A Hybrid Type 1 Randomized Trial for Improved Post-Stroke Hypertension: This Study Aims to Examine the Impact of Group Medical Visits and Home Blood Pressure Monitoring Versus Home Blood Pressure Monitoring Alone on the the Impact of Hypertension in Those With Recent Stroke.
Massachusetts General Hospital
Summary
The investigators want to improve care for people who have had a stroke. High blood pressure is the leading cause for having a second stroke and can lead to poor brain health. The goal of this study is to compare two new ways of lowering blood pressure. The first way is to help people check their blood pressure at home. The second way is to bring people together and learn about blood pressure in a group setting. The study team thinks that using both methods together will make it easier to lower blood pressure after a stroke. The study team needs this study to test these two methods together in people who have had a stroke. The investigators believe this is an important study because having high blood pressure makes having another stroke very likely. Therefore, the investigators want to lower blood pressure in people with strokes to keep their brains as healthy as possible and to help with stroke recovery.
Description
Lowering blood pressure is a clear and effective target for improved secondary stroke prevention. Two evidenced-based interventions have shown clinical effectiveness in non-stroke populations to improve hypertension. Frist, home blood pressure monitoring (HBPM) has been shown to be accurate, pragmatic, effective, and incorporated into AHA guidelines. The second evidence-based intervention is the virtual group visit (VGV) model. VGVs are shared medical appointments conducted over virtual conference rooms that aim to provide pragmatic, patient-centered, cost-effective care for chronic disease ma…
Eligibility
- Age range
- 35+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Incident, mild to moderate, ischemic or hemorrhagic stroke (NIHSS≤15, ICH score≤3) * history or new diagnosis of hypertension * ability to read and speak English * internet access * established primary care physician at MGH Exclusion Criteria: * severe stroke (NIHSS\>15, ICH score\>3) * discharge location to inpatient rehabilitation or skilled nursing facility * dementia * subjects with moderate to severe aphasia without a caregiver to consent on their behalf
Interventions
- BehavioralGroup medical visits and home blood pressure monitoring
This arm will receive instructions for home blood pressure monitoring but also be enrolled in group medical visits.
Location
- Massachusetts General HospitalBoston, Massachusetts