Photo Credit: freepik
The following is a summary of “Supporting GPs and people with hypertension to maximise medication use to control blood pressure: a pilot cluster RCT of the MIAMI intervention,” published in the November 2024 issue of Primary Care by Morrissey et al.
Hypertension is a key risk factor for heart disease and stroke. Poor treatment adherence and physician inertia are major barriers to effective blood pressure management.
Researchers conducted a retrospective study to analyze the feasibility of the Maximizing Adherence, Minimizing Inertia (MIAMI) intervention supports general practitioners (GPs) in improving blood pressure management and refining the intervention for a definitive randomized control trial (RCT).
A pilot cluster RCT included a MIAMI intervention and usual-care control. Clinical measures and self-reported questionnaires were collected at baseline and 12 weeks. Semi-structured interviews assessed fidelity and health economics costings (as measured by a protocol checklist and through qualitative interviews).
The results showed 6 GP practices (intervention arm n = 3, control arm n = 3) and 52 patients (intervention arm n = 25, control arm n = 27) participated, with all practices and 92% of patients retained. Fidelity was good (as measured by a checklist and through qualitative interviews), though 3 protocol deviations occurred. Outcomes and measures were acceptable, and the MIAMI intervention’s implementation cost was estimated at €490 per participant. Qualitative data indicated the intervention was acceptable and feasible for both GP and patient participants, except the urine test component, which GPs found challenging to implement due to logistical issues.
The study concluded that the MIAMI intervention was largely acceptable and feasible, though adjustments to components and trial processes were needed to support a definitive RCT.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02635-7
