title: Reinforcing adherence to antihypertensive medications.
abstract: This pilot study evaluated a reinforcement intervention to improve adherence to antihypertensive therapy. Twenty-nine participants were randomized to standard care or standard care plus financial reinforcement for 12 weeks. Participants in the reinforcement group received a cell phone to self-record videos of adherence, for which they earned rewards. These participants sent videos demonstrating on-time adherence 97.8% of the time. Pill count adherence differed significantly between the groups during treatment, with 98.8%±1.5% of pills taken during treatment in the reinforcement condition vs 92.6%±9.2% in standard care (P<.002). Benefits persisted throughout a 3-month follow-up, with 93.8%±9.3% vs 78.0%±18.5% of pills taken (P<.001). Pill counts correlated significantly (P<.001) with self-reports of adherence, which also differed between groups over time (P<.01). Systolic blood pressure decreased modestly over time in participants overall (P<.01) but without significant time-by-group effects. These results suggest that reinforcing medication adherence via cellular phone technology and financial reinforcement holds potential to improve adherence.
authors.affiliation: Calhoun Cardiology Center and Department of Medicine, University of Connecticut School of Medicine, Farmington, CT.
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Petry
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Alessi
authors.forename: Shannon
authors.initials: S
authors.lastname: Byrne
authors.forename: William B
authors.initials: WB
authors.lastname: White
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D040421:Cell Phone / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D010865:Pilot Projects; D012054:Reinforcement, Psychology; D057566:Self Report; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents