Trial reportThe British journal of general practice : the journal of the Royal College of General Practitioners2007
A cluster randomised controlled trial of the effect of a treatment algorithm for hypertension in patients with type 2 diabetes.
Trial report in The British journal of general practice : the journal of the Royal College of General Practitioners, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 6 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes.The Cochrane database of systematic reviews · 2023Pooled it
- Non-medical prescribing versus medical prescribing for acute and chronic disease management in primary and secondary care.The Cochrane database of systematic reviews · 2016Pooled it
- Tools developed and disseminated by guideline producers to promote the uptake of their guidelines.The Cochrane database of systematic reviews · 2016Pooled it
- Pooled it
- Nurse led interventions to improve control of blood pressure in people with hypertension: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2010Pooled it
- The potency of team-based care interventions for hypertension: a meta-analysis.Archives of internal medicine · 2009Pooled it
- The evaluation of a nurse-led hypertension management model in an urban community healthcare: A randomized controlled trial.Medicine · 2020Trial
- Trial
- Effect of an educational toolkit on quality of care: a pragmatic cluster randomized trial.PLoS medicine · 2014Trial
- Outcomes of Patient Education in Nurse-led Clinics: A Systematic Review.Journal of caring sciences · 2023Review
- First-line diuretics versus other classes of antihypertensive drugs for hypertension.The Cochrane database of systematic reviews · 2023Review
- Article
- Traditional, complementary and alternative medical systems and their contribution to personalisation, prediction and prevention in medicine-person-centred medicine.The EPMA journal · 2012Article
- Medication intensification in diabetes in rural primary care: a cluster-randomised effectiveness trial.BMJ open · 2012Article
- How usual is usual care in pragmatic intervention studies in primary care? An overview of recent trials.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Article
Corrections and comments
- Commented on by
Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGood blood pressure (BP) control reduces the risk of complications in people with type 2 diabetes, yet many do not achieve this. Guidelines for managing hypertension recommend increasing antihypertensive medications until control is achieved, but the effect of such recommendations in routine primary care is unknown.
aimTo evaluate the effectiveness of a BP treatment algorithm in primary care patients with type 2 diabetes. DESIGN OF STUDY: A cluster randomised controlled trial of 1534 patients with type 2 diabetes.
settingForty-two practices in Nottingham, UK.
methodPractices were randomised to continue usual care or to use a treatment algorithm designed so that practice nurses and GPs would increase antihypertensive treatment in steps until the target of 140/80 mmHg was reached. Participants were assessed by a clinical interview and case note review at recruitment and at 1 year. The primary outcome measure was the proportion of participants achieving target BP at 1 year.
resultsAt 1 year there was no difference between the proportions of participants with well controlled BP in the intervention and control arms (36.6% versus 34.3%; P = 0.27). Mean systolic and diastolic blood pressures were identical in the two arms (143/78 mmHg). There was some evidence that participants in the intervention arm were more likely to be receiving higher doses of their antihypertensive drugs, although there was no significant difference in the number of different antihypertensive drugs prescribed. Participants in the intervention arm had a higher rate of primary care BP-related consultations over 12 months than those receiving usual care (rate ratio = 1.55, 95% confidence interval [CI] = 1.26 to 1.88, P<0.001).
conclusionDespite increased monitoring and possibly higher doses of medication there was no improvement in blood pressure control. Improvements achieved by specialist nurse-led clinics in secondary care may not translate to people with type 2 diabetes in primary care settings.
Indexed as
Identifiers
17263930PMC2034174W2121345430What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.