Testing Feasibility of Medication Adherence Problem Solving for Hypertension (MASH)
Hypertension, Adherence, Medication
About this trial
This is an interventional supportive care trial for Hypertension focused on measuring Medication adherence, Hypertension, Telehealth
Eligibility Criteria
Inclusion Criteria: Aged ≥ 18 years at time of study entry Able to read, write, and converse in English Have an active prescription for at least one HTN medication, reporting no antihypertensive prescription changes for 30 days prior to study entry Have prescription drug coverage or participate in a prescription assistance program that covers medication costs. Diagnosis of HTN, based on self-report or confirmed through medical records, where available. (Self-reported high BP has long been shown to be strongly correlated with presence of a HTN diagnosis.22-24 Self-report combined with presence of a prescribed HTN medication ensures that only participants with HTN will be included) Must self-administer their own medications Uncontrolled BP: systolic (SBP) ≥ 130 mmHg and/or diastolic (DBP) ≥ 80 mmHg at baseline Nonadherent to HTN medication (Hill-Bone Medication Subscale score < 36) at screening Exclusion Criteria: Acutely ill (e.g., symptoms of myocardial infarction, respiratory distress, stroke) Patients who have end-stage renal disease (ESRD) and/or are on dialysis In state of hypertensive crisis (SBP >180 and/or DBP > 120 mmHg) at the time of study screening. Any participant in hypertensive crisis will be referred to their health care provider immediately for further instruction and follow-up, per current guidelines2 BP measurement is contraindicated on both upper extremities Terminal chronic illness with a life expectancy of 6 months or less
Sites / Locations
- Rush University Medical CenterRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Telehealth Intervention Group
Control
The intervention components are: 1) educational modules and 2) bi-weekly telehealth visits for managed problem solving for 12 weeks. All intervention participants will be provided four educational modules, electronically and in print form. The modules are adapted from evidence-based materials developed by the American Heart Association, American College of Cardiology, and Centers for Disease Control and Prevention and cover (1) the causes of HTN, (2) how HTN raises risks for other chronic conditions, (3) medications for effectively managing high BP, and (4) how to manage barriers to medication adherence. Telehealth visits will supplement and reinforce the educational modules, addressing participants' specific knowledge needs and enhancing self-efficacy.
The study will use a usual-care control group. The standard of care for this patient population does not involve any type of medication adherence intervention or monitoring beyond regular clinic follow-up visits with their health care provider. Control group participants will be given printed handouts on the American Heart Association's Life's Simple 7 lifestyle changes for reducing cardiovascular risk, along with the instructions for using the MEMS cap. If control group participants ask about their antihypertensive medications during the study, they will be referred to their prescribing provider or pharmacist for any information that could not be obtained from the medication label or pharmacy packaging.