Mi Propio Camino Intervention RCT for Blood Pressure Medication Adherence (MPC)
Mi Propio Camino (Finding My Own Way): Personalized Approaches to Improve Blood Pressure Control
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: John Billimek, PhD
- Phone Number: 949-824-3065
- Email: john.billimek@uci.edu
Study Locations
-
-
California
-
Irvine, California, United States, 92697
- Health Policy Research Institute
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion criteria are: (1) age 18 years or greater, (2) uncontrolled hypertension (BP above 140/90 mmHg), (3) Hispanic ethnicity, (4) Spanish or English-speaking, (5) at least one office visit at the study clinic in prior 12 months.
Exclusion criteria: Persons with stage 4 or 5 chronic kidney disease (CKD) will be excluded.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Mi Propio Camino (MPC; My Own Way)
Participants will complete the MPC intervention alongside usual care for hypertension
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The Mi Propio Camino (MPC) intervention will be comprised of four sessions.
Session 1 will encompass: the facts about high blood pressure (BP), understanding blood pressure readings, provide an overview of changes one can make to manage their BP, introduce MPC personal experience monitoring, and usage the mHealth kit.
Subsequently, sessions 2-4 will emphasize the benefits of personal experience monitoring through 1) personal insight (finding what works for them) and 2) empowerment to work with their providers.
Session 2 will reinforce this by introducing: synergy between medication and lifestyle, principles of heart-healthy eating and physical activity.
Session 3 will incorporate discussion of negative beliefs about medication and patient directed lifestyle learning-rotating stations.
Lastly, session 4 will introduce the continuation of personal experience monitoring on their own through the use of behavioral strategies for adherence and provider communication strategies.
Other Names:
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Active Comparator: Habilidades para Controlar la Presion (HCP; Skills for Blood Pressure Control)
Participants will complete the HCP intervention alongside usual care for hypertension.
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The HCP intervention will be comprised of four sessions and introduce seven lifestyle strategies (LS) subdivided per these sessions.
Session 1 will encompass the facts about high blood pressure (BP), understanding blood pressure readings, provide an overview of changes one can make to manage their BP, present specific health threats from high BP, and incorporate LS1: taking control of your medication.
Subsequently, sessions 2-4 will reinforce the benefits of taking medications through presenting 1) reduced risk for complications and 2) strategies to remember to take medications.
Session 2 will present LS2: eating a well-balanced, low-salt diet and LS3: enjoying regular physical activity.
Session 3 will follow with introducing LS4: maintaining a healthy weight and LS5: shaking the salt habit while eating out.
Session 4 will present LS6: managing stress and LS7: working together with their doctor followed by a review of strategies they can continue on their own.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Medication Adherence (Objective)
Time Frame: 6 months post-intervention
|
Medication adherence is assessed at 6-month follow-up with Medication Event Monitoring System (MEMS) pill bottle cap monitors (MWV/WestRock), an objective, gold-standard measure for pill-taking behavior.
MEMS caps can be affixed to a medicine bottle to record each time the bottle is opened, indicating when the patient took the medication.
Daily adherence is defined as the proportion of days that the prescribed number of doses was taken by the patient during a 30-day period.
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6 months post-intervention
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Medication Adherence (Subjective)
Time Frame: 6 months post-intervention
|
Subjective medication adherence was assessed with a validated Spanish-language version of the Morisky Medication Adherence Scale (8-item MMAS; score range 0-8 with higher scores corresponding to better adherence).
Scores were analyzed as a continuous scale score at 6-month follow-up.
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6 months post-intervention
|
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Number of Participants Who Were Nonadherent Due To Beliefs (Subjective)
Time Frame: 6 months post-intervention
|
Nonadherence related to beliefs was assessed with the Safran Medication Adherence questionnaire, and defined as endorsement of one or more of 6 belief-related nonadherence items in the questionnaire at 6-month follow-up.
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6 months post-intervention
|
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Medication-related Beliefs (Specific)
Time Frame: 5 months post-intervention
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Medication-related beliefs were assessed using the Beliefs about Medicines Questionnaire - Specific Necessity-Concerns scale (range -20 - +20), with higher scores indicating more positive beliefs about one's prescribed blood pressure medications (i.e.
greater perceived necessity relative to concerns).
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5 months post-intervention
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Systolic Blood Pressure
Time Frame: 6 months post-intervention
|
This outcome measure will be recorded following the American Heart Association (AHA) and American College of Cardiology (ACC) guidelines for proper methods and accurate blood pressure (BP) measurement.
Accurate BP measurements are subdivided into pre and post-steps.
Before measuring of BP, patients are to be prepared for proper technique including: having the patient sit quietly with their feet on the floor, back supported and relaxed for 5 minutes, supporting arm used for measurement on a desk and ensuring it is positioned at heart level.
Subsequently, the middle of the BP cuff should be positioned on the patient's upper arm ensuring that the correct cuff size is used based on the cuff size criteria from AHA.
As our patients are already taking medication that might affect BP, timing of measurements should be standardized to the patient's medication intake.
Blood pressure will be collected for analysis at baseline, upon completion of intervention period and upon completion of outcome
|
6 months post-intervention
|
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Diastolic Blood Pressure
Time Frame: 6 months post-intervention
|
This outcome measure will be recorded following the American Heart Association (AHA) and American College of Cardiology (ACC) guidelines for proper methods and accurate blood pressure (BP) measurement.
Accurate BP measurements are subdivided into pre and post-steps.
Before measuring of BP, patients are to be prepared for proper technique including: having the patient sit quietly with their feet on the floor, back supported and relaxed for 5 minutes, supporting arm used for measurement on a desk and ensuring it is positioned at heart level.
Subsequently, the middle of the BP cuff should be positioned on the patient's upper arm ensuring that the correct cuff size is used based on the cuff size criteria from AHA.
As our patients are already taking medication that might affect BP, timing of measurements should be standardized to the patient's medication intake.
Blood pressure will be collected for analysis at baseline, upon completion of intervention period and upon completion of outcome.
|
6 months post-intervention
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Medication-related Behavioral Skills
Time Frame: Collected for analysis at baseline, upon completion of intervention period and upon completion of outcome assessment period at 1-month and 6-month follow up.
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Knowledge of Medication-related Behavioral Skills will be assessed withthe PROMIS Self-Efficacy for Managing Chronic Conditions Manage Medications/Treatment scale
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Collected for analysis at baseline, upon completion of intervention period and upon completion of outcome assessment period at 1-month and 6-month follow up.
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Medication-related Information
Time Frame: Collected for analysis at baseline, upon completion of intervention period and upon completion of outcome assessment period at 1-month and 6-month follow up.
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Knowledge of medication-related information will be assessed with a questionnaire adapted from the Medication Knowledge Questionnaire (MKQ)
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Collected for analysis at baseline, upon completion of intervention period and upon completion of outcome assessment period at 1-month and 6-month follow up.
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Activation of Behavioral Strategies
Time Frame: Collected for analysis at baseline, upon completion of intervention period and upon completion of outcome assessment period at 1-month and 6-month follow up.
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Activation of behavioral strategies measured with the Medication Adherence Strategies Inventory (ASI)60, an inventory of 7 common strategies for adherence.
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Collected for analysis at baseline, upon completion of intervention period and upon completion of outcome assessment period at 1-month and 6-month follow up.
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: John Billimek, PhD, University of California, Irvine
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 20174025
- 1R01HL142964 (U.S. NIH Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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