The medication Adherence and Blood Pressure Control (ABC) trial: a multi-site randomized controlled trial in a...

Area of Science:

• Clinical Trials
• Cardiovascular Health
• Health Behavior Interventions

Background:

• Hypertension management is challenged by poor medication adherence, particularly in diverse, low-income populations.
• Objective adherence measures like electronic monitoring are underutilized in evaluating hypertension interventions.
• Accessible, real-world interventions are needed to address medication non-adherence.

Purpose of the Study:

• To evaluate a stepped care intervention's effectiveness in improving medication adherence and blood pressure (BP) control.
• To assess interventions using objective adherence measures (Electronic Medication Event Monitoring) and BP control.
• To test a combination of accessible behavioral interventions for hypertensive patients.

Main Methods:

• Randomized, controlled, multi-site trial involving hypertensive patients in primary care.
• Intervention included home Self-BP Monitoring (SBPM) and, for uncontrolled BP, telephone-based nurse case management (SBPM+NCM).
• Primary adherence measure: Electronic Medication Event Monitoring (MEMS); primary BP control measure: in-office BP.

Main Results:

• The study design and methodology are presented, including recruitment and follow-up procedures.
• Objective adherence data (MEMS) were collected to assess intervention effectiveness.
• In-office BP was the primary outcome for hypertension control.

Conclusions:

• The ABC Trial provides a framework for testing real-world adherence interventions using objective measures.
• Findings will inform the development of practical solutions for improving medication adherence and BP control.
• The stepped care approach combined with objective monitoring offers a potential strategy for managing hypertension.