Antoinette Schoenthaler|Michelle Leon|Mark J. Butler|Karsten Steinhaeuser|William Wardzinski
Development and Evaluation of a Tailored Mobile Health Intervention to Improve Medication Adherence in Black Patients With Uncontrolled Hypertension and Type 2 Diabetes: Pilot Randomized Feasibility Trial
NYU Langone Health|Fordham University|Feinstein Institute for Medical Research|Northwell Health|Radiant Research (United States)|Radiant Research (United States)
research underscored need develop socioculturally tailored interventions improve adherence behaviors minority patients hypertension htn type 2 diabetes t2d novel mobile health mhealth approaches potential methods delivering tailored interventions minority patients increased cardiovascular riskthis study aims develop evaluate acceptability preliminary efficacy tailored mhealth adherence intervention versus attention control ac medication adherence systolic blood pressure sbp diastolic blood pressure dbp hemoglobin a1c hba1c 3 months 42 black patients uncontrolled htn andor t2d initially nonadherent medicationsthis twophase pilot study consisting formative phase clinical efficacy phase formative phase consisted qualitative interviews 10 members target patient population 710 70 female mean age 658 years sd 56 tailor intervention based informationmotivationbehavioral skills model adherence clinical efficacy phase consisted 3month pilot randomized controlled trial evaluate tailored mhealth intervention versus ac tabletdelivered intervention included tailoring survey individualized adherence profile personalized list interactive adherencepromoting modules whereas ac included tailoring survey health education videos delivered tablet acceptability assessed semistructured exit interviews medication adherence assessed using 8item morisky medication adherence scale whereas blood pressure hba1c assessed using automated devicesin phase 1 thematic analysis semistructured interviews revealed following 5 major barriers adherence disruptions daily routine forgetfulness concerns adverse effects preference natural remedies burdens medication taking patients recommended inclusion modules address improving patientprovider communication peer vignettes stress reduction strategies facilitate adherence total 42 black patients 2342 55 male mean age 576 years sd 111 participated clinical efficacy pilot trial 3 months groups showed significant improvements adherence mean 135 sd 160 p001 sbp 476 mm hg p04 betweengroup differences p50 p10 decreases dbp hba1c time nonsignificant 197 mm hg p20 02 p45 respectively patients reported high acceptability intervention improving adherencethis pilot study demonstrated preliminary evidence acceptability tailored mhealth adherence intervention among sample black patients uncontrolled htn t2d initially nonadherent medications future research explore whether repeated opportunities use mhealth intervention would result improvements behavioral clinical outcomes time modifications intervention result pilot study guide future effortsclinicaltrialsgov nct01643473 httpclinicaltrialsgovct2show nct01643473