Characteristics of included randomised controlled trials
| RCT | Population | Intervention | Outcomea | Interpretation |
|---|---|---|---|---|
| McManus et al15 | 441 people receiving treatment in primary care for hypertension but not controled below the target of <140/85 mm Hg. | (1) Patients in the intervention group received treatment targets along with facilities to measure their own blood pressure at their general practice; they were also asked to visit their GP or practice nurse if their blood pressure was repeatedly above the target level. | SBP −2.30 (−5.39 to 0.79) | Positive for SBP |
| (2) Patients in the control group received usual care | DBP −1.10 (−2.75 to 0.55) | |||
| Control not reported | ||||
| Bailey et al18 | Patients with hypertension about to start BP-lowering treatment | (1) Self-monitoring: use of an Omron HEM706 monitor. Asked to record BP twice daily for 8 weeks | SBP 5.0 (−4.7 to 14.7) | No effect SBP, positive effect DBP. Physicians in intervention group not instructed to adjust for self-monitored BP readings |
| (2) Usual care: no self-recording | DBP −2.0 (−3.4 to −0.6) | |||
| Control not reported | ||||
| Carnahan et al16 | Patients with hypertension starting treatment in hospital clinic | (1) Self-monitoring: instructed to use own sphygmomanometer twice a day. | SBP −7.5 (−14.2 to −0.8) | Positive effect SBP, no effect DBP |
| Readings recorded and delivered to the clinic when visiting | DBP 0 (−3.9 to 3.9) | |||
| (2) Usual care | Control not reported | |||
| Friedman et al13 | Taking BP-lowering drugs, SBP ≥160 mmHg or DBP ≥90 mmHg on average two readings | (1) Home monitoring and telecommunication system | SBP −4.0 (−3.9 to 3.1) | No effect SBP, positive effect DBP |
| • Weekly automated home blood pressure recording | DBP −4.4 (−6.5 to −2.3) | |||
| • Telephone-linked computer system to patient | Control not reported | |||
| (2) Usual care | ||||
| Haynes et al21 | Males with hypertension not compliant or at goal DBP (≥90 mmHg) | (1) Patient self-monitoring and education | SBP not reported | No effect DBP |
| (2) Usual care | DBP −3.5 (−7.0 to 0.1) | |||
| Control not reported | ||||
| Johnson et al22 | All taking BP-lowering medication for ≥1 year with uncontrolled hypertension (DBP≥95 mmHg) | (1) Self-recording | SBP not reported | No effect RCT |
| (2) Home visit: BP measured in their homes every 4 weeks with result given to them and physician. Both groups visited at home after 2 weeks | DBP −1.0 (−5.7 to 3.7) | |||
| (3) Both interventions | Control not reported | |||
| (4) Neither intervention | ||||
| Mehos et al19 | People with uncontrolled hypertension SBP 140-179 mmHg and/or DBP 90-109 mmHg | (1) Home blood pressure monitoring | SBP −10.1 (−19.8 to −0.4) | No effect SBP, positive effect DBP |
| (2) Usual care | DBP −6.7 (−13.2 to −0.3) | |||
| Control not reported | ||||
| Pierce et al23 | People with uncontrolled hypertension (SBP ≥160 and/or DBP ≥95 mmHg) | (1) Self-monitoring | SBP not reported | No effect RCT (self-monitoring arm) |
| (2) Health-education programme | DBP not reported | |||
| (3) Both interventions | Control 1.2 (0.6 to 2.7) | |||
| (4) Usual care | ||||
| Rogers et al12 | Change in BP medication because: | (1) Telecommunication service with three components: automated BP at home; central processing of BP readings; weekly reports to both physician and patient | SBP −4.8 (−9.8 to 0.2) | No effect SBP, positive effect DBP, no effect control of blood pressure |
| (1) SBP ≥140 or DBP ≥90 mmHg | (2) Usual care | DBP −4.0 (−7.7 to −0.3) | ||
| (2) Side-effects from drugs | Control 1.1 (0.5 to 2.3) | |||
| (3) SBP >180 or DBP >110 without current antihypertensive therapy | ||||
| Soghikian et al17 | Hypertension but no entry BP level required or defined | (1) Home blood pressure measurement: patients asked to measure BP twice weekly, mail record of BP, medications and side effects to project office every 4 weeks | SBP −3.3 (−6.4 to −0.2) | Positive effect SBP, no effect DBP |
| (2) Usual care | DBP −1.6 (−3.5 to to 0.3) | |||
| Control not reported | ||||
| Vetter20 | Hypertension, SBP 160-200 mmHg or DBP 95-115 mmHg in patients who are untreated or uncontrolled | (1) Home measurement of blood pressure by patients | SBP −0.5 (−2.8 to 1.8) | No effect SBP, positive effect DBP, no effect on control of blood pressure |
| (2) Usual care | DBP −1.3 (−2.4 to −0.2) | |||
| Control 0.8 (0.6 to 1.1) | ||||
| Baqu et al25 | Patients with poorly controlled essential hypertension, defined as systolic blood pressure > or = 140 or diastolic blood pressure > or = 90 mmHg. | (1) The patients were given an OMRON HEM-705CP automatic blood pressure monitor on two occasions, for use during 15 days at weeks 6 and 14. Blood pressure was recorded at each visit (baseline, 6, 8,14,16, and 24 weeks) | SBP not reported | No effect for blood pressure control |
| (2) Usual care | DBP not reported | |||
| Control 1.21 (0.94 to 1.58) | ||||
| Zarnke26 | Average BP readings <160/95 mmHg taking BP lowering drugs or receiving non-pharmacological advice | (1) Patient-directed group: instructed in home BP measurement, measured own BP twice daily and instructed by means of algorithm to change own BP medication | SBP not reported | Positive RCT mean arterial BP improved by −3 mmHg at 8 weeks follow-up |
| Control not reported | ||||
| Artinian et al11 | Hypertension, SBP ≥140 mmHg or ≥90 mmHg or for patients with diabetes ≥130 mmHg or ≥85 mmHg | (1) Home BP telemonitoring: self-monitoring at home and transmitting BP readings over telephone | SBP −26.0 (−40.0 to 11.6) | No effect RCT (pilot study with short follow-up period of 3 months) |
| (2) Nurse-managed community-based BP monitoring | DBP −12.0 (−21.5 to −2.5) | |||
| (3) Usual care | Control not reported | |||
| Midanik et al9 | Untreated patients with hypertension: SBP <180 mmHg and DBP 90–99 mmHg | (1) Self-monitoring: patients trained to take two consecutive readings twice a week. | SBP −2.0 (−7.4 to 3.4) | No effect RCT |
| Sent in readings every 4 weeks for 1 year | DBP 0 (−2.9 to 2.9) | |||
| (2) Usual care | Control not reported | |||
| Rudd et al10 | Hypertension: SBP ≥140 mmHg or DBP ≥90 mmHg in previous 6 months or history of drug treatment | (1) Self-measurement with nurse management based on algorithm | SBP −8.5 (−14.3 to −2.7) | Positive RCT for SBP and DBP |
| (2) Usual care | DBP −3.1 (−6.0 to −0.2) | |||
| Control not reported | ||||
| Earp et al24 | Hypertension treated at outpatient hypertension clinic or general practice clinic | (1) Home visits: over 18 months by nurse or pharmacist. | SBP not reported | No effect RCT |
| (2) Home visits plus involvement of ‘significant other’ – involved daily/several times a week BP monitoring | Control 1.3 (0.6 to 2.7) | |||
| (3) Usual care | ||||
| Billault et al27 | Attended hypertension clinic, no entry SBP/DBP defined | (1) Booklet with personalised standardised medical information explained to patient and their family doctor | SBP −1.1 (−5.8 to 3.6) | No effect RCT |
| (2) Usual care | DBP 1.4 (−1.5 to 4.3) | |||
| Control not reported | ||||
| Burelle et al28 | Uncontrolled and non-adherent patients with hypertension education and special dosing devices | (1) TIME: home visits, education | SBP −7.4 (−22.5 to 7.7) | No effect RCT, very small study |
| (2) Usual care | DBP 7.1 (−5.2 to 19.4) | |||
| Control not reported | ||||
| Cakir et al29 | Persons with hypertension (mean systolic BP of 140 mmHg and/or mean diastolic BP, DBP, of 90 mmHg on 3 separate occasions during a 3-week period), and aged 18–65 years | (1) Patient education (‘lifestyle intervention’) while participants in the (2) control group were provided with routine outpatient services and were asked to maintain their usual lifestyles, including dietary and exercise habits, for 6 months until they were reexamined. | SBP −10.0 (−15.0 to −5.0) | Positive for SBP and DBP |
| DBP −8.6 (−12.3 to −4.9) | ||||
| Control not reported | ||||
| Fielding et al30 | Hypertension, either: SBP ≥140 and/or DBP ≥90 mmHg | • (1) IMPACT consisted of monthly 10-minute individual sessions for patients with counsellor | SBP −8.5 (−14.8 to −2.2) | Positive RCT |
| (2) Usual care | DBP −3.9 (−7.1 to −0.7) | |||
| Control not reported | ||||
| Hennessy et al31 | Total of 10 696 patients with a diagnosis of hypertension cared for by 93 primary care providers. | (1) Academic detailing, provision of provider-specific data about hypertension control, provision of educational materials to the provider, and provision of educational and motivational materials to patients. | Patient education | No effect RCT |
| (2) Usual care | BP 0.00 (−0.73 to 0.73) | |||
| DBP 1.00 (0.56 to 1.44) | ||||
| Control 0.83 (0.76 to 0.92) | ||||
| Physician education | ||||
| SBP 0.00 (−0.73 to 0.73) | ||||
| DBP 1.00 (0.56 to 1.44) | ||||
| Control 0.83 (0.76 to 0.92) | ||||
| Morisky et al40 | BP (mmHg) entry criteria based on age: 20–39: >140/90 40–59: >150/95 ≥60: ≥160/100 | (1) Three interventions: exit interview; instructional session on adherence and follow-up care; group sessions | SBP not reported | Improved BP control but substantially greater numbers lost to follow-up in (C) arm at 2 and 5 years |
| (2) Usual care | DBP not reported | |||
| Control 0.6 (0.4 to 0.9) | ||||
| Mühlhauser et al34 | Hypertension (mean last two measurements ≥160 and/or ≥95 mmHg). | (1) Hypertension treatment and teaching programme | SBP −5.0 (−9.3 to −0.7) | Positive RCT for SBP/DBP, no effect on control of BP |
| (2) Usual care | DBP −3.0 (−0.4 to −0.6) | |||
| Control 1.1 (0.4 to 2.6) | ||||
| Hunt et al32 | Patients with mildly uncontrolled hypertension as defined as a last blood pressure of 140 to 159/90 to 99 mmHg from query of an electronic medical record database. | Patients randomised to intervention (1) were mailed two educational packets approximately 3 months apart. (2) The control group consisted of similar patients receiving usual care for hypertension. | SBP −2.00 (−4.70 to 0.70) | No effect on SBP, DBP |
| DBP −2.00 (−4.25 to 0.25) | ||||
| Control not reported | ||||
| McKinstry et al33 | Parallel, single blind, Single urban general practice over 1 year in the UK of patients with hypertension. | (1) Patient-held guideline with written explicit exhortation to challenge care when appropriate. | SBP −1.00 (−5.73 to 3.73) | No effect for SBP or blood pressure control |
| (2) Usual care | DBP −2.00 (−4.63 to 0.63) | |||
| Control 0.98 (0.60 to 1.60) | ||||
| Roca-Cusachs et al35 | Newly diagnosed patients with hypertension. Mean values were: (E) 156.3/95.8 (C) 160.3/96.1 | (1) Patient education: booklet; educational talks; personal tutorial | SBP1.3 (−4.3 to 6.9) | No effect RCT |
| (2) Usual care | DBP 1.9 (−1.1 to 4.9) | |||
| Control not reported | ||||
| Sackett et al41 | Hypertension ≥95 mmHg | (1) Augmented convenience site physician care | SBP not reported | No effect RCT |
| (2) Mastery learning: via audio-cassette and booklet and re-emphasised by a ‘patient educator’ | DBP not reported | |||
| (3) Both interventions | Control 0.7 (0.3 to 2.1) | |||
| (4) Usual care | ||||
| Tanner et al38 | Hypertension DBP ≥90 mmHg | (1) Intervention group: booklet | SBP not reported | No effect RCT |
| (2) Usual care | DBP 0.2 (−4.7 to 5.1) | |||
| Control not reported | ||||
| Watkins et al36 | Hypertension | (1) Information booklet on hypertension sent out to patients | SBP 0.6 (−3.0 to 4.2) | No effect RCT |
| (2) Usual care | DBP 0.4 (−14 to 2.2) | |||
| Control not reported | ||||
| Webb et al39 | Hypertension; DBP≥90 mmHg | (1) Education: three group education sessions by nurse-health educator | SBP not reported | No effect RCT |
| (2) Counselling: three ‘individualised’ counselling sessions | DBP −3.3 (−7.0 to 0.4) | |||
| (3) Usual care: three appointments with family physician | Control not reported | |||
| Zismer et al36 | Hypertension or ≥140 or ≥90 mmHg | (1) Experimental group A: educational ‘self-care’ intervention: pill taking; appointment keeping; dietary sodium reduction | SBP −15.7 (−26.0 to −5.4) | Positive RCT for SBP/DBP |
| (2) Experimental group B-received additional support from family member | DBP −8.7 (−15.5 to −1.9) | |||
| (3) Usual care | Control not reported | |||
| Coe et al43 | Hypertension mean BP ≥140/95 mmHg | (1) Computer-generated treatment recommendations by algorithm | SBP −1.2 (−10.1 to 7.7) | No effect RCT |
| (2) Usual physician care | DBP 1.1 (−3.6 to 5.8) | |||
| Control not reported | ||||
| Dickinson et al42 | Mean baseline BP 159/89 mmHg | (1) Computer-generated feedback-monthly feedback reports | SBP 1.0 (−8.3 to 10.3) | No effect RCT but improved follow-up at clinic |
| (2) Education programme: three separate self-instructions | DBP −1.0 (−6.9 to 4.9) | |||
| (3) Both | Control 1.0 (0.2 to 3.8) | |||
| (4) Neither | ||||
| Evans et al44 | Hypertension DBP >90 mmHg | (1) Mailed continuous to physicians 14 weekly medical education instalments of information, chart and follow-up appointment system to encourage detection and recall of patients | SBP 0.8 (−4.2 to 5.8) | No effect RCT |
| (2) Usual care | DBP 0.3 (−2.0 to 2.6) | |||
| Control 0.8 (0.5 to 1.5) | ||||
| Hetlevik et al45 | Patients with hypertension | (1) Computer-based decision support system. | SBP −1.5 (−3.2 to 0.2) | No effect RCT |
| Re-enforcement by mean of telephone repetitions seminar on risk intervention | DBP −0.6 (14 to 0.2) | |||
| (2) Usual care | Control not reported | |||
| McAllister et al46 | Patients with hypertension: | (1) Compute-generated feedback to physician on individual patient; inter and intra practice DBP ranking; commentary on treatment by GP according to a ‘stepped-care’ approach. | SBP not reported | No effect RCT |
| (1) DBP >90 mmHg on treatment | (2) Control group filled out same forms but no feedback given | DBP not reported | ||
| Control 0.9 (0.5 to 1.4) | ||||
| Montgomery et al47 | Patients with hypertension aged 60-80 years taking BP-lowering drugs | (1) Computer-based decision support system | SBP −4.0 (−8.3 to 0.3) | No effect RCT |
| (2) Risk chart | DBP 1.0 (−1.2 to 3.2) | |||
| (3) Usual care | Control 1.0 (0.7 to 1.6) | |||
| Ornstein et al48 | Hypertension: Uncontrolled/untreated >140/90 mmHg or on treatment. At baseline 40% (E) and 43.7% (C) had ‘controlled’ BP (<140/90 mmHg) | (1) Multi-method quality improvement | SBP not reported | Positive RCT (for BP control but not for many of the other quality indicators) |
| • Practice site visits | DBP not reported | |||
| • 2-day network meetings in each study year | Control 0.8 (0.7 to 0.9) | |||
| (2) Usual care: received copies of practice guidelines and quarterly performance reports | ||||
| New et al49 | Patients with diabetes and hypertension (>140/80 mmHg) | (1) Educational outreach delivered by specialist nurses | SBP not reported | No effect RCT |
| (2) Usual care | DBP not reported | |||
| Control 1.0 (0.9 to 1.1). | ||||
| Sanders et al50 | Patients with diabetes and hypertension (BP level not defined) | (1) Chart reminder | SBP −6.8 (−11.3 to −2.3) | No effect RCT |
| (2) Usual care | DBP −2.1 (−4.8 to −0.6) | |||
| Control not reported | ||||
| Bogden et al51 | Hypertension, either: | (1) Pharmacist interacted with physicians and patients according to pre-specified checklist | SBP −12.0 (−20.1 to −3.4) | Positive RCT |
| ≥150 or ≥95mmHg | (2) Control: usual medical care | DBP −8.0 (−12.0 to −0.7) | ||
| ≥140 or ≥90 mmHg with CVS risk factors or target organ damage | Control 0.2 (0.1 to 0.5) | |||
| Garcia-Pena et al52 | Hypertension, mean SBP ≥160 or/both DBP ≥90 | (1) Nurse-based intervention: nurses trained in aging and clinical aspects of hypertension | SBP −3.3 (−5.9 to −0.7) | Positive RCT |
| (2) Usual care from institute's clinic and mailed pamphlet about hypertension | DBP −3.7 (−5.1 to −2.3) | |||
| Control 0.1 (0.1 to 0.2) | ||||
| Hawkins et al53 | Hypertension OPD clinic US (42% E) (49% C) | (1) Clinical pharmacist: chronic disease management in OPD setting (medical care monitored by general practice faculty) | SBP 0.0 (−1.9 to 1.9) | No effect RCT but improved follow-up at clinic |
| (2) Usual care by physician | DBP 0.0 (−0.7 to 0.7) | |||
| Control not reported | ||||
| Jewell et al54 | New diagnosis DBP >100 mmHg aged 30-39 years, >105 mmHg aged >40 years | (1) Nurse-led care. Agreed protocol determined treatment and frequency of attendance in both groups. Target was to reduce DBP <90 mmHg | SBP not reported | No effect RCT |
| Uncontrolled DBP >95 mmHg | (2) Usual care using same protocol | DBP not reported | ||
| Control 0.9 (0.2 to 3.6) | ||||
| Logan et al55 | Hypertension (DBP ≥95 mmHg, or DBP 91-94 mmHg and SBP >140 mmHg) | (1) Work-site care by nurse management protocol: including drug regimen and regular review | SBP not reported | Positive RCT for DBP and control of BP |
| (2) Usual care from their own family doctors | DBP −3.9 (−5.2 to −2.6) | |||
| Control 0.4 (0.3 to 0.6) | ||||
| Park et al56 | Hypertension ≥140/90 mmHg | (1) Pharmacist administered monthly patient management: education, medication changes verbal counselling and written information | SBP −13.0 (−22.6 to −3.4) | Positive RCT |
| (2) Traditional pharmacy services | DBP −5.0 (−9.9 to −0.1) | |||
| Control 0.2 (0.1 to 0.8) | ||||
| Solomon et al57 | Treated patients with hypertension | (1) Patient-centred pharmaceutical care model (employing standardised care) implemented by clinical pharmacy residents | SBP −6.9 (−12.7 to −1.1) | Positive effect SBP, no effect DBP |
| (2) Usual care | DBP −0.1 (−4.4 to 3.2) | |||
| Control not reported | ||||
| De Castro et al58 | A total of 71 patients in a single hospital clinic outpatient in Brazil. | (1) C – under routine clinical management and sham intervention | SBP −5.00 (−12.13 to 2.13) | No significant effect for SBP and DBP |
| (2) Intervention – received a pharmaceutical care programme delivered by 9 trained pharmacists: patient education and support | DBP −2.00 (−7.11 to 3.11) | |||
| Control not reported | ||||
| Schroeder et al59 | 245 women and men recruited with uncontrolled hypertension (> or = 150/90 mmHg) from 21 general practices in Bristol, UK. All patients with hypertension coded and latest BP≤150/90 | Participants were randomised to receive (1) nurse-led adherence support or (2) usual care alone. | SBP −1.70 (−6.42 to 3.02) | No effect on SBP or DBP or medication adherence |
| DBP −0.10 (−2.54 to 2.34) | ||||
| Control not reported | ||||
| Sookaneknun et al60 | Adults with hypertension from hospital and 2 primary care units | (1) Patients were monitored monthly by reviewing their medications and supported by providing pharmaceutical care and counseling. | SBP −5.70 (−10.28 to −1.12) | Positive effect for SBP, DBP and BP control |
| (2) usual care | DBP −2.50 (−5.61 to 0.61) | |||
| Control 0.69 (0.41 to 1.17) | ||||
| Tobe et al61 | Diagnosis of hypertension with SBP greater or equal to 130 mmHg | 1) Medical clinic measurement of blood pressure by home care nurse using BpTRU automated oscillometric blood pressure cuff | SBP −7.00 (−13.45 to −0.55) | Positive effect for SBP |
| DBP greater or equal to 80 mmHg | (2) Healthy lifestyle classes stressing a healthier dietary regimen, exercise, smoking cessation and drug adherence | DBP −0.80 (−5.12 to 3.52) | ||
| Diagnosis of type 2 diabetes mellitus | Control not reported | |||
| Tonstad et al62 | Subjects that participated in a health screening with systolic blood pressure 140-169 mmHg and diastolic blood pressure | Randomly allocated either to (1) monthly nurse-led lifestyle counselling (intervention group, n = 31) or to (2) conventional primary care (control group, n = 20) to be followed by lifestyle counselling. | SBP 0.00 (−5.30 to 5.30) | No effect on SBP or DBP |
| 90-99 mmHg at a minimum of three separate readings treated or not treated with antihypertensive drugs. | DBP −1.00 (−4.81 to 2.81) | |||
| Control not reported | ||||
| Bulpitt et al63 | Hypertension, mean BP | (1) Computer-held records: allowed doctor to record clinical information in structured format | SBP −0.4 (−5.9 to 5.1) | No effect RCT |
| 178/105 mmHg (intervention) | (2) Standard hospital notes | DBP 0.2 (−2.6 to 3.0) | ||
| 177/106 mmHg (Control) | Control not reported | |||
| Hypertension Detection and Follow up (HDFP)64–66 | Hypertension DBP ≥90 mmHg | (1) Stepped care, designed to provide rigorous, systematic, antihypertensive drug treatment with: free care; emphasis placed on clinic attendance and compliance; convenience; stepped drug treatment according to BP response; patients seen at intervals determined by their clinic status, at least every 4 months, and generally every 2 months | (1) Stratum 1:90-104 | Positive RCT, reduction in all cause mortality as well |
| (2) Referred care: referred to their ‘primary sources of care, usually own physicians | SBP −8.2 (−9.2 to −7.1) | |||
| DBP −4.2 (−4.7 to −3.7) | ||||
| (2) Stratum 2: 105-114 mmHg | ||||
| SBP −11.7 (−13.7 to −9.7) | ||||
| DBP −7.6 (−9.2 to −6.0) | ||||
| (3) Stratum 3: ≥115 mmHg | ||||
| SBP −10.6 (−13.7 to −7.5) | ||||
| DBP −6.5 (−7.4 to −5.6) | ||||
| Control 0.4 (0.3 to 0.5) | ||||
| Takala et al67,68 | Hypertension, aged 40-49 years, SBP ≥160 mmHg or DBP | (1) ‘Improved treatment system’ included: written instructions; card with details of BP readings, drugs prescribed, time of next appointment; appointments at 1-monthly intervals; invitation for outpatient review; appointment if defaulted on any appointment | Age 40-49 | No effect RCT but improved follow-up at clinic |
| ≥95 mmHg; aged 50-64 years, SBP ≥170 mmHg or DBP ≥105 mmHg. | (2) Usual care | SBP 3.0 (−5.1 to 11.1) | ||
| DBP 3.0 (−1.1 to −7.1) | ||||
| Age 50-59 | ||||
| SBP 3.0 (−5.5 to 11.5) | ||||
| DBP 5.0 (0.7 to 9.3) | ||||
| Control 0.5 (0.2 to 1.0) | ||||
| Turnbull et al69 | Mild to moderate hypertension and aged between 18 and 75 years. | (1) Information communication technology package for risk assessment and management, access to a dietitian commissioned by the program and a tailored set of audiovisual and written material. | SBP −0.70 (−4.41 to 3.01) | No effect on SBP and DBP and blood pressure control |
| (2) Usual care | DBP −0.10 (−1.75 to 1.55) | |||
| Control 1.90 (1.14 to 3.19) | ||||
| Wetzels et al70 | Persons were eligible if had been diagnosed with hypertension and inadequate BP control despite drugs and indication for Rx escalation | A total of 258 patients with high BP despite use of antihypertensive medication were randomly assigned to either (1) continuation of usual care or to the (2) introduction of electronic monitoring. | SBP −2.00 (−7.04 to 3.04) | No effect on SBP and DBP and blood pressure control |
| DBP −1.00 (−3.57 to 1.57) | ||||
| Control 0.69 (0.40 to 1.19) | ||||
| Ahluwalia et al71 | Patients with hypertension (SBP ≥180 mmHg and/or DBP ≥110 mmHg) | (1) Mailed reminder: postcard addressed in the presence of the patient and mailed next day as a reminder to attend clinic | Return to clinic 1.4 (0.5 to 4.4) | No effect RCT |
| (2) Given routine clinic appointment | ||||
| Barnett et al72 | Hypertension mean 150/102 mmHg | (1) Computer reminder to GP: generated automatic reminder to GP | Return to clinic 0.01 (0.0 to 0.2) | Positive RCT |
| (2) Usual care | ||||
| Bloom et al73 | Hypertension ≥140/90 mmHg | (1) Educational material about hypertension, reinforced 1 week later | Return to clinic 0.3 (0.1 to 0.9) | Positive RCT |
| (2) Usual care | ||||
| Cummings et al74 | Newly diagnosed hypertension SBP <140 mmHg and DBP >90 mmHg | (1) Appointment reminder: reminder card sent 1 week in advance of appointment and telephone patients who missed appointments to schedule new ones | Return to clinic 0.5 (0.3 to 0.7) | Positive RCT |
| (2) Usual care | ||||
| Fletcher et al75 | Hypertension DBP ≥100 mmHg | (1) Reminder (letter or phone) to attend follow up appointment at clinic, offer of assistance if problems arose, followed up until attended clinic or missed two consecutive appointments | Return to clinic 0.3 (0.2 to 0.7) | Positive RCT |
| (2) Usual care | ||||
| Krieger et al76 | Hypertension SBP ≥140 mmHg or DBP≥90 mmHg | (1) Outreach and tracking by community health worker | Return to clinic 0.5 (0.3 to 0.7) | Positive RCT |
| (2) Usual care | ||||
| Marquez et al77 | Eighty-five primary care centers in Spain, with a duration of 6 months. | (1) Control – under routine clinical management; | Mail intervention | Positive effect on SBP, DBP and blood pressure control depending on intervention |
| Patients. A total of 636 patients with newly diagnosed uncontrolled hypertension were included. | (2) Mail intervention – received a mailed message reinforcing compliance and reminding or of the visits (15 days, 2 and 4 months) | SBP −0.30 (−3.05 to 2.45) | ||
| (3) Telephone intervention – received a telephone call at 15 days, then at 7 and 15 weeks. | DBP −7.10 (−12.05 to −2.15) | |||
| Control 0.52 (0.34 to 0.79) | ||||
| Telephone intervention | ||||
| SBP −9.50 (−11.95 to −7.05) | ||||
| DBP −0.20 (−1.91 to 1.51) | ||||
| Control 0.57 (0.37 to 0.87) | ||||
| Marquez et al78 | All patients were receiving monotherapy for uncontrolled hypertension. | (1) Patients in the control group received their physician's usual interventions. | SBP 4.70 (−1.29 to 10.69) | No effect SBP, DBP and blood pressure control |
| (2) Patients in the intervention group received messages and reminders sent to their mobile phones 2 days per week during 4 months. | DBP 1.60 (−2.10 to 5.30) | |||
| Control 0.58 (0.22 to 1.54) | ||||
↵a Outcomes: SBP and DBP mean difference in mmHg is reported. Negative figure favours intervention, positive figure favours control or usual care. Control of blood pressure measured according to treatment target definition in each RCT. Odds ratio less than one favours intervention. Return to Clinic: number of patients lost to follow-up at review. Odds ratio less than one favours intervention. BP = blood pressure. C = control. CVS = cardiovascular. DBP = diastolic blood pressure. E = experimental group. OPD = outpatient department. RCT = randomised controled trial. SBP = systolic blood pressure. TIME = Treatment Information on Medications for the Elderly.