Hypertension Clinical Trial
Official title:
Improving Medication Adherence in Hypertensive Individuals With Bipolar Disorder
This study will test an adherence intervention (iTAB-CV) delivered via interactive text
messaging which first targets behavioral intent and then adds cues/reminders and
reinforcement to form the habit of taking antihypertensives in non-adherent individuals with
BD. Thirty eight individuals with BD and HTN being treated with evidence-based
antihypertensive agents and mood stabilizing or antipsychotic medications who are
non-adherent with their HTN medicine will be enrolled.
This study uses a prospective cohort design with participants serving as their own control.
Investigators will test the iTAB-CV intervention quantitatively for feasibility and
acceptability as well as for efficacy in increasing adherence to antihypertensives,
decreasing systolic blood pressure, and increasing adherence to BD medication.
This study will test an adherence intervention (iTAB-CV) delivered via interactive text
messaging which first targets behavioral intent and then adds cues/reminders and
reinforcement to form the habit of taking antihypertensives in non-adherent individuals with
BD. Thirty eight individuals with BD and HTN being treated with evidence-based
antihypertensive agents and mood stabilizing or antipsychotic medications who are
non-adherent with their HTN medicine will be enrolled.
This study uses a prospective cohort design with participants serving as their own control.
Investigators will test the iTAB-CV intervention quantitatively for feasibility and
acceptability as well as for efficacy in increasing adherence to antihypertensives,
decreasing systolic blood pressure, and increasing adherence to BD medication.
All study participants will be followed for a 3-month period. iTAB-CV, delivered via mobile
phone, is intended to be a brief adjunct to standard primary care and mental health
treatment. All individuals will continue to receive treatment as usual with their regular
provider(s). Individuals who meet eligibility criteria will have a 30 day run-in period in
which their medication adherence will be measured with TRQ and MEMS but without an additional
intervention. Following the run-in period, Stage 1 of the iTAB-CV intervention will be
introduced. Researchers will conduct an interview in order to customize iTAB-CV for each
participant at the baseline session. In the first month of iTAB-CV, participants will receive
alternating daily texts with psychoeducational and motivational content once daily and a
daily mood rating request to both monitor their mood and to determine engagement with the
iTAB-CV intervention. In the second stage of iTAB-CV, participants will receive daily texts
which will include medication reminders, contextual cues, and immediate reinforcement for
medication taking behavior in addition to the content from stage 1.
Assessments that include evaluation of treatment adherence, psychiatric symptoms,
self-efficacy for medication taking behavior, illness beliefs, medication attitudes, and
habit strength for both antihypertensive and BD medications will be conducted at four time
points over a 3-month time period (screening, baseline/week 4, week 8, and week 12). Blood
pressure will be measured at each of the four contacts. Individuals who drop out of the
intervention, and who agree, will be followed up with outcomes assessments over the same
3-month time period that they would have been evaluated had they remained in the study.
About one month after study completion, a member of the research team will call each
participant and ask questions about their bipolar and blood pressure medication taking
habits.
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