Effect of Self-monitoring of Blood Pressure on Diagnosis of Hypertension During Higher-Risk Pregnancy: The BUMP 1 Randomized Clinical Trial.
Tucker, KL
Mort, S
Yu, L-M
Campbell, H
Rivero-Arias, O
Wilson, HM
Allen, J
Band, R
Chisholm, A
Crawford, C
Dougall, G
Engonidou, L
Franssen, M
Green, M
Greenfield, S
Hinton, L
Hodgkinson, J
Lavallee, L
Leeson, P
McCourt, C
Mackillop, L
Sandall, J
Santos, M
Tarassenko, L
Velardo, C
Yardley, L
Chappell, LC
McManus, RJ
BUMP Investigators,
- Publisher:
- American Medical Association
- Publication Type:
- Journal Article
- Citation:
- JAMA: Journal of the American Medical Association, 2022, 327, (17), pp. 1656-1665
- Issue Date:
- 2022-05-03
Closed Access
Filename | Description | Size | |||
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Effect of Self-monitoring of Blood Pressure on Diagnosis of Hypertension During Higher-Risk Pregnancy_The BUMP 1 Randomized Clinical Trial.pdf | 2.52 MB | Adobe PDF |
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Full metadata record
Field | Value | Language |
---|---|---|
dc.contributor.author | Tucker, KL | |
dc.contributor.author | Mort, S | |
dc.contributor.author | Yu, L-M | |
dc.contributor.author | Campbell, H | |
dc.contributor.author | Rivero-Arias, O | |
dc.contributor.author | Wilson, HM | |
dc.contributor.author | Allen, J | |
dc.contributor.author | Band, R | |
dc.contributor.author | Chisholm, A | |
dc.contributor.author | Crawford, C | |
dc.contributor.author | Dougall, G | |
dc.contributor.author | Engonidou, L | |
dc.contributor.author | Franssen, M | |
dc.contributor.author | Green, M | |
dc.contributor.author | Greenfield, S | |
dc.contributor.author | Hinton, L | |
dc.contributor.author | Hodgkinson, J | |
dc.contributor.author | Lavallee, L | |
dc.contributor.author | Leeson, P | |
dc.contributor.author | McCourt, C | |
dc.contributor.author | Mackillop, L | |
dc.contributor.author |
Sandall, J https://orcid.org/0000-0003-2000-743X |
|
dc.contributor.author | Santos, M | |
dc.contributor.author | Tarassenko, L | |
dc.contributor.author | Velardo, C | |
dc.contributor.author | Yardley, L | |
dc.contributor.author | Chappell, LC | |
dc.contributor.author | McManus, RJ | |
dc.contributor.author | BUMP Investigators, | |
dc.date.accessioned | 2022-10-14T03:20:05Z | |
dc.date.available | 2022-10-14T03:20:05Z | |
dc.date.issued | 2022-05-03 | |
dc.identifier.citation | JAMA: Journal of the American Medical Association, 2022, 327, (17), pp. 1656-1665 | |
dc.identifier.issn | 0098-7484 | |
dc.identifier.issn | 1538-3598 | |
dc.identifier.uri | http://hdl.handle.net/10453/162599 | |
dc.description.abstract | Importance: Inadequate management of elevated blood pressure (BP) is a significant contributing factor to maternal deaths. Self-monitoring of BP in the general population has been shown to improve the diagnosis and management of hypertension; however, little is known about its use in pregnancy. Objective: To determine whether self-monitoring of BP in higher-risk pregnancies leads to earlier detection of pregnancy hypertension. Design, Setting, and Participants: Unblinded, randomized clinical trial that included 2441 pregnant individuals at higher risk of preeclampsia and recruited at a mean of 20 weeks' gestation from 15 hospital maternity units in England between November 2018 and October 2019. Final follow-up was completed in April 2020. Interventions: Participating individuals were randomized to either BP self-monitoring with telemonitoring (n = 1223) plus usual care or usual antenatal care alone (n = 1218) without access to telemonitored BP. Main Outcomes and Measures: The primary outcome was time to first recorded hypertension measured by a health care professional. Results: Among 2441 participants who were randomized (mean [SD] age, 33 [5.6] years; mean gestation, 20 [1.6] weeks), 2346 (96%) completed the trial. The time from randomization to clinic recording of hypertension was not significantly different between individuals in the self-monitoring group (mean [SD], 104.3 [32.6] days) vs in the usual care group (mean [SD], 106.2 [32.0] days) (mean difference, -1.6 days [95% CI, -8.1 to 4.9]; P = .64). Eighteen serious adverse events were reported during the trial with none judged as related to the intervention (12 [1%] in the self-monitoring group vs 6 [0.5%] in the usual care group). Conclusions and Relevance: Among pregnant individuals at higher risk of preeclampsia, blood pressure self-monitoring with telemonitoring, compared with usual care, did not lead to significantly earlier clinic-based detection of hypertension. Trial Registration: ClinicalTrials.gov Identifier: NCT03334149. | |
dc.format | ||
dc.language | eng | |
dc.publisher | American Medical Association | |
dc.relation.ispartof | JAMA: Journal of the American Medical Association | |
dc.relation.isbasedon | 10.1001/jama.2022.4712 | |
dc.rights | info:eu-repo/semantics/closedAccess | |
dc.subject | 11 Medical and Health Sciences | |
dc.subject.classification | General & Internal Medicine | |
dc.subject.mesh | Adult | |
dc.subject.mesh | Blood Pressure | |
dc.subject.mesh | Blood Pressure Monitoring, Ambulatory | |
dc.subject.mesh | Female | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Hypertension | |
dc.subject.mesh | Hypertension, Pregnancy-Induced | |
dc.subject.mesh | Pre-Eclampsia | |
dc.subject.mesh | Pregnancy | |
dc.subject.mesh | Pregnancy, High-Risk | |
dc.subject.mesh | Self-Testing | |
dc.subject.mesh | Telemetry | |
dc.subject.mesh | Adult | |
dc.subject.mesh | Blood Pressure | |
dc.subject.mesh | Blood Pressure Monitoring, Ambulatory | |
dc.subject.mesh | Female | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Hypertension | |
dc.subject.mesh | Hypertension, Pregnancy-Induced | |
dc.subject.mesh | Pre-Eclampsia | |
dc.subject.mesh | Pregnancy | |
dc.subject.mesh | Pregnancy, High-Risk | |
dc.subject.mesh | Self-Testing | |
dc.subject.mesh | Telemetry | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Hypertension, Pregnancy-Induced | |
dc.subject.mesh | Pre-Eclampsia | |
dc.subject.mesh | Hypertension | |
dc.subject.mesh | Blood Pressure Monitoring, Ambulatory | |
dc.subject.mesh | Telemetry | |
dc.subject.mesh | Pregnancy | |
dc.subject.mesh | Pregnancy, High-Risk | |
dc.subject.mesh | Blood Pressure | |
dc.subject.mesh | Adult | |
dc.subject.mesh | Female | |
dc.subject.mesh | Self-Testing | |
dc.title | Effect of Self-monitoring of Blood Pressure on Diagnosis of Hypertension During Higher-Risk Pregnancy: The BUMP 1 Randomized Clinical Trial. | |
dc.type | Journal Article | |
utslib.citation.volume | 327 | |
utslib.location.activity | United States | |
utslib.for | 11 Medical and Health Sciences | |
pubs.organisational-group | /University of Technology Sydney | |
pubs.organisational-group | /University of Technology Sydney/Faculty of Health | |
pubs.organisational-group | /University of Technology Sydney/Faculty of Health/Midwifery | |
utslib.copyright.status | closed_access | * |
pubs.consider-herdc | false | |
dc.date.updated | 2022-10-14T03:20:03Z | |
pubs.issue | 17 | |
pubs.publication-status | Published | |
pubs.volume | 327 | |
utslib.citation.issue | 17 |
Abstract:
Importance: Inadequate management of elevated blood pressure (BP) is a significant contributing factor to maternal deaths. Self-monitoring of BP in the general population has been shown to improve the diagnosis and management of hypertension; however, little is known about its use in pregnancy. Objective: To determine whether self-monitoring of BP in higher-risk pregnancies leads to earlier detection of pregnancy hypertension. Design, Setting, and Participants: Unblinded, randomized clinical trial that included 2441 pregnant individuals at higher risk of preeclampsia and recruited at a mean of 20 weeks' gestation from 15 hospital maternity units in England between November 2018 and October 2019. Final follow-up was completed in April 2020. Interventions: Participating individuals were randomized to either BP self-monitoring with telemonitoring (n = 1223) plus usual care or usual antenatal care alone (n = 1218) without access to telemonitored BP. Main Outcomes and Measures: The primary outcome was time to first recorded hypertension measured by a health care professional. Results: Among 2441 participants who were randomized (mean [SD] age, 33 [5.6] years; mean gestation, 20 [1.6] weeks), 2346 (96%) completed the trial. The time from randomization to clinic recording of hypertension was not significantly different between individuals in the self-monitoring group (mean [SD], 104.3 [32.6] days) vs in the usual care group (mean [SD], 106.2 [32.0] days) (mean difference, -1.6 days [95% CI, -8.1 to 4.9]; P = .64). Eighteen serious adverse events were reported during the trial with none judged as related to the intervention (12 [1%] in the self-monitoring group vs 6 [0.5%] in the usual care group). Conclusions and Relevance: Among pregnant individuals at higher risk of preeclampsia, blood pressure self-monitoring with telemonitoring, compared with usual care, did not lead to significantly earlier clinic-based detection of hypertension. Trial Registration: ClinicalTrials.gov Identifier: NCT03334149.
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