title: The medication Adherence and Blood Pressure Control (ABC) trial: a multi-site randomized controlled trial in a hypertensive, multi-cultural, economically disadvantaged population.
abstract: The Medication Adherence and BP Control Trial (ABC Trial) is a randomized, controlled, multi-site, medication adherence and blood pressure (BP) control trial in an economically disadvantaged and multi-cultural population of hypertensive patients followed in primary care practices. To date, no other such trial has been published in which objective measures of adherence (electronic pill bottles) were used to assess the effectiveness of these behavioral interventions for hypertension. This study tested a combination of commercially-available interventions that can be easily accessed by health care providers and patients, and therefore may provide a real-world solution to the problem of non-adherence among hypertensives. The aim of the ABC Trial was to test the effectiveness of a stepped care intervention in improving both medication adherence to an antihypertensive medication regimen and BP control. Step 1 of the intervention employed home Self-BP Monitoring (SBPM); at this stage, there were two arms: (1) Usual Care (UC) and (2) Intervention. At Step 2, patients in the intervention arm whose BP had not come under control after 3 months were further randomized to one of two conditions: (1) continuation of SBPM (alone) or (2) continuation of SBPM plus telephone-based nurse case management (SBPM+NCM). Electronic Medication Event Monitoring (MEMS) was the primary measure of medication adherence, and in-office BP was the primary measure of hypertension control. We present an overview of the study design, details of the administrative structure of the study and a description of clinical site recruitment, patient recruitment, and follow-up assessments.
authors.affiliation: Columbia University, College of Physicians and Surgeons, New York-Presbyterian Hospital, New York, NY, USA. wg131@columbia.edu
authors.forename: William
authors.initials: W
authors.lastname: Gerin
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Tobin
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Schwartz
authors.forename: William
authors.initials: W
authors.lastname: Chaplin
authors.forename: Nina
authors.initials: N
authors.lastname: Rieckmann
authors.forename: Karina W
authors.initials: KW
authors.lastname: Davidson
authors.forename: Tanya M
authors.initials: TM
authors.lastname: Goyal
authors.forename: Juhee
authors.initials: J
authors.lastname: Jhalani
authors.forename: Andrea
authors.initials: A
authors.lastname: Cassells
authors.forename: Karina
authors.initials: K
authors.lastname: Feliz
authors.forename: Chamanara
authors.initials: C
authors.lastname: Khalida
authors.forename: Marleny
authors.initials: M
authors.lastname: Diaz-Gloster
authors.forename: Gbenga
authors.initials: G
authors.lastname: Ogedegbe
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001521:Behavior Therapy / Q000379:methods*; D019090:Case Management; D003153:Community Health Services; D004641:Emigration and Immigration; D005006:Ethnicity / Q000523:psychology*; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009518:New York; D010349:Patient Compliance / Q000523:psychology*; D011203:Poverty; D012107:Research Design; D012648:Self Care; D013689:Telephone
chemical_list: D000959:Antihypertensive Agents