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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

Authors

Jennifer, K. Burton

Simon Conroy

Tomas Welsh

PIP LOGAN pip.logan@nottingham.ac.uk
Professor of Rehabilitation Research

Dr JASPAL TAGGAR Jaspal.Taggar@nottingham.ac.uk
Clinical Associate Professor and Headof Primary Care Undergraduate Education

Lukasz Tanajewski

JOHN GLADMAN john.gladman@nottingham.ac.uk
Professor of Medicine of Older People



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., …Gladman, J. (2018). Withdrawal of antihypertensive therapy in people with dementia: feasibility study. Pilot and Feasibility Studies, 4(1), 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 http://eprints.nottingham.ac.uk/id/eprint/49252
Publisher URL https://pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-017-0221-0
Related Public URLs https://creativecommons.org/licenses/by/4.0/
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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