NCT02377960

Check and Support -Enhancing the Treatment of Hypertension in Outpatient Care, a Multicenter Study

Check and Support -Pragmatic Randomized Controlled Study of the Effectiveness of 12 Month SMS-Text Message Support and IMB-based Initiation of Medication in Adults With Hypertension for Better Blood Pressure Control and Medication Adherence

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 119 (actual)
• Sponsor: Kuopio University Hospital · Academic / Other
• Sex: All
• Age: 30 Years – 75 Years
• Healthy volunteers: Not accepted

Summary

The purpose of this pragmatic multi-centre, cluster randomized controlled trial is to test the effectiveness of tailored SMS-text message support combined with an information-motivation-behavioral skills (IMB) model-based initiation of medication in helping outpatient care patients with hypertension to achieve blood pressure target and to enhance medication adherence.

Detailed description

Background Usual blood pressure is strongly related to vascular and overall mortality and high blood pressure is globally the leading risk factor for cardiovascular and related diseases. It is also well established that pharmacologic blood pressure reduction prevents cardiovascular events and deaths in persons with hypertension. Today's physicians have plenty of knowledge and multiple effective and safety tools to treat hypertension but still majority of patients with antihypertensive medication do not achieve the blood pressure target. Poor medication adherence has been widely accepted to be the most important factor in failing to control hypertension and even 50% of hypertensive patients quit the antihypertensive medication during the first year of medication. Numerous interventions to enhance medication adherence have been developed but even though, an intervention effective, simple and low cost enough to be carried out wide-scale in non-research settings is still to be found. Objectives To test whether a tailored SMS-text message support combined with an IMB model-based initiation of medication will increase the proportion of patients achieving the systolic blood pressure target at 12-month follow-up compared to usual care. Additional objectives include investigating whether the intervention have effect on * Medication adherence * Systolic and diastolic blood pressure level * Hypertension-related use of health care services * Blood glucose, blood cholesterol, microalbuminuria, creatinine, ECG, body mass index, waist circumference exercising habits, smoking and alcohol use * Perceived quality of life at base line and at 12-month follow-up * Setting (physicians) and knowing (participants) an adequate BP target And, besides Detecting the participants who especially benefit from intervention * Analyzing the quality and quantity of self-monitored BP and * Assessing whether the IMB model-based structured initiation of medication can be used for screening of non-compliant patients and directing resources more accurately to them * Collecting and analyzing participants' and physicians' feedback for future development of intervention Study design Pragmatic randomized controlled multicenter trial. The eight study centers are grouped to comparable pairs and randomized to function as intervention and control sites (2-cluster design).

Conditions

• Hypertension
• Blood Pressure
• Patient Compliance
• Patient Adherence
• Medication Adherence

Interventions

Type	Name	Description
BEHAVIORAL	IMB model-based initiation of antihypertensive medication	1.An IMB model-based initiation of medication i.e. a nine-point check list to be fulfilled by physician and patient together when ordering the antihypertensive medication for the first time
BEHAVIORAL	Tailored SMS-text message support	2.Tailored SMS-text message support for the first 12 months of medication. At the beginning (2 weeks), text messages are send on daily basis and focused on medications-reminders and coping with potential side-effects of medication. After that, text messages will be sent less often and the focus will change to keeping up with medication and reminding of importance of performing adequate home BP self-monitoring, achieving the BP target and attending clinical appointments.
BEHAVIORAL	Usual care	Usual care

Timeline

• Start date: 2015-01-27
• Primary completion: 2018-03-06
• Completion: 2018-03-06
• First posted: 2015-03-04
• Last updated: 2018-07-11

Locations

6 sites across 1 country: Finland