Electronic Pill Bottles or Bidirectional Text Messaging to Improve Hypertension Medication Adherence (Way 2 Text): a Randomized Clinical Trial.
health behavior
hypertension
medication adherence
primary care
Journal
Journal of general internal medicine
ISSN: 1525-1497
Titre abrégé: J Gen Intern Med
Pays: United States
ID NLM: 8605834
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
07
11
2018
accepted:
17
07
2019
revised:
30
04
2019
pubmed:
10
8
2019
medline:
18
11
2020
entrez:
10
8
2019
Statut:
ppublish
Résumé
Poor medication adherence contributes to inadequate control of hypertension. However, the value of adherence monitoring is unknown. To evaluate the impact of monitoring adherence with electronic pill bottles or bidirectional text messaging on improving hypertension control. Three-arm pragmatic randomized controlled trial. One hundred forty-nine primary care patients aged 18-75 with hypertension and text messaging capabilities who were seen at least twice in the prior 12 months with at least two out-of-range blood pressure (BP) measurements, including the most recent visit. Patients were randomized in a 1:2:2 ratio to receive (1) usual care, (2) electronic pill bottles for medication adherence monitoring (pill bottle), and (3) bidirectional text messaging for medication adherence monitoring (bidirectional text). Change in systolic BP during the final 4-month visit compared with baseline. At the 4-month follow-up visit, mean (SD) change values in systolic blood pressure were - 4.7 (23.4) mmHg in usual care, - 4.3 (21.5) mmHg in the pill bottle arm, and - 4.6 (19.8) mmHg in the text arm. There was no significant change in systolic blood pressure between control and the pill bottle arm (p = 0.94) or the text messaging arm (p = 1.00), and the two intervention arms did not differ from each other (p = 0.93). Despite good measured adherence, neither feedback with electronic pill bottles nor bidirectional text messaging about medication adherence improved blood pressure control. Adherence to prescribed medications was not improved enough to affect BP control or it was not the primary driver of poor control. clinicaltrials.gov (NCT02778542).
Sections du résumé
BACKGROUND
Poor medication adherence contributes to inadequate control of hypertension. However, the value of adherence monitoring is unknown.
OBJECTIVE
To evaluate the impact of monitoring adherence with electronic pill bottles or bidirectional text messaging on improving hypertension control.
DESIGN
Three-arm pragmatic randomized controlled trial.
PATIENTS
One hundred forty-nine primary care patients aged 18-75 with hypertension and text messaging capabilities who were seen at least twice in the prior 12 months with at least two out-of-range blood pressure (BP) measurements, including the most recent visit.
INTERVENTIONS
Patients were randomized in a 1:2:2 ratio to receive (1) usual care, (2) electronic pill bottles for medication adherence monitoring (pill bottle), and (3) bidirectional text messaging for medication adherence monitoring (bidirectional text).
MAIN MEASURES
Change in systolic BP during the final 4-month visit compared with baseline.
KEY RESULTS
At the 4-month follow-up visit, mean (SD) change values in systolic blood pressure were - 4.7 (23.4) mmHg in usual care, - 4.3 (21.5) mmHg in the pill bottle arm, and - 4.6 (19.8) mmHg in the text arm. There was no significant change in systolic blood pressure between control and the pill bottle arm (p = 0.94) or the text messaging arm (p = 1.00), and the two intervention arms did not differ from each other (p = 0.93).
CONCLUSIONS
Despite good measured adherence, neither feedback with electronic pill bottles nor bidirectional text messaging about medication adherence improved blood pressure control. Adherence to prescribed medications was not improved enough to affect BP control or it was not the primary driver of poor control.
TRIAL REGISTRATION
clinicaltrials.gov (NCT02778542).
Identifiants
pubmed: 31396815
doi: 10.1007/s11606-019-05241-x
pii: 10.1007/s11606-019-05241-x
pmc: PMC6848522
doi:
Substances chimiques
Antihypertensive Agents
0
Banques de données
ClinicalTrials.gov
['NCT02778542']
Types de publication
Journal Article
Pragmatic Clinical Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2397-2404Subventions
Organisme : NCI NIH HHS
ID : K08 CA234326
Pays : United States
Commentaires et corrections
Type : CommentIn
Références
J Hypertens. 2017 Jun;35(6):1133-1144
pubmed: 28306634
QJM. 2013 Oct;106(10):909-14
pubmed: 23696676
Med Care. 2002 Sep;40(9):794-811
pubmed: 12218770
J Hypertens. 2009 Aug;27(8):1540-51
pubmed: 19474761
BMJ. 2008 May 17;336(7653):1114-7
pubmed: 18480115
Health Psychol. 2010 Jul;29(4):421-8
pubmed: 20658830
J Clin Hypertens (Greenwich). 2008 Aug;10(8):644-6
pubmed: 18772648
BMC Health Serv Res. 2008 Dec 23;8:272
pubmed: 19102784
Am J Hypertens. 1996 Aug;9(8):719-25
pubmed: 8862216
JAMA. 2014 Feb 5;311(5):507-20
pubmed: 24352797
Ann Intern Med. 2012 Mar 20;156(6):416-24
pubmed: 22431674
Hypertension. 2006 Sep;48(3):374-84
pubmed: 16864749
JMIR Mhealth Uhealth. 2017 Feb 01;5(2):e9
pubmed: 28148474
Arch Intern Med. 2011 Jul 11;171(13):1173-80
pubmed: 21747013
JAMA Intern Med. 2016 Mar;176(3):340-9
pubmed: 26831740
Aten Primaria. 2004 Nov 15;34(8):399-405
pubmed: 15546536
J Gen Intern Med. 2018 Sep;33(9):1536-1542
pubmed: 29546659
Ann Intern Med. 2001 May 15;134(10):968-77
pubmed: 11352698
PLoS One. 2017 Oct 9;12(10):e0185453
pubmed: 28991903
Eur J Intern Med. 2008 Oct;19(6):427-34
pubmed: 18848176
Arch Intern Med. 2002 Feb 25;162(4):413-20
pubmed: 11863473
JAMA. 2002 Dec 18;288(23):2981-97
pubmed: 12479763
JAMA. 2013 Jul 3;310(1):46-56
pubmed: 23821088
JAMA Cardiol. 2016 Oct 1;1(7):847-848
pubmed: 27603755
Arch Intern Med. 2000 Aug 14-28;160(15):2281-6
pubmed: 10927724
Am J Hypertens. 2011 Sep;24(9):989-98
pubmed: 21654858
J Clin Hypertens (Greenwich). 2017 Oct;19(10):1015-1024
pubmed: 28856834
N Engl J Med. 2013 Aug 1;369(5):448-57
pubmed: 23902484
JAMA. 2010 May 26;303(20):2043-50
pubmed: 20501926
AIDS Behav. 2010 Jun;14(3):580-9
pubmed: 19771504
Clin Infect Dis. 2001 Oct 15;33(8):1417-23
pubmed: 11550118
PLoS One. 2014 Feb 05;9(2):e88166
pubmed: 24505411
NCHS Data Brief. 2017 Oct;(289):1-8
pubmed: 29155682
J Clin Hypertens (Greenwich). 2017 Dec;19(12):1276-1284
pubmed: 28941056
LDI Issue Brief. 2012 Jul-Aug;17(9):1-4
pubmed: 22934330
Circulation. 2009 Oct 20;120(16):1598-605
pubmed: 19805653
N Engl J Med. 2012 Jul 5;367(1):1-3
pubmed: 22716935
Circulation. 2016 Feb 9;133(6):592-600
pubmed: 26769742
NCHS Data Brief. 2013 Oct;(133):1-8
pubmed: 24171916
JAMA. 2015 Nov 10;314(18):1926-35
pubmed: 26547464
N Engl J Med. 2018 Apr 19;378(16):1509-1520
pubmed: 29669232
NCHS Data Brief. 2015 Nov;(220):1-8
pubmed: 26633197
Am J Hypertens. 2010 Feb;23(2):149-54
pubmed: 19927136
Am J Med Sci. 2014 Aug;348(2):135-8
pubmed: 24983758
Epidemiol Rev. 2010;32:56-69
pubmed: 20354039
J Gen Intern Med. 2016 Nov;31(11):1294-1300
pubmed: 27255750
Circulation. 2017 Mar 7;135(10):e146-e603
pubmed: 28122885