Hypertension and Adherence in Rural Practice

农村实践中的高血压和依从性

• 批准号: 6654897
• 负责人: MICHELLE Y MARTIN
• 金额: $ 76.84万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-30 至 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6654897
• 关键词: African American; antihypertensive agents; behavioral /social science research tag; cardiovascular disorder chemotherapy; cardiovascular disorder prevention; community health services; counseling; health care service evaluation; health care service utilization; health services research tag; hypertension; low socioeconomic status; rural area; social support network; therapy compliance; African American; antihypertensive agents; behavioral /social science research tag; cardiovascular disorder chemotherapy; cardiovascular disorder prevention; community health services; counseling; health care service evaluation; health care service utilization; health services research tag; hypertension; low socioeconomic status; rural area; social support network; therapy compliance

DESCRIPTION (provided by investigator): Hypertension (HTN) is the most prevalent, modifiable risk factor for stroke, coronary heart disease (CHD), and congestive heart failure (CHF). African-Americans and individuals with low educational and income levels are at the greatest risk for HTN-related morbidity and mortality. As few as 11 percent of HTN patients are adequately controlled, with estimates of non-adherence from 20-90 percent. This proposed 4-year project is a randomized clinical trial evaluating the effect of a theory-driven, multi-component adherence promotion intervention on medication adherence in a sample of low-income, predominantly African-American, residents of rural Alabama who are receiving pharmacologic treatment for HTN. A sample of 426 patients will be recruited from the population of patients enrolled in the ADPH HTN Management Program. Participants will be randomly assigned to one of two treatment conditions: Adherence Promotion (AP) intervention or Cancer Information (CI) control. Both conditions involve a series of home visits and follow-up phone calls conducted by a trained and experienced Community Health Advisor (CHA.). The AP treatment condition is a theory-driven, multi-component intervention utilizing interactive software to direct the CHA and participant through a semi-structured dialogue incorporating individualized assessment and tailored feedback intended to help patients develop behavior management skills that can be used to maintain consistent patterns of medication use and regular attendance at scheduled clinic appointments. The CI control condition will utilize non-interactive software to direct the CHA and participant through a semi-structured dialogue addressing general information about common cancers and standard recommendations relevant to cancer prevention and control. The primary outcome, pill counts for prescribed antihypertensive medications, will be collected at 3-, 6-, 9-, and 12-month follow-up. Patient self-reported adherence and attendance at appointments to refill prescriptions for antihypertensive medications will be examined as secondary measures of treatment adherence. A number of adherence-related measures (BP, symptoms and side effects, attitudes about HTN and medication use, depression) will also be obtained to examine theoretical constructs addressed in the development of the AP intervention and to examine patient characteristics associated with response to treatment.

描述（调查员提供）：高血压（HTN）是最多的 中风，冠心病（CHD）的普遍，可修改的危险因素和 充血性心力衰竭（CHF）。非裔美国人和低人 与HTN相关的教育和收入水平最大的风险 发病率和死亡率。只有11％的HTN患者足够 受控，估计不遵守20-90％。这提出了 4年项目是一项随机临床试验，评估了 理论驱动的，多组分的依从性促进药物干预 在低收入，主要是非裔美国人的样本中遵守居民 阿拉巴马州农村的人正在接受HTN的药理治疗。样本 将从入学的患者人群中招募426名患者 ADPH HTN管理程序。参与者将随机分配给 两个治疗条件：依从性促进（AP）干预或癌症 信息（CI）控制。两种情况都涉及一系列家庭访问， 经过训练且经验丰富的社区健康进行的后续电话 顾问（Cha。）。 AP治疗条件是理论驱动的多组分 干预使用交互式软件指导CHA和参与者 通过半结构化对话，结合了个性化评估和 量身定制的反馈旨在帮助患者发展行为管理技能 可以用来保持一致的药物使用和常规方式 预定的诊所约会。 CI控制条件将 利用非交互式软件来指导CHA和参与者 半结构化对话解决有关常见癌症的一般信息 以及与癌症预防和控制有关的标准建议。这 主要结果，处方药的药丸计数将 在3个，6、9和12个月的随访中收集。患者自我报告 遵守和出席的约会，以补充处方的处方 降压药将被检查为 治疗依从性。许多与依从性相关的措施（BP，症状和 副作用，对HTN的态度和使用药物的态度，抑郁症）也将是 获得了研究在开发中涉及的理论结构 AP干预并检查与反应相关的患者特征 治疗。