Medication Adherence Program

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age40+
SponsorTulane University

About this trial

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.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

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

Disqualifiers

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

Trial design

Design model

Parallel

Treatments tested in this trial

  • STAR-MAP health coaching

    Behavioral

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

  • Medication reminder tools

    Behavioral

    Medication-taking reminder app and pillbox

Treatment groups

402 Participants
are divided into 2 treatment groups
Group A: STAR-MAPExperimental treatment 2 interventions
Group B: Medication App and Reminder System Medication Adherence Program (MARS-MAP)Active comparator 1 intervention

Trial outcomes

Primary outcomes

1

Difference in proportion with PDC >=0.8 at 12 months

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

Time frame
12 months

Secondary outcomes

1

Difference in mean change in PDC, baseline to 12 months

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

Time frame
Baseline to 12 months
2

Difference in mean change in 4-item Krousel-Wood Medication Adherence Scale score, 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))

Time frame
Baseline to 12 months
3

Difference in proportion with 4-item Krousel-Wood Medication Adherence Scale score <1 at 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))

Time frame
12 months
4

Difference in change in proportion with high adherence as measured by urine metabolite analysis, baseline to 12 months

Adherence determined by liquid chromatography tandem mass spectrometry analysis of urinary metabolites of antihypertensive medications

Time frame
Baseline to 12 months

Other outcomes

1

Difference in mean change in 4-item Krousel-Wood Medication Adherence Scale score, 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))

Time frame
Baseline to 6 months
2

Difference in proportion with 4-item Krousel-Wood Medication Adherence Scale score <1 at 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))

Time frame
6 months
3

Difference in change in proportion with high adherence as measured by urine metabolite analysis, baseline to 6 months

Adherence determined by liquid chromatography tandem mass spectrometry analysis of urinary metabolites of antihypertensive medications

Time frame
Baseline to 6 months
4

Difference in proportion with controlled BP at 6 months

Controlled blood pressure (BP) defined as systolic BP \<130 mm Hg and diastolic BP \<80 mm Hg; BP measured using standardized protocol

Time frame
6 months

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Tulane University

Lead sponsor

Ohio State University

Collaborator

Minds at Work

Collaborator

National Heart, Lung, and Blood Institute (NHLBI)

Collaborator