- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne NCT02846220
Promoting Medication Adherence Among Older Adults With Hypertension
Overcoming Immunity to Change: A Feasibility Study of a New Method to Promote Medication Adherence Among Older Adults With Hypertension
Over 70% of US adults 65 or older are diagnosed with hypertension, the leading cause of cardiovascular disease and premature deaths in the world. Despite availability of effective drugs to control blood pressure, uncontrolled blood pressure and low adherence to antihypertensive drugs persist as major public health and clinical challenges. On average, 50% of adults adhere to chronic disease medications and lower levels of adherence are associated with worse blood pressure control and adverse outcomes. Many barriers to adherence are well known and have been targeted in interventions to improve medication adherence. As of yet, no single intervention has emerged as superior or even particularly effective in improving adherence. The investigators have recently identified unconscious, self-protective 'hidden motives' that contribute to nonadherence to chronic disease medications. There is a critical need to expand on this insight to test the potential for targeting individuals' 'hidden motives' for low adherence using an innovative learning process called Immunity-to-Change.
As a critical step in testing this intervention to target these 'hidden motives', the investigators will undertake a pilot study to assess the feasibility and acceptability of the Overcoming Immunity-to-Change intervention and determine effect sizes of the intervention on adherence, blood pressure (BP) control, and quality of life (QOL). The investigators will test the Immunity-to-Change intervention in a sample of nonadherent older adults with hypertension (n=18). Another sample of nonadherent older adults with hypertension will be monitored for comparison (n=18).
Przegląd badań
Status
Warunki
Interwencja / Leczenie
Typ studiów
Zapisy (Rzeczywisty)
Faza
- Nie dotyczy
Kontakty i lokalizacje
Lokalizacje studiów
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Louisiana
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New Orleans, Louisiana, Stany Zjednoczone, 70112
- Tulane University
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Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
Akceptuje zdrowych ochotników
Płeć kwalifikująca się do nauki
Opis
Inclusion Criteria:
- Men and women ages 55 and older, with the goal of a sex- and race-balanced sample
- Diagnosis of essential hypertension
- Uncontrolled hypertension
- Current treatment with antihypertensive medication
- Low antihypertensive pharmacy refill
- English speaking
- Telephone access
- Ability to read print on a computer screen and use the computer keyboard
- Written consent to participate and HIPAA authorization
- Written acceptance of study contract
- Approval of health care provider
Exclusion Criteria:
- Cognitive impairment
- Enrollment in another clinical trial
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Brak (otwarta etykieta)
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
---|---|
Brak interwencji: Zwykła opieka
|
|
Eksperymentalny: Health coaching
Two-hour in-person group counseling session led by health coach, involving development of personalized immunity maps that lay out adherence goal, behaviors that distract from goal, hidden motives that compete with achieving goal, and underlying assumptions Eight 50-minute individual telephone counseling sessions every three weeks with a health coach, focusing on uncovering hidden motives and challenging assumptions with the goal of overturning nonadherence mindsets |
Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
---|---|---|
Change in medication adherence (PDC)
Ramy czasowe: Baseline to 6 months
|
Change in proportion of days covered (PDC) from baseline to 6 months
|
Baseline to 6 months
|
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
---|---|---|
Change in medication adherence (MMAS-8)
Ramy czasowe: Baseline to 6 months
|
Change in MMAS-8 score from baseline to 6 months
|
Baseline to 6 months
|
Change in medication adherence (KWood-4)
Ramy czasowe: Baseline to 6 months
|
Change in KWood-4 score from baseline to 6 months
|
Baseline to 6 months
|
Change in medication adherence (MMAS-8)
Ramy czasowe: Baseline to 3 months
|
Change in MMAS-8 score from baseline to 3 months
|
Baseline to 3 months
|
Change in medication adherence (KWood-4)
Ramy czasowe: Baseline to 3 months
|
Change in KWood-4 score from baseline to 3 months
|
Baseline to 3 months
|
Change in proportion with low adherence (PDC)
Ramy czasowe: Baseline to 6 months
|
Change in proportion with low adherence (PDC<0.8)
from baseline to 6 months
|
Baseline to 6 months
|
Change in proportion with low adherence (MMAS-8)
Ramy czasowe: Baseline to 6 months
|
Change in proportion with low adherence (MMAS-8<6) from baseline to 6 months
|
Baseline to 6 months
|
Change in proportion with low adherence (KWood-4)
Ramy czasowe: Baseline to 6 months
|
Change in proportion with low adherence (KWood-4>0) from baseline to 6 months
|
Baseline to 6 months
|
Change in proportion with low adherence (MMAS-8)
Ramy czasowe: Baseline to 3 months
|
Change in proportion with low adherence (MMAS-8<6) from baseline to 3 months
|
Baseline to 3 months
|
Change in proportion with low adherence (KWood-4)
Ramy czasowe: Baseline to 3 months
|
Change in proportion with low adherence (KWood-4>0) from baseline to 3 months
|
Baseline to 3 months
|
Change in systolic blood pressure
Ramy czasowe: Baseline to 6 months
|
Change in systolic blood pressure from baseline to 6 months
|
Baseline to 6 months
|
Change in diastolic blood pressure
Ramy czasowe: Baseline to 6 months
|
Change in diastolic blood pressure from baseline to 6 months
|
Baseline to 6 months
|
Change in systolic blood pressure
Ramy czasowe: Baseline to 3 months
|
Change in systolic blood pressure from baseline to 3 months (if available from insurance records)
|
Baseline to 3 months
|
Change in diastolic blood pressure
Ramy czasowe: Baseline to 3 months
|
Change in diastolic blood pressure from baseline to 3 months (if available from insurance records)
|
Baseline to 3 months
|
Change in proportion with controlled blood pressure
Ramy czasowe: Baseline to 6 months
|
Change in proportion with controlled blood pressure (SBP<140 & DBP<90) from baseline to 6 months
|
Baseline to 6 months
|
Change in proportion with controlled blood pressure
Ramy czasowe: Baseline to 3 months
|
Change in proportion with controlled blood pressure (SBP<140 & DBP<90) from baseline to 3 months
|
Baseline to 3 months
|
Change in health-related quality of life
Ramy czasowe: Baseline to 6 months
|
Change in health-related quality of life score (SF-36) from baseline to 6 months
|
Baseline to 6 months
|
Change in health-related quality of life
Ramy czasowe: Baseline to 3 months
|
Change in health-related quality of life score (SF-36) from baseline to 3 months
|
Baseline to 3 months
|
Inne miary wyników
Miara wyniku |
Opis środka |
Ramy czasowe |
---|---|---|
Change in hidden motives score
Ramy czasowe: Baseline to 6 months
|
Change in hidden motives score from baseline to 6 months
|
Baseline to 6 months
|
Change in hidden motives score
Ramy czasowe: Baseline to 3 months
|
Change in hidden motives score from baseline to 3 months
|
Baseline to 3 months
|
Change in explicit attitudes score
Ramy czasowe: Baseline to 6 months
|
Change in explicit attitudes score (Beliefs about Medicines Questionnaire) from baseline to 6 months
|
Baseline to 6 months
|
Change in explicit attitudes score
Ramy czasowe: Baseline to 3 months
|
Change in explicit attitudes score (Beliefs about Medicines Questionnaire) from baseline to 3 months
|
Baseline to 3 months
|
Change in implicit attitudes score
Ramy czasowe: Baseline to 6 months
|
Change in implicit attitudes score (d-score from single-category implicit association test) from baseline to 6 months
|
Baseline to 6 months
|
Change in explicit ambivalence score
Ramy czasowe: Baseline to 6 months
|
Change in explicit ambivalence score (absolute value of difference between standardized positive and negative explicit attitudes scores) from baseline to 6 months
|
Baseline to 6 months
|
Change in explicit ambivalence score
Ramy czasowe: Baseline to 3 months
|
Change in explicit ambivalence score (absolute value of difference between standardized positive and negative explicit attitudes scores) from baseline to 3 months
|
Baseline to 3 months
|
Change in implicit ambivalence score
Ramy czasowe: Baseline to 6 months
|
Change in implicit ambivalence score (absolute value of difference between standardized explicit and implicit attitude scores)
|
Baseline to 6 months
|
Change in short risk aversion switch point
Ramy czasowe: Baseline to 6 months
|
Change in short switch point on risk aversion scale from baseline to 6 months
|
Baseline to 6 months
|
Change in short risk aversion switch point
Ramy czasowe: Baseline to 3 months
|
Change in short switch point on risk aversion scale from baseline to 3 months
|
Baseline to 3 months
|
Change in long risk aversion switch point
Ramy czasowe: Baseline to 6 months
|
Change in long switch point on risk aversion scale from baseline to 6 months
|
Baseline to 6 months
|
Change in long risk aversion switch point
Ramy czasowe: Baseline to 3 months
|
Change in long switch point on risk aversion scale from baseline to 3 months
|
Baseline to 3 months
|
Change in risk valuation
Ramy czasowe: Baseline to 6 months
|
Change in value indicated on risk aversion scale from baseline to 6 months
|
Baseline to 6 months
|
Change in risk valuation
Ramy czasowe: Baseline to 3 months
|
Change in value indicated on risk aversion scale from baseline to 3 months
|
Baseline to 3 months
|
Change in medication-taking self-efficacy (MUSE)
Ramy czasowe: Baseline to 6 months
|
Change in score on MUSE medication-taking subscale from baseline to 6 months
|
Baseline to 6 months
|
Change in medication-taking self-efficacy (MUSE)
Ramy czasowe: Baseline to 3 months
|
Change in score on MUSE medication-taking subscale from baseline to 3 months
|
Baseline to 3 months
|
Change in learning-about-medications self-efficacy (MUSE)
Ramy czasowe: Baseline to 6 months
|
Change in score on MUSE learning-about-medications subscale from baseline to 6 months
|
Baseline to 6 months
|
Change in learning-about-medications self-efficacy (MUSE)
Ramy czasowe: Baseline to 3 months
|
Change in score on MUSE learning-about-medications subscale from baseline to 3 months
|
Baseline to 3 months
|
Change in self-efficacy (MUSE)
Ramy czasowe: Baseline to 6 months
|
Change in score on MUSE scale from baseline to 6 months
|
Baseline to 6 months
|
Change in self-efficacy (MUSE)
Ramy czasowe: Baseline to 3 months
|
Change in score on MUSE scale from baseline to 3 months
|
Baseline to 3 months
|
Change in self-efficacy (Self-Efficacy for Managing Chronic Disease)
Ramy czasowe: Baseline to 6 months
|
Change in score on SEMCD scale from baseline to 6 months
|
Baseline to 6 months
|
Change in self-efficacy (Self-Efficacy for Managing Chronic Disease)
Ramy czasowe: Baseline to 3 months
|
Change in score on SEMCD scale from baseline to 3 months
|
Baseline to 3 months
|
Change in chronic stress
Ramy czasowe: Baseline to 6 months
|
Change in chronic stress from baseline to 6 months, as measured by salivary cortisol
|
Baseline to 6 months
|
Change in perceived stress
Ramy czasowe: Baseline to 6 months
|
Change in score on 4-item version of Perceived Stress Scale from baseline to 6 months
|
Baseline to 6 months
|
Change in perceived stress
Ramy czasowe: Baseline to 3 months
|
Change in score on 4-item version of Perceived Stress Scale from baseline to 3 months
|
Baseline to 3 months
|
Współpracownicy i badacze
Śledczy
- Główny śledczy: Marie A Krousel-Wood, MD MSPH, Tulane University
- Dyrektor Studium: Erin M Peacock, PhD MPH, Tulane University
Publikacje i pomocne linki
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Rzeczywisty)
Zakończenie podstawowe (Rzeczywisty)
Ukończenie studiów (Rzeczywisty)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Oszacować)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
Inne numery identyfikacyjne badania
- 735133
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
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