The aim of this study is to assess the efficacy of Telephone-Lined Care for Hypertension Regimen Adherence in an older (50 years old or more) African-American population (TLC-HTN-AA). TLC-HTN-AA is a computer-based telecommunication system that will monitor, educate and counsel African-American adults with hypertension on adherence to medication, diet, and exercise regimens through regular automated telephone conversations with the patient as well as provide timely and useful reports to them and their primary health care providers. The specific goals of this project are to: 1) tailor the TLC-HTN-AA to the needs, preferences, and perspectives of an urban hypertensive African-American population; 2) evaluate in a randomized clinical trial, in clinical settings, the efficacy of TLC-HTN-AA used over a six month period of improving blood pressure control through improved adherence to treatment regimens (medication, diet, physical activity) and in sustaining this level of adherence over an additional six month maintenance period. Patients will be randomized to the intervention (TLC-HTN-AA) and control arms. Patients in the intervention arm will call TLC-HTN-AA once a week and will receive information, education and advice with regards to adherence to their treatment regimens. Patients in the control arm will only receive basic education about adherence to their treatment regimen. The following primary hypotheses will be tested: 1 )TLC-HTN-AA use will improve mean medication regimen adherence levels and the proportion of study subjects who achieve adequate adherence (80 percent of doses taken) at the end of the intervention period.; 2)TLC-HTN-AA use will improve adherence to healthy diet recommendations and the proportion of subjects who have appropriate intake of foods from all five food group domains measured and of sodium at the end of the intervention period; 3)TLC-HTN-AA use will improve levels of regular exercise as well as adherence to Center for Disease Control and Prevention and the American College of Sports Medicine (CDC-ACSM) recommendations for moderate or vigorous intensity physical activity at the end of the intervention period.; 4) Patients receiving TLC-HTN-AA will be more likely to become adherent to all three target regimens than patients in the control group.
| Migneault, Jeffrey P; Dedier, Julien J; Wright, Julie A et al. (2012) A culturally adapted telecommunication system to improve physical activity, diet quality, and medication adherence among hypertensive African-Americans: a randomized controlled trial. Ann Behav Med 43:62-73 |
