Describing the Management of Hypertension in a UK Care Home Population
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 3,000
- 试验地点
- 1
- 主要终点
- Frequency of blood pressure measurements
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •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.
排除标准
- •no exclusion criteria applied to keep the sample representative of the real-world care home population.
结局指标
主要结局
Frequency of blood pressure measurements
时间窗: 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
时间窗: 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
时间窗: 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
次要结局
- 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))
研究者
Oliver Todd
Academic Clinical Lecturer
University of Leeds