# A randomized controlled pilot study investigating adherence to blood pressure diaries with personal pictures in stroke follow-up care

## TL;DR

This pilot study explored whether adding personal pictures to blood pressure diaries improves adherence in stroke patients, but found no significant difference in adherence between groups.

## Contribution

The study introduces the feasibility of using personalized blood pressure diaries with patient-selected images in stroke follow-up care.

## Key findings

- No significant difference in adherence was found between the personalized and standard blood pressure diary groups.
- Blood pressure measurements were within the recommended range and documentation was precise in both groups.
- Patient-reported outcomes like depression scores did not differ significantly between the groups.

## Abstract

Blood pressure (BP) management is essential in secondary stroke prevention. Strategies to ensure continuous home BP monitoring are needed. Few studies investigated factors influencing adherence to home BP management. Therefore, we designed a pilot study to investigate the feasibility of keeping BP diaries (BPDs) with personal images.

In this prospective trial, we randomized persons with a diagnosis of stroke or transient ischemic attack into two groups: (i) 10 patients received a personalized BPD with pictures of their choosing and (ii) 10 patients received a BPD without photographs. We instructed participants in both groups to document their BP at home twice daily over 28 days. Adherence was defined as the number of BP measurements performed relative to the maximum number of recommended measurements. We assessed patient reported outcomes as exploratory endpoints.

We found no statistically significant difference in mean adherence between the control group (64%) and the intervention group (69%). The BP was within the recommended range and precision of documentation was high in both groups, without statistically significant differences. Patient reported outcomes such as depression scores did not differ significantly between study groups.

Our findings underline the relevance to investigate aspects of adherence to home BP management suggesting the inclusion of patient-provided pictures to be feasible.

The online version of this article (10.1007/s00508-025-02530-w) contains supplementary material, which is available to authorized users.