Edinburgh Napier University

British Heart Foundation

DL_2023_068

In Scotland blood pressure (BP) monitoring accounts for 1.2 million primary care appointments annually. Reducing high BP decreases cardiovascular disease. However, BP checked by patients at home is more accurate than when checked by doctors or nurses in the surgery. The Scale Up BP and successor Florence services aimed to improve the quality of BP monitoring and management by allowing patients to measure their own BP at home and electronically report it to their practice. In the current COVID-19 emergency it could support remote management of BP. In the pilot phase people found Scale Up BP helped them manage their BP more effectively, this was then followed up by a larger programme - Florence. This should lead to reduced rates of cardiovascular disease, but this is difficult to measure without a matched comparison group. This project therefore aims to use anonymised data to compare rates of hospital admission for cardiovascular disease for Scale Up BP/Florence users with multiple matched patients from GP practices which do not offer this service yet. It will also compare patterns of service use before and during the current covid19 pandemic. Similarly two other studies will investigate the use and impact of cardiovascular rehabilitation services and medicines optimisation on outcomes for people at risk of stroke and heart attack.

The outcomes will inform decisions about future investment in BP telemonitoring and cardiovascular rehabilitation services both at a management and individual patient level, plus guidance on medicines optimisation. For BP telemonitoring the expected benefits are reduced GP practice visits for routine BP monitoring, better BP control. For all interventions (BP telemonitoring, cardiovascular rehabilitation and medicines optimisation) the expected longer term benefits are reduction in the incidence of major cardiovascular events including stroke, myocardial infarction and uncontrolled heart failure leading to hospital admission. NHS Scotland data provides an almost unique opportunity to measure the impact of this intervention outside a clinical trial setting and provide a sound evidence base for changes to service and recommending services to patients.

Public Health Research

03/12/2024

De-Personalised

TRE