Medication Adherence Program (MAP)

September 28, 2026 updated by: Tulane University

Supporting Tailored Adaptive Change and Reinforcement for Medication Adherence Program: Randomized Trial of a Novel Approach to Improve Adherence in Older Hypertensive Women and Men

Randomized controlled trial testing the efficacy of the Supporting Tailored Adaptive change and Reinforcement for Medication Adherence Program (STAR-MAP), a health coaching approach that aims to improve antihypertensive medication adherence, blood pressure control, and quality of life. Participants (n=402) >=40 years old with a diagnosis of hypertension, uncontrolled blood pressure, and low antihypertensive medication adherence will be recruited through a statewide health insurer, Blue Cross Blue Shield of Louisiana, and randomized to receive either interactive health coaching sessions with medication reminder tools (intervention) or medication reminder tools only (control) over one year. Data will be collected from participants at baseline, 6 months, 12 months, and 24 months using questionnaires, physical measurement (height, weight, blood pressure), a computer-based single-category implicit association test, and laboratory analysis of antihypertensive medication urinary metabolites.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

402

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Louisiana
      • Baton Rouge, Louisiana, United States, 70808
        • Pennington Biomedical Research Center
      • Covington, Louisiana, United States, 70433
        • Tulane Doctors Dermatology & Multispecialty Clinic
      • Metairie, Louisiana, United States, 70002
        • Tulane Doctors Heart & Vascular and Primary Care Clinic
      • New Orleans, Louisiana, United States, 70112
        • Tulane University Clinical and Translational Unit
      • Shreveport, Louisiana, United States, 71101
        • LSU Health Sciences Shreveport Clinical Trials Office

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

40 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • fully insured by Blue Cross Blue Shield of Louisiana (BCBSLA)
  • continuously enrolled in BCBSLA for one year
  • planning to remain a member of BCBSLA for next year
  • English-speaking
  • telephone access
  • aged ≥40 years
  • diagnosis of essential hypertension (ICD-10-CM code I10)
  • currently filling antihypertensive medication
  • low antihypertensive medication refill (proportion of days covered (PDC) <0.8)
  • low self-report adherence (4-item Krousel-Wood Medication Adherence Scale (K-Wood-MAS-4) score ≥1)
  • uncontrolled blood pressure (BP) (systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg)
  • desire to improve BP

Exclusion Criteria:

  • living in a household with someone already enrolled in the study
  • enrollment in another clinical trial for drug adherence or BP control
  • moderate to severe cognitive impairment

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: STAR-MAP

Interactive health coaching sessions and medication reminder tools
Behavioral: STAR-MAP health coaching

Interactive health coaching delivered in 11 sessions over one year; focusing on using adaptive change tactics to improve medication-taking behavior

Behavioral: Medication reminder tools

Medication-taking reminder app and pillbox
Active Comparator: Medication App and Reminder System Medication Adherence Program (MARS-MAP)

Medication reminder tools only
Behavioral: Medication reminder tools

Medication-taking reminder app and pillbox

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Difference in proportion with PDC >=0.8 at 12 months
Time Frame: 12 months

Proportion of days covered (PDC) calculated from pharmacy refill data
12 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Difference in mean change in PDC, baseline to 12 months
Time Frame: Baseline to 12 months

Proportion of days covered (PDC) calculated from pharmacy refill data
Baseline to 12 months
Difference in mean change in 4-item Krousel-Wood Medication Adherence Scale score, baseline to 12 months
Time Frame: Baseline to 12 months

Self-reported adherence measured by 4-item Krousel-Wood Medication Adherence Scale (K-Wood-MAS-4; minimum value: 0 (better adherence); maximum value: 4 (worse adherence))
Baseline to 12 months
Difference in proportion with 4-item Krousel-Wood Medication Adherence Scale score <1 at 12 months
Time Frame: 12 months

Self-reported adherence measured by 4-item Krousel-Wood Medication Adherence Scale (K-Wood-MAS-4; minimum value: 0 (better adherence); maximum value: 4 (worse adherence))
12 months
Difference in change in proportion with high adherence as measured by urine metabolite analysis, baseline to 12 months
Time Frame: Baseline to 12 months

Adherence determined by liquid chromatography tandem mass spectrometry analysis of urinary metabolites of antihypertensive medications
Baseline to 12 months
Difference in proportion with controlled BP at 12 months
Time Frame: 12 months

Controlled blood pressure (BP) defined as systolic BP <130 mm Hg and diastolic BP <80 mm Hg; BP measured using standardized protocol
12 months
Difference in mean change in SBP, baseline to 12 months
Time Frame: Baseline to 12 months

Systolic blood pressure (SBP) measured using standardized protocol
Baseline to 12 months
Difference in mean change in DBP, baseline to 12 months
Time Frame: Baseline to 12 months

Diastolic blood pressure (DBP) measured using standardized protocol
Baseline to 12 months
Difference in mean change in health-related quality of life scores, baseline to 12 months
Time Frame: Baseline to 12 months

Quality of life measured using 12-item Short Form Survey (SF-12); scores for eight subscales, Mental Component Summary, and Physical Component Summary calculated and compared (minimum: 0 (worse quality of life); maximum: 100 (better quality of life))
Baseline to 12 months

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Difference in mean change in 4-item Krousel-Wood Medication Adherence Scale score, baseline to 6 months
Time Frame: Baseline to 6 months

Self-reported adherence measured by 4-item Krousel-Wood Medication Adherence Scale (K-Wood-MAS-4; minimum value: 0 (better adherence); maximum value: 4 (worse adherence))
Baseline to 6 months
Difference in proportion with 4-item Krousel-Wood Medication Adherence Scale score <1 at 6 months
Time Frame: 6 months

Self-reported adherence measured by 4-item Krousel-Wood Medication Adherence Scale (K-Wood-MAS-4; minimum value: 0 (better adherence); maximum value: 4 (worse adherence))
6 months
Difference in change in proportion with high adherence as measured by urine metabolite analysis, baseline to 6 months
Time Frame: Baseline to 6 months

Adherence determined by liquid chromatography tandem mass spectrometry analysis of urinary metabolites of antihypertensive medications
Baseline to 6 months
Difference in proportion with controlled BP at 6 months
Time Frame: 6 months

Controlled blood pressure (BP) defined as systolic BP <130 mm Hg and diastolic BP <80 mm Hg; BP measured using standardized protocol
6 months
Difference in mean change in SBP, baseline to 6 months
Time Frame: Baseline to 6 months

Systolic blood pressure (SBP) measured using standardized protocol
Baseline to 6 months
Difference in mean change in DBP, baseline to 6 months
Time Frame: Baseline to 6 months

Diastolic blood pressure (DBP) measured using standardized protocol
Baseline to 6 months
Difference in mean change in health-related quality of life scores, baseline to 6 months
Time Frame: Baseline to 6 months

Quality of life measured using 12-item Short Form Survey (SF-12); scores for eight subscales, Mental Component Summary, and Physical Component Summary calculated and compared (minimum: 0 (worse quality of life); maximum: 100 (better quality of life))
Baseline to 6 months
Difference in proportion with PDC >=0.8 at 24 months
Time Frame: 24 months

Proportion of days covered (PDC) calculated from pharmacy refill data
24 months
Difference in mean change in PDC, baseline to 24 months
Time Frame: Baseline to 24 months

Proportion of days covered (PDC) calculated from pharmacy refill data
Baseline to 24 months
Difference in mean change in 4-item Krousel-Wood Medication Adherence Scale score, baseline to 24 months
Time Frame: Baseline to 24 months

Self-reported adherence measured by 4-item Krousel-Wood Medication Adherence Scale (K-Wood-MAS-4; minimum value: 0 (better adherence); maximum value: 4 (worse adherence))
Baseline to 24 months
Difference in proportion with 4-item Krousel-Wood Medication Adherence Scale score <1 at 24 months
Time Frame: 24 months

Self-reported adherence measured by 4-item Krousel-Wood Medication Adherence Scale (K-Wood-MAS-4; minimum value: 0 (better adherence); maximum value: 4 (worse adherence))
24 months
Difference in change in proportion with high adherence as measured by urine metabolite analysis, baseline to 24 months
Time Frame: Baseline to 24 months

Adherence determined by liquid chromatography tandem mass spectrometry analysis of urinary metabolites of antihypertensive medications
Baseline to 24 months
Difference in proportion with controlled BP at 24 months
Time Frame: 24 months

Controlled blood pressure (BP) defined as systolic BP <130 mm Hg and diastolic BP <80 mm Hg; BP measured using standardized protocol
24 months
Difference in mean change in SBP, baseline to 24 months
Time Frame: Baseline to 24 months

Systolic blood pressure (SBP) measured using standardized protocol
Baseline to 24 months
Difference in mean change in DBP, baseline to 24 months
Time Frame: Baseline to 24 months

Diastolic blood pressure (DBP) measured using standardized protocol
Baseline to 24 months
Difference in mean change in health-related quality of life scores, baseline to 24 months
Time Frame: Baseline to 24 months

Quality of life measured using 12-item Short Form Survey (SF-12); scores for eight subscales, Mental Component Summary, and Physical Component Summary calculated and compared (minimum: 0 (worse quality of life); maximum: 100 (better quality of life))
Baseline to 24 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Tulane University

Collaborators

National Heart, Lung, and Blood Institute (NHLBI)
Ohio State University
Minds at Work

Investigators

  • Principal Investigator: Marie A Krousel-Wood, MD, MSPH, Tulane University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 7, 2022

Primary Completion (Estimated)

April 30, 2027

Study Completion (Estimated)

April 30, 2027

Study Registration Dates

First Submitted

December 17, 2021

First Submitted That Met QC Criteria

December 17, 2021

First Posted (Actual)

January 11, 2022

Study Record Updates

Last Update Posted (Actual)

October 1, 2026

Last Update Submitted That Met QC Criteria

September 28, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2020-2221
  • R01HL153750 (U.S. NIH Grant/Contract)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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