- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05293756
OPtimizing Technology to Improve Medication Adherence and BP Control (OPTIMA-BP)
OPtimizing Technology to Improve Medication Adherence and Blood Pressure Control
Hypertension (HTN) has a greater impact on African Americans (AA) than any other U.S. racial group. Uncontrolled blood pressure (BP) contributes to higher rates of disability, death, and health resource use among AA. HTN is the single most influential risk factor for cardiovascular disease (CVD), as well as a risk factor for the incidence of stroke, diabetes, chronic kidney disease, and dementia. Importantly, older adults account for 15% of the U.S. population, and two-thirds of older adults over age 60 have HTN, with higher rates observed in AA older adults. Strategies to support self-managing HTN and BP control are crucial as the older population is projected to age considerably and become more racially and ethnically diverse. Research has documented the negative effects on health and health outcomes of poorly controlled BP and is one of the most important modifiable CVD risk factors. Lower BP targets will require aggressive management and an increase in antihypertensive medications. Therefore, to achieve lower targets in this population, greater efforts, including patient-centered methods will be needed to support self-managing HTN, especially in terms of medication adherence.
As we shifted into the digital age, the use of mHealth technologies (smart phones, applications, SMS or text messaging) has been a powerful approach and mechanism for the treatment and management of chronic diseases. However, behavioral interventions that incorporate technology do not reach minorities or disadvantaged AA older adults with HTN. OPtimizing Technology to Improve Medication Adherence and BP Control (OPTIMA-BP) will leverage existing knowledge of effective technology-based components for HTN self-management to support and improve BP control using unique aspects of mHealth platforms in AA older adults. Findings from this study, if confirmed, will improve BP control and support self-managing HTN, as well as has the potential to close the health disparity gap between AA and non-AA older adults with HTN.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
OPTIMA-BP investigates the effectiveness of a technology-based intervention (TBI) for hypertension self-management and to improve blood pressure (BP) control.
The investigators aims to:
- To test the effects of OPTIMA-BP over a 12-month period vs. a 6 month waitlist control (WL) on systolic BP and health-related quality of life (HRQOL) in African American older adults with HTN in a prospective, randomized control trial.
- To test if the attitudinal/knowledge mechanisms of self-management (HTN knowledge, self-efficacy, perceived social support) and proximal behavioral target mechanisms (taking medications to reduce systolic BP, diet, exercise) mediate OPTIMA-BP vs. WL's impact on the primary and secondary outcomes (systolic BP, diastolic BP, HRQOL, serum lipids, and at least 62% of the sample with BP <130/80 mmHg) over a 12-month period.
The investigator also aims to:
3. Utilize qualitative evaluation to confirm self-management barriers and perceived strengths or limitations of the intervention, which will inform future refinements should these randomized controlled trial (RCT) findings be positive
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Carolyn Still, PhD
- Phone Number: 216-368-6338
- Email: carolyn.still@case.edu
Study Locations
-
-
Ohio
-
Cleveland, Ohio, United States, 44143
- Recruiting
- Case Western Reserve University
-
Contact:
- Carolyn Still
- Phone Number: 216-368-6338
- Email: cwh11@case.edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Self-identify as African American
- 50 years of age or older
- Diagnosed with hypertension, with a systolic blood pressure≥ 130 mmHg but less than 170 mmHg
- Prescribed at least two hypertensive, one of which is a diuretic/thiazide and or calcium channel blocker antihypertensive medication
- Own a smartphone with a data plan, the capability to download the Medisafe app, or view videos
- Able to read/understand English
Exclusion Criteria:
- Unable to give informed consent or judged to have impaired cognitive ability or severe memory
- Currently using a medication management application (app)
- Experienced a major CVD event or procedure (e.g., myocardial infarction, stroke, heart surgery) within the past year
- Patients with a diagnosis of chronic kidney disease (defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2) and/or receiving dialysis.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Intervention: OPTIMA-BP Implementation
Participants randomized to OPTIMA-BP intervention for 6 months then observed for a 6 month follow up period
|
Participants will continue their regular medical care, supplemented by the OPTIMA-BP intervention:
|
No Intervention: Waitlist: OPTIMA-BP implementation
Participants randomized to waitlist for 6 months, then offered the OPTIMA-BP intervention for 6 months.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Blood Pressure Control
Time Frame: Baseline - 6 months
|
Systolic BP < 130 mmHg or Diastolic BP < 80 mmHg, represents improved blood pressure control, measured digitally using a standard automatic BP device (Omron HEM-907 XL).
|
Baseline - 6 months
|
Health Related Quality of Life (HRQOL)
Time Frame: Baseline - 6 months
|
Assess HRQOL using PROMIS Global Health-10.
(Raw score range from 4-20, higher score represents better health
|
Baseline - 6 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Controlled BP (<130/80 mmHg)
Time Frame: Baseline - 6 months
|
Assess the Change in systolic BP/diastolic BP.
Goal of 62% of Study sample with SBP <130 mmHg.
Systolic BP <130 mmHg represents better BP control
|
Baseline - 6 months
|
Biological risk markers
Time Frame: Baseline - 6 months
|
Measured serum cholesterol (mg/dL); high-density lipoprotein (mg/dL); low density lipoprotein (mg/dL) and cholesterol (mg/dL)
|
Baseline - 6 months
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Carolyn Still, PhD, Case Western Reserve University, School of Nursing
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1R01NR019585-01A1 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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