title: A practice-based randomized controlled trial to improve medication adherence among Latinos with hypertension: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Latinos experience disproportionately higher rates of uncontrolled hypertension as compared to Blacks and Whites. While poor adherence is a major contributor to disparities in blood pressure control, data in Latino patients are scant. More importantly, translation of interventions to improve medication adherence in community-based primary care practices, where the majority of Latino patients receive their care is non-existent.
  
  
  METHODS
  Using a randomized controlled design, this study evaluates the effectiveness of a culturally tailored, practice-based intervention compared to usual care on medication adherence, among 148 Latino patients with uncontrolled hypertension who are non-adherent to their antihypertensive medications. Bilingual medical assistants trained as Health Coaches deliver the intervention using an electronic medical record system-embedded adherence script. Patients randomized to the intervention group receive patient-centered counseling with a Health Coach to develop individualized self-monitoring strategies to overcome barriers and improve adherence behaviors. Health Coach sessions are held biweekly for the first 3 months (6 sessions total) and then monthly for the remaining 3 months (3 sessions total). Patients randomized to the usual care group receive standard hypertension treatment recommendations as determined by their primary care providers. The primary outcome is the rate of medication adherence at 6 months. The secondary outcome is reduction in systolic and diastolic blood pressure at 6 months.
  
  
  CONCLUSIONS
  If successful, findings from this study will provide salient information on the translation of culturally tailored, evidence-based interventions targeted at medication adherence and blood pressure control into practice-based settings for this high-risk population.
  
  
  BACKGROUND
  NCT01643473 on 16 July 2012.
authors.affiliation: Department of Population Health, Center for Healthful Behavior Change, New York University School of Medicine, 227 East 30th Street, 634, New York, NY, 10016, USA. antoinette.schoenthaler@nyumc.org.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Schoenthaler
authors.affiliation: Department of Population Health, Center for Healthful Behavior Change, New York University School of Medicine, 227 East 30th Street, 634, New York, NY, 10016, USA. franzenith.delacalle@nyumc.org.
authors.forename: Franzenith
authors.initials: F
authors.lastname: De La Calle
authors.affiliation: Department of Population Health, Center for Healthful Behavior Change, New York University School of Medicine, 227 East 30th Street, 634, New York, NY, 10016, USA. Miguel.barrios-barrios@nyumc.org.
authors.forename: Miguel
authors.initials: M
authors.lastname: Barrios-Barrios
authors.affiliation: Department of Population Health, Center for Healthful Behavior Change, New York University School of Medicine, 227 East 30th Street, 634, New York, NY, 10016, USA. aury.garcia@nyumc.org.
authors.forename: Aury
authors.initials: A
authors.lastname: Garcia
authors.affiliation: Union Health Center, New York, NY, 10001, USA. MPitaro@unionhealthcenter.org.
authors.forename: Maria
authors.initials: M
authors.lastname: Pitaro
authors.affiliation: Union Health Center, New York, NY, 10001, USA. Alum@unionhealthcenter.org.
authors.forename: Audrey
authors.initials: A
authors.lastname: Lum
authors.affiliation: Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA. Milagros.Rosal@umassmed.edu.
authors.forename: Milagros
authors.initials: M
authors.lastname: Rosal
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002985:Clinical Protocols; D003376:Counseling; D065246:Culturally Competent Care / Q000208:ethnology*; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology; D055118:Medication Adherence / Q000208:ethnology*; D062405:Motivational Interviewing; D009519:New York City / Q000453:epidemiology; D012107:Research Design; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents