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Published on: October 22, 2014
ESCAPE ancillary blood pressure measurement study 2: changes in end-digit preference after 2 years of a cluster
Clarisse Dibao-Dina1, Jean-Pierre Lebeau, Dominique Huas
1aDepartment of General Practice, François-Rabelais University, PRES Centre-Val de Loire University, Tours bBiostatistics Department, CNRS, UMR 558, Lyon-1 Medical University, Lyon, France.
Objective:
The aim of the ESCAPE AMPA 2 trial was to describe the evolution of end-digit preference (EDP) practices in primary care after 2 years of trial.
Methods:
A descriptive analysis of the EDP in the intervention group (IG) and in the electronic control group (ECG) of the ESCAPE trial and a comparative analysis of EDP changes in blood pressure (BP) measures of both groups were carried out between baseline and 2 years. In the ESCAPE trial, physicians in the IG were new users of electronic devices provided in the trial to measure their patients' BP and physicians in the ECG were former users of electronic devices. Hierarchical mixed-effects models were used for statistical analysis in a pragmatic cluster randomized-controlled trial.
Results:
After 2 years, the proportion of BP measures ending with a 0 or a 5 was significantly higher in the ECG than in the IG (50.4 vs. 33.4%, P<0.0001). There was no significant change in EDP tendency between baseline and the end of the trial in the ECG (65.6-56.7%, P=0.39) and in the IG (29.6-38.2%, P=0.07), with a between-groups P value of 0.11. Over 2 years, there was no significant change in systematic EDP in the ECG (18.8-20.0%, P=0.29) and in the IG (4.8-10.6%, P=0.01), with a between-groups P value of 0.17.
Conclusion:
EDP is not eliminated by electronic devices and tends to increase with time for new users.
Related Concept Videos
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:23Assessment of blood pressure in brachial artery(two-step method)
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:17Measurement of Blood Pressure
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
01:21Sites for measuring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement