78%) were hypertensive at home. At 60 days post-surgery, 31 (61%) patients in the counseling group and 30 (61%) in the HBPM group were reached by telephone with the remaining followed by EHR. Thirty-six (71%) patients in the counseling group and 36 (73%) in the HBPM group had seen their primary care provider. Seventeen of 36 (47%) in the counseling group and 18 of 31 (58%) in the HBPM group received new or adjusted hypertension medications. Sixty-one participants answered questions regarding their satisfaction with the study with 52 (85%) reporting that they felt moderately to very satisfied.

Conclusions: This feasibility study suggests that interventional blood pressure trials in the preoperative clinic are feasible, but telephone follow-up leads to significant gaps in outcome ascertainment.

Trial registration: Clinicaltrials.gov, NCT03634813 . Registered 16 of August 2018.

Keywords: Home blood pressure monitoring; Hypertension; Preoperative blood pressure screening.

Associated data

ClinicalTrials.gov/NCT03634813

Abstract

Associated data

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