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Supporting tailored adaptive change and reinforcement for medication adherence program (STAR-MAP): Rationale and
Erin Peacock1, Brice Mohundro2, Jingjing Li1
1Department of Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA; Center for Health Outcomes, Implementation, and Community-Engaged Science, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA.
Contemporary Clinical Trials
|May 22, 2026
Summary
This study tested a new intervention to improve medication adherence in adults with hypertension. The novel approach targets subconscious attitudes, aiming for better blood pressure control and quality of life.
Area of Science:
- Cardiovascular Medicine
- Behavioral Science
- Health Services Research
Background:
- Low adherence to antihypertensive medication is a significant clinical problem, leading to uncontrolled blood pressure and increased cardiovascular risk.
- Existing interventions often focus on conscious patient processes with limited success.
- This study explores a novel intervention targeting subconscious implicit attitudes to improve medication adherence.
Purpose of the Study:
- To determine the efficacy and sustainability of the STAR-MAP intervention.
- To assess the intervention's impact on medication adherence, blood pressure control, and quality of life.
- To examine implicit attitudes as a mediating mechanism for adherence improvement.
Main Methods:
- A randomized controlled trial (Medication Adherence Program - MAP) involving adults aged 40+ with hypertension and low adherence.
- Participants were randomized to either the STAR-MAP intervention (virtual health coaching, pillbox, app) or enhanced usual care (pillbox, app only).
- The primary outcome was the proportion of participants with proportion of days covered (PDC) ≥0.8 at 12 months. Secondary outcomes included changes in PDC, adherence scale scores, blood pressure, and quality of life.
Main Results:
- The study is designed to generate critical data on the STAR-MAP intervention's effectiveness.
- It aims to detect a 15% between-group difference in medication adherence (PDC ≥0.8) at 12 months.
- The trial is powered to analyze effects on blood pressure control and quality of life over 24 months.
Conclusions:
- The MAP study will provide crucial data on the efficacy of the STAR-MAP intervention.
- Findings could inform new strategies for improving medication adherence and blood pressure control.
- This research has the potential to enhance cardiovascular health and promote healthy aging in adults with uncontrolled hypertension.
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