Over 70% of US adults 65 or older are diagnosed with hypertension, the leading cause of cardiovascular disease and premature deaths in the world. Despite availability of effective drugs to control blood pressure, uncontrolled blood pressure and low adherence to antihypertensive drugs persist as major public health and clinical challenges. On average, 50% of adults adhere to chronic disease medications and lower levels of adherence are associated with worse blood pressure control and adverse outcomes. Many barriers to adherence are well known and have been targeted in interventions to improve medication adherence. As of yet, no single intervention has emerged as superior or even particularly effective in improving adherence. The investigators have recently identified unconscious, self-protective 'hidden motives' that contribute to nonadherence to chronic disease medications. There is a critical need to expand on this insight to test the potential for targeting individuals' 'hidden motives' for low adherence using an innovative learning process called Immunity-to-Change. As a critical step in testing this intervention to target these 'hidden motives', the investigators will undertake a pilot study to assess the feasibility and acceptability of the Overcoming Immunity-to-Change intervention and determine effect sizes of the intervention on adherence, blood pressure (BP) control, and quality of life (QOL). The investigators will test the Immunity-to-Change intervention in a sample of nonadherent older adults with hypertension (n=18). Another sample of nonadherent older adults with hypertension will be monitored for comparison (n=18).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
36
Tulane University
New Orleans, Louisiana, United States
Change in medication adherence (PDC)
Change in proportion of days covered (PDC) from baseline to 6 months
Time frame: Baseline to 6 months
Change in medication adherence (MMAS-8)
Change in MMAS-8 score from baseline to 6 months
Time frame: Baseline to 6 months
Change in medication adherence (KWood-4)
Change in KWood-4 score from baseline to 6 months
Time frame: Baseline to 6 months
Change in medication adherence (MMAS-8)
Change in MMAS-8 score from baseline to 3 months
Time frame: Baseline to 3 months
Change in medication adherence (KWood-4)
Change in KWood-4 score from baseline to 3 months
Time frame: Baseline to 3 months
Change in proportion with low adherence (PDC)
Change in proportion with low adherence (PDC\<0.8) from baseline to 6 months
Time frame: Baseline to 6 months
Change in proportion with low adherence (MMAS-8)
Change in proportion with low adherence (MMAS-8\<6) from baseline to 6 months
Time frame: Baseline to 6 months
Change in proportion with low adherence (KWood-4)
Change in proportion with low adherence (KWood-4\>0) from baseline to 6 months
Time frame: Baseline to 6 months
Change in proportion with low adherence (MMAS-8)
Change in proportion with low adherence (MMAS-8\<6) from baseline to 3 months
Time frame: Baseline to 3 months
Change in proportion with low adherence (KWood-4)
Change in proportion with low adherence (KWood-4\>0) from baseline to 3 months
Time frame: Baseline to 3 months
Change in systolic blood pressure
Change in systolic blood pressure from baseline to 6 months
Time frame: Baseline to 6 months
Change in diastolic blood pressure
Change in diastolic blood pressure from baseline to 6 months
Time frame: Baseline to 6 months
Change in systolic blood pressure
Change in systolic blood pressure from baseline to 3 months (if available from insurance records)
Time frame: Baseline to 3 months
Change in diastolic blood pressure
Change in diastolic blood pressure from baseline to 3 months (if available from insurance records)
Time frame: Baseline to 3 months
Change in proportion with controlled blood pressure
Change in proportion with controlled blood pressure (SBP\<140 \& DBP\<90) from baseline to 6 months
Time frame: Baseline to 6 months
Change in proportion with controlled blood pressure
Change in proportion with controlled blood pressure (SBP\<140 \& DBP\<90) from baseline to 3 months
Time frame: Baseline to 3 months
Change in health-related quality of life
Change in health-related quality of life score (SF-36) from baseline to 6 months
Time frame: Baseline to 6 months
Change in health-related quality of life
Change in health-related quality of life score (SF-36) from baseline to 3 months
Time frame: Baseline to 3 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.