Improving Hypertension Medication Adherence for Older Adults
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Jeannie K Lee, PharmD
- Phone Number: 520.626.9419
- Email: jklee@arizona.edu
Study Contact Backup
- Name: Wendy A Rogers, Ph.D.
- Phone Number: 217.300.1470
- Email: wendyr@illinois.edu
Study Locations
-
-
Arizona
-
Tucson, Arizona, United States, 85721
- University of Arizona
-
-
Illinois
-
Champaign, Illinois, United States, 61820
- University of Illinois Urbana-Champaign
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- age 65 years or older
- self-manage at least one hypertension medication
- able to read and speak English
- willing to participate in the study for six months
- currently have and use an Apple iPhone
- have hypertension medication adherence ≤ 90% in the last 2 weeks of the 4-week baseline monitoring period using an AARDEX MEMS® cap
Exclusion Criteria:
- have inadequate visual acuity (worse than 20/50 corrected near vision on Snellen test)
- experience severe depression (> 11 on Geriatric Depression Scale Short Form, GDS-15)
- are at risk for cognitive impairment (< 23 on Montreal Cognitive Assessment, MoCA)
- been instructed by their healthcare provider to withhold their blood pressure medication
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Other: Blood Pressure Technology System M
These participants will receive information about high blood pressure, medications and strategies that can be used to take medications and manage blood pressure.
They will complete a mid-assessment at 3-months and a post-assessment at 6-months.
|
Participants will be provided the blood pressure technology system M.
The study staff will teach the participants how to use the system on their personal cell phones with instruction guides.
Participants will be asked to use the system for 6-months.
|
|
Other: Blood Pressure Technology System E
These participants receive information about high blood pressure and medications.
They will complete a mid-assessment at 3-months and a post-assessment at 6-months.
|
Participants will be provided the blood pressure technology system E. The study staff will teach the participants how to use the system on their personal cell phones with instruction guides.
Participants will be asked to use the system for 6-months.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Medication Adherence (MEMS Cap)
Time Frame: 3 months, 6 months
|
The Medication Event Monitoring System (MEMS®Cap) assesses objective medication adherence using the smart pill bottle cap.
Digital sensors in the track cap automatically record the date and time of cap opening and upload the information to AARDEX Medication Adherence Software.
Percentage of medication taken at the correct time frame.
|
3 months, 6 months
|
|
Medication Adherence Report Scale (MARS-5)
Time Frame: 3 months, 6 months
|
The Medication Adherence Report Scale (MARS-5) is a 5-item self-report scale to assess medication adherence related to the frequency of not taking a prescribed dose of medication or not taking the dose prescribed.
Self-report score of 5-25.
Item scores are summed for a total scale score, where higher scores reflect greater medication adherence.
Scale: 5=never, 4=rarely, 3=sometimes, 2=often, and 1=always.
|
3 months, 6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Systolic Blood Pressure (SBP)
Time Frame: Baseline, 3-months, 6-months
|
The mean of two seated blood pressure readings taken at least 15 minutes apart using a validated automated device.
6-month change in mean seated systolic BP among M system users versus E system users.
|
Baseline, 3-months, 6-months
|
|
Perceived Autonomy
Time Frame: Baseline, 3-months, 6-months
|
The Treatment Self-Regulation Questionnaire (TSRQ) assesses perceived autonomy, treatment-related motivation, and health behavior change.
A 15-item questionnaire measures motivation and regulation styles that individuals employ to manage their health-related treatments or behaviors.
Scale: 1=Not at all true to 7=Very true.
Score 1-7 for each of the following components: TSRQ Autonomous motivation, TSRQ Introjected regulation, TSRQ External regulation, and TSRQ Amotivation.
The subscales are averaged to report the mean TSRQ score.
Higher numbers indicate higher autonomous motivation, controlled motivation, or amotivation.
6-month change in perceived autonomy among M system users versus E system users.
|
Baseline, 3-months, 6-months
|
|
Perceived Competence
Time Frame: Baseline, 3-months, 6-months
|
The Perceived Competence Scale (PCS) is a 4-item questionnaire designed to measure self-perceptions of competence in different contexts (e.g., managing medications).
We modified the questions to reflect blood pressure medications.
Scale: 1=Not at all true to 7=Very true.
Each score on the scale is summed, and a total score is reported (ranges between 4 and 28), with higher scores indicating higher perceived competence with medication adherence.
6-month change in perceived competence among M system users versus E system users.
|
Baseline, 3-months, 6-months
|
|
Mobile Device Proficiency
Time Frame: Baseline, 3-months, 6-months
|
The Mobile Device Proficiency Questionnaire (MDPQ) assesses experience with mobile devices, comfort level, and successful use.
A 16-item survey measures older adults' proficiency and comfort level in using mobile devices such as smartphones and tablets, including navigating various features and functions.
Each questionnaire item is assigned a value from 1 to 5 (1 = Never Tried; 5 = Very Easily).
Eight subscale scores are computed by taking the mean of the items within each respective subscale.
The overall score is calculated by adding together all subscale scores.
The MDPQ-16 total score ranges from 8 to 40, with higher scores reflecting greater proficiency.
6-month change in mobile device proficiency among M system users versus E system users.
|
Baseline, 3-months, 6-months
|
|
Hypertension Knowledge Level Scale
Time Frame: Baseline, 6 months
|
The Hypertension Knowledge Level Scale (HK-LS) consists of 22 questions with 6 sub-dimensions and scores, including: HK-LS Definition [0-2], HK-LS Medical treatment [0-4], HK-LS Drug Compliance [0-4], HK-LS Lifestyle [0-5], HK-LS Diet [0-2], and HK-LS Complications [0-5].
The sub-dimension scores are summed to generate an overall score.
The HK-LS Overall ranges from 0 to 22, with a higher score indicating higher knowledge about hypertension.
|
Baseline, 6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Publications and helpful links
General Publications
- Chan AHY, Horne R, Hankins M, Chisari C. The Medication Adherence Report Scale: A measurement tool for eliciting patients' reports of nonadherence. Br J Clin Pharmacol. 2020 Jul;86(7):1281-1288. doi: 10.1111/bcp.14193. Epub 2020 May 18.
- Williams GC, Freedman ZR, Deci EL. Supporting autonomy to motivate patients with diabetes for glucose control. Diabetes Care. 1998 Oct;21(10):1644-51. doi: 10.2337/diacare.21.10.1644.
- Roque NA, Boot WR. A New Tool for Assessing Mobile Device Proficiency in Older Adults: The Mobile Device Proficiency Questionnaire. J Appl Gerontol. 2018 Feb;37(2):131-156. doi: 10.1177/0733464816642582. Epub 2016 Apr 11.
- Lee JY, Kusek JW, Greene PG, Bernhard S, Norris K, Smith D, Wilkening B, Wright JT Jr. Assessing medication adherence by pill count and electronic monitoring in the African American Study of Kidney Disease and Hypertension (AASK) Pilot Study. Am J Hypertens. 1996 Aug;9(8):719-25. doi: 10.1016/0895-7061(96)00056-8.
- Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD, Wright JT Jr. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018 Jun;71(6):e13-e115. doi: 10.1161/HYP.0000000000000065. Epub 2017 Nov 13. No abstract available.
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
- R01NR018469 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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