Self Measurement and management using the Internet for Lowering blood pressure in Everyday practice (SMILE study)

ISRCTN ISRCTN70714356
DOI https://doi.org/10.1186/ISRCTN70714356
Secondary identifying numbers 10176
Submission date
10/08/2011
Registration date
10/08/2011
Last edited
30/11/2017
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Circulatory System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English Summary

Background and study aims
This study addresses overlapping issues in patient engagement: a patient support tool to implement a lifestyle intervention that practice nurses currently do not have the time and expertise to implement, and home blood pressure measurements with self-titration (dose adjustment) of medication for lowering blood pressure.

Who can participate?
Patients aged over 18 with high blood pressure

What does the study involve?
The study involves two phases. In Phase 1 the LifeGuide web tool, diet materials, and web pages used in an obesity web intervention (on diet and exercise) are used as the basis for writing the initial web pages for the web intervention. Focus groups and 1:1 interviews with patients and nurses are used to modify the site. In Phase 2 patients are randomly allocated to one of three groups. The first group receive usual care (normal clinic measurement by a GP or nurse). The second group use home blood pressure measurement with telemonitoring. The third group use home blood pressure measurement with telemonitoring and receive access to the lifestyle website with reinforcement by the practice nurse over a 3-month period. After 3 months the changes in blood pressure in the three groups are compared.

What are the possible benefits and risks of participating?
Not provided at time of registration

Where is the study run from?
University of Southampton (UK)

When is the study starting and how long is it expected to run for?
September 2011 to September 2012

Who is funding the study?
NIHR National School of Primary Care Research (UK)

Who is the main contact?
Prof. Paul Little

Contact information

Prof Paul Little
Scientific

Primary Medical Care
Aldermoor Health Centre
Aldermoor Close
Southampton
SO16 5ST
United Kingdom

ORCiD logoORCID ID 0000-0003-3664-1873

Study information

Study designRandomised interventional prevention process of care trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)GP practice
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleSelf Measurement and management using the Internet for Lowering blood pressure in Everyday practice: a randomised controlled trial
Study acronymSMILE
Study hypothesisThis study addresses overlapping issues in patient engagement:
1. A patient support tool to implement lifestyle intervention (the effective and acceptable DASH diet and exercise) that practice nurses currently do not have the time and expertise to implement
2. Home blood pressure measurements with self titration of medication

It involves two distinct phases, the initial development of a web intervention followed by a randomised controlled trial to explore the extent to which the interventions can change.
Ethics approval(s)First MREC, 29/03/2011, ref: 11/SC/0051
ConditionEssential hypertension
InterventionCurrent interventions as of 30/11/2017:
1. Phases:
1.1. Phase 1 patient Interviews: 16 + 3 healthcare professionals
1.2. Phase 1 focus groups: 8 healthcare professionals
1.3. Phase 2 RCT: 50, randomised into 3 groups
2. At baseline, weight and blood pressure measured
3. End of study, weight and blood pressure measured within GP surgery
4. Home measurement, self monitoring of blood pressure by patients
5. Follow up after 12 months
6. Study entry: registration and one or more randomisations

Previous interventions:
1. Phases:
1.1. Phase 1 patient Interviews: 30
1.2. Phase 1 focus groups: 35
1.3. Phase 2 RCT: 90, randomised into 3 groups
2. At baseline, weight and blood pressure measured
3. End of study, weight and blood pressure measured within GP surgery
4. Home measurement, self monitoring of blood pressure by patients
5. Follow up after 12 months
6. Study entry: registration and one or more randomisations
Intervention typeOther
Primary outcome measureMean change in systolic blood pressure after 3 months
Secondary outcome measuresNo secondary outcome measures
Overall study start date01/09/2011
Overall study end date30/09/2012

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsPlanned Sample Size: 155; UK Sample Size: 155 - to include both phases
Participant inclusion criteria1. Over 18 years
2. Treated essential hypertension
3. Poor control blood pressure greater than 140/90 mmHg and less than 200/110 mmHg
3. Home access to the internet
4. Access to a telephone line
Participant exclusion criteria1. Inability to self monitor (including diagnosis of of dementia, score of >10 on short orientation memory concentration test)
2. Postural hypertension (systolic blood pressure drop >20mmHg)
3. More than two antihypertensive medications
4. Terminal disease
5. Hypertension not managed by family doctor
6. Spouse already randomised to the study group
Recruitment start date01/09/2011
Recruitment end date30/09/2012

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centres

Primary Medical Care
University of Southampton
Aldermoor Health Centre
Southampton
SO16 5ST
United Kingdom
Park & St Francis Surgery
SO53 4ST
The Clanfield Practice
PO8 0QL
Cowplain Family Practice
PO8 8DL
The Oaklands Practice
GU46 7LS
Rowlands Castle
PO9 6BN
Nightingale Surgery
SO51 7QN
Woolston Lodge
SO19 9AL
Regents Park Surgery
SO15 3UA

Sponsor information

University of Southampton (UK)
University/education

Research Governance Office
Highfield
Southampton
SO17 1BJ
England
United Kingdom

Website http://www.soton.ac.uk/
ROR logo "ROR" https://ror.org/01ryk1543

Funders

Funder type

Government

NIHR National School of Primary Care Research; Grant Codes: 4.74

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planThis was a very small pilot and development study that mainly concentrated on the development of the website, and was used as the basis for arguing for a much larger Programme grant subsequently funded by NIHR PGfAR: the trial from that Programme will be published and the data will be made available.
IPD sharing planThe datasets generated during and/or analysed during the current study are not expected to be made available due to the fact that this was preliminary pilot work.

Editorial Notes

30/11/2017: Contact, sponsor address, trial participating centres and interventions updated, condition category, plain English summary, publication and dissemination plan and IPD sharing statement added.