Blood Pressure Management in the Care Home Population (BPITCH)

University of Leeds

Status: Active, not recruiting

Conditions: Hypertension; Aging

Study type: Observational

Funder types: Other

Identifiers

NCT06337682

CB_CY_P09_23_11

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 3,000 estimated patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 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.

Exclusion criteria

• no exclusion criteria applied to keep the sample representative of the real-world care home population.

Trial design

3,000 participants in 1 patient group

Care home cohort

Description:

Individuals aged 65 or over registered to a GP practice which is part of the Connected Bradford Database who have been admitted to a CH between January 2016 and January 2020, with a recorded length of stay more than 6 weeks, will be included in the study.