Describing the Management of Hypertension in a UK Care Home Population
Trial Snapshot
- Phase
- Not Applicable
- Status
- Active, not recruiting
- Sponsor
- University of Leeds
- Enrollment
- 3,000
- Locations
- 1
- Primary Endpoint
- Frequency of blood pressure measurements
Study Overview
Brief Summary
The UK care home population is projected to increase significantly over the coming decades. A high proportion of individuals in a care home have multiple long-term conditions and take large amounts of prescribed medication. This means they are routinely excluded from research studies and so there is little evidence on which to base treatment of long-term conditions such as high blood pressure. Furthermore, given that 1 in 4 people admitted into a care home die within 1 year, the benefit of treating high blood pressure to reduce the risk of heart attack or stroke must be balanced with the need to optimise quality of life. The aim of this study is to describe the health and social characteristics of the UK care home population with a particular focus on the management of blood pressure in the population. It is hoped that the findings of this study will help inform future research into the management of chronic conditions in care home residents.
Detailed Description
The investigators will use the connected Bradford dataset to examine UK electronic health records to describe the UK care home population and management of hypertension in this population. The sample will include all adults aged 65 and over who have been admitted into a care home between January 2016 and December 2019. The investigators will extract data at the time of care home admission including age, sex, ethnicity, coded diagnosis of hypertension, indices of frailty and risk of falls as well as comorbidities relevant to cardiovascular risk and falls risk. Analysis will include looking at the prevalence of hypertension amongst the care home population, describing treatment patterns (i.e. number and type of prescribed anti-hypertensive medications, frequency of blood pressure monitoring) and the proportion of patients with blood pressure controlled according to National Institute of Health and Care Excellence (NICE) guidelines. The investigators will also look to establish whether there are any changes in the number and type of prescribed antihypertensive medication before and after admission to a care home (i.e. intensification of pharmacological therapy or deprescribing) and whether this differs amongst different subgroups of populations including patients with terminal illness and stroke diagnosis. The investigators will also estimate frequency of falls in the year following care home admission.
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Retrospective
Eligibility Criteria
- Ages
- 65 Years to — (Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •registered to a GP practice contributing to the Connected Bradford dataset at the point of admission
- •a recorded length of stay in a care home of longer than six weeks
- •recorded social care entry for nursing or residential care in the Bradford council social care data.
Exclusion Criteria
- •no exclusion criteria applied to keep the sample representative of the real-world care home population.
Outcomes
Primary Outcomes
Frequency of blood pressure measurements
Time Frame: from the point of admission up to 12 months following admission
the proportion of individuals entering a care home, with a diagnosis of hypertension, have their blood pressure measured in the year following admission
change in antihypertensive medication
Time Frame: 6 months before admission to 6 months following admission
change in the number or type of antihypertensive mediation from six months before care home admission to six months following care home admission
Injurious falls
Time Frame: from the point of admission up to 12 months after admission
one year incidence of a fall resulting in hospital attendance in those entering a care home
Secondary Outcomes
- Blood pressure treatment(12 months following admission)
- Prevalence of hypertension(at the day of admission to a care home (this will vary between each individual))
- Antihypertensive medication(at the day of admission to a care home (this will vary between each individual))
Investigators
Oliver Todd
Academic Clinical Lecturer
University of Leeds