Text Messaging to Improve Hypertension Medication Adherence in African Americans: BPMED Intervention Development and Study Protocol.
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Date
2015-01-08
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Abstract
BACKGROUND Hypertension HTN is a major public health concern in the United States with almost 78 million Americans age 20 years and over suffering from the condition Moreover HTN is a key risk factor for health disease and stroke African Americans disproportionately shoulder the burdens of HTN with greater prevalence disease severity earlier onset and more HTN related complications than age matched whites Medication adherence for the treatment of HTN is poor with estimates indicating that only about half of hypertensive patients are adherent to prescribed medication regimens Although no single intervention for improving medication adherence has emerged as superior to others text message medication reminders have the potential to help improve medication adherence in African Americans with uncontrolled HTN as mobile phone adoption is very high in this population OBJECTIVE The purpose of this two phased study was to develop Phase I and test in a randomized controlled trial RCT Phase II a text message system BPMED to improve the quality of medication management through increasing medication adherence in African Americans with uncontrolled HTN METHODS In Phase I we recruited 16 target end users from a primary care clinic to assist in the development of BPMED through participating in one of three focus groups Focus groups sought to gain patient perspectives on HTN medication adherence mobile phone use and the use of text messaging to support medication adherence Potential intervention designs were presented to participants and feedback on the designs was solicited In Phase II we conducted two pilot RCTs to determine the feasibility acceptability and preliminary efficacy of BPMED in primary care and emergency department settings Both pilot studies recruited approximately 60 participants who were randomized equally between usual care and the BPMED intervention RESULTS Although data collection is now complete data analysis from the two pilot RCTs is still ongoing and results are expected in 2015 CONCLUSIONS This study was designed to determine preliminary feasibility and acceptability of our approach among African Americans with uncontrolled HTN in primary care and emergency department settings Results from these studies are of great interest as little work has been done to document the use of text message medication reminders to improve HTN related outcomes particularly within underserved urban minorities TRIAL REGISTRATION Clinicaltrials gov NCT01465217 https clinicaltrials gov ct2 show NCT01465217 Archived by WebCite at http www webcitation org 6V0tto0lZ