Withdrawal of antihypertensive therapy in people with dementia: feasibility study

Background: This study explored the feasibility of a randomised controlled withdrawal trial of antihypertensive medication in normotensive people with dementia. Feasibility aspects included response, recruitment, exclusion and drop-out rates, suitability of outcome measures, acceptability of study p...

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Main Authors: van der Wardt, Veronika, Burton, Jennifer, K., Conroy, Simon, Welsh, Tomas
Format: Article
Published: Biomed Central 2018
Subjects:
Online Access:https://eprints.nottingham.ac.uk/49252/
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author van der Wardt, Veronika
Burton, Jennifer, K.
Conroy, Simon
Welsh, Tomas
author_facet van der Wardt, Veronika
Burton, Jennifer, K.
Conroy, Simon
Welsh, Tomas
author_sort van der Wardt, Veronika
building Nottingham Research Data Repository
collection Online Access
description Background: This study explored the feasibility of a randomised controlled withdrawal trial of antihypertensive medication in normotensive people with dementia. Feasibility aspects included response, recruitment, exclusion and drop-out rates, suitability of outcome measures, acceptability of study procedures and an indicative economic evaluation for a randomised controlled trial. Methods: A cohort study attempting the withdrawal of antihypertensive drugs where appropriate and a feasibility study of home-based blood pressure monitoring, in people with dementia treated for hypertension, was undertaken. Interviews with participants and carers and an indicative economic evaluation were also undertaken. Results: Three hundred and sixty-two primary care practices in the East Midlands were contacted of which only 41 (11% (95%CI 8–15%)) agreed to support the study. These 41 practices posted 940 letters to potential participants. Thirty participants were enrolled in the cohort study of whom 9 were eligible for the antihypertensive withdrawal programme, 20 participated in a home blood pressure monitoring sub-group analysis and 12 took part in an interview study. Twenty-two of those enrolled in the cohort study were followed up at 6 months. The withdrawal programme was acceptable to participants and general practitioners (GPs). The study procedures including assessments and home blood pressure monitoring were acceptable to the participants and their carers. The economic evaluation was not possible. Conclusion: A withdrawal trial of antihypertensive medication in normotensive people with dementia may not be feasible in the UK because of low recruitment rates.
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spelling nottingham-492522020-05-04T19:26:03Z https://eprints.nottingham.ac.uk/49252/ Withdrawal of antihypertensive therapy in people with dementia: feasibility study van der Wardt, Veronika Burton, Jennifer, K. Conroy, Simon Welsh, Tomas Background: This study explored the feasibility of a randomised controlled withdrawal trial of antihypertensive medication in normotensive people with dementia. Feasibility aspects included response, recruitment, exclusion and drop-out rates, suitability of outcome measures, acceptability of study procedures and an indicative economic evaluation for a randomised controlled trial. Methods: A cohort study attempting the withdrawal of antihypertensive drugs where appropriate and a feasibility study of home-based blood pressure monitoring, in people with dementia treated for hypertension, was undertaken. Interviews with participants and carers and an indicative economic evaluation were also undertaken. Results: Three hundred and sixty-two primary care practices in the East Midlands were contacted of which only 41 (11% (95%CI 8–15%)) agreed to support the study. These 41 practices posted 940 letters to potential participants. Thirty participants were enrolled in the cohort study of whom 9 were eligible for the antihypertensive withdrawal programme, 20 participated in a home blood pressure monitoring sub-group analysis and 12 took part in an interview study. Twenty-two of those enrolled in the cohort study were followed up at 6 months. The withdrawal programme was acceptable to participants and general practitioners (GPs). The study procedures including assessments and home blood pressure monitoring were acceptable to the participants and their carers. The economic evaluation was not possible. Conclusion: A withdrawal trial of antihypertensive medication in normotensive people with dementia may not be feasible in the UK because of low recruitment rates. Biomed Central 2018-01-09 Article PeerReviewed van der Wardt, Veronika, Burton, Jennifer, K., Conroy, Simon and Welsh, Tomas (2018) Withdrawal of antihypertensive therapy in people with dementia: feasibility study. Pilot and Feasibility Studies, 4 . 29/1-29/9. ISSN 2055-5784 Hypertension; Dementia; Antihypertensive medication; Withdrawal; Cessation; Feasibility study; Patient experience; Recruitment; Primary care https://pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-017-0221-0 doi:10.1186/s40814-017-0221-0 doi:10.1186/s40814-017-0221-0
spellingShingle Hypertension; Dementia; Antihypertensive medication; Withdrawal; Cessation; Feasibility study; Patient experience; Recruitment; Primary care
van der Wardt, Veronika
Burton, Jennifer, K.
Conroy, Simon
Welsh, Tomas
Withdrawal of antihypertensive therapy in people with dementia: feasibility study
title Withdrawal of antihypertensive therapy in people with dementia: feasibility study
title_full Withdrawal of antihypertensive therapy in people with dementia: feasibility study
title_fullStr Withdrawal of antihypertensive therapy in people with dementia: feasibility study
title_full_unstemmed Withdrawal of antihypertensive therapy in people with dementia: feasibility study
title_short Withdrawal of antihypertensive therapy in people with dementia: feasibility study
title_sort withdrawal of antihypertensive therapy in people with dementia: feasibility study
topic Hypertension; Dementia; Antihypertensive medication; Withdrawal; Cessation; Feasibility study; Patient experience; Recruitment; Primary care
url https://eprints.nottingham.ac.uk/49252/
https://eprints.nottingham.ac.uk/49252/
https://eprints.nottingham.ac.uk/49252/