Withdrawal of antihypertensive therapy in people with dementia: feasibility study

van der Wardt, Veronika; Burton, Jennifer, K.; Conroy, Simon; Welsh, Tomas; Logan, Pip; Taggar, Jaspal; Tanajewski, Lukasz; Gladman, John

Abstract

© 2018 The Author(s). Background: This study explored the feasibility of a randomised controlled withdrawal trial of antihypertensive medication in normotensive people with dementia. Feasibility aspects included response, recruitment, exclusion and drop-out rates, suitability of outcome measures, acceptability of study procedures and an indicative economic evaluation for a randomised controlled trial. Methods: A cohort study attempting the withdrawal of antihypertensive drugs where appropriate and a feasibility study of home-based blood pressure monitoring, in people with dementia treated for hypertension, was undertaken. Interviews with participants and carers and an indicative economic evaluation were also undertaken. Results: Three hundred and sixty-two primary care practices in the East Midlands were contacted of which only 41 (11% (95%CI 8-15%)) agreed to support the study. These 41 practices posted 940 letters to potential participants. Thirty participants were enrolled in the cohort study of whom 9 were eligible for the antihypertensive withdrawal programme, 20 participated in a home blood pressure monitoring sub-group analysis and 12 took part in an interview study. Twenty-two of those enrolled in the cohort study were followed up at 6 months. The withdrawal programme was acceptable to participants and general practitioners (GPs). The study procedures including assessments and home blood pressure monitoring were acceptable to the participants and their carers. The economic evaluation was not possible. Conclusion: A withdrawal trial of antihypertensive medication in normotensive people with dementia may not be feasible in the UK because of low recruitment rates.

Citation

van der Wardt, V., Burton, J. K., Conroy, S., Welsh, T., Logan, P., Taggar, J., Tanajewski, L., & Gladman, J. (2018). Withdrawal of antihypertensive therapy in people with dementia: feasibility study. Pilot and Feasibility Studies, 4(1), Article 29. https://doi.org/10.1186/s40814-017-0221-0

• Journal Article Type: Article
• Acceptance Date: Dec 15, 2017
• Online Publication Date: Jan 9, 2018
• Publication Date: Apr 25, 2018
• Deposit Date: Jan 22, 2018
• Publicly Available Date: Jan 22, 2018
• Journal: Pilot and Feasibility Studies
• Electronic ISSN: 2055-5784
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 4
• Issue: 1
• Article Number: 29
• DOI: https://doi.org/10.1186/s40814-017-0221-0
• Keywords: Hypertension; Dementia; Antihypertensive medication; Withdrawal; Cessation; Feasibility study; Patient experience; Recruitment; Primary care
• Public URL: https://nottingham-repository.worktribe.com/output/903670
• Publisher URL: https://pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-017-0221-0
• Related Public URLs: https://creativecommons.org/licenses/by/4.0/
• Contract Date: Jan 22, 2018