Hypertension and Adherence in Rural Practice

农村实践中的高血压和依从性

• 批准号: 7266179
• 负责人: MICHELLE Y MARTIN
• 金额: $ 4.26万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-01 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7266179
• 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

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（由研究者提供）： 高血压 (HTN) 是最常见的 中风、冠心病 (CHD) 的普遍的、可改变的危险因素 充血性心力衰竭（CHF）。非裔美国人和低收入人群 受教育程度和收入水平与高血压相关的风险最大 发病率和死亡率。只有 11% 的 HTN 患者能够充分 不遵守的估计为 20-90%。这个提议 为期 4 年的项目是一项随机临床试验，评估一种药物的效果 理论驱动的多成分依从性促进用药干预 低收入（主要是非裔美国人）居民样本的依从性 阿拉巴马州农村地区正在接受高血压药物治疗的人。的样本 将从入组的患者群体中招募 426 名患者 ADPH HTN 管理计划。参与者将被随机分配到其中之一 两种治疗条件：依从性促进 (AP) 干预或癌症 信息（CI）控制。这两种情况都涉及一系列的家访和 由训练有素且经验丰富的社区卫生人员进行后续电话咨询 顾问（CHA.）。 AP治疗条件是一个理论驱动的、多成分的 利用交互式软件指导 CHA 和参与者进行干预 通过半结构化对话，结合个性化评估和 量身定制的反馈旨在帮助患者培养行为管理技能 可用于保持一致的药物使用模式和定期 出席预定的诊所预约。 CI 控制条件将 利用非交互式软件指导 CHA 和参与者通过 半结构化对话，涉及常见癌症的一般信息 以及与癌症预防和控制相关的标准建议。这 主要结局，即处方抗高血压药物的药丸数量，将 在 3、6、9 和 12 个月的随访中收集。患者自我报告 遵守并出席预约以补充处方 抗高血压药物将作为次要措施进行检查 治疗依从性。一些与依从性相关的措施（血压、症状和 副作用、对高血压和药物使用的态度、抑郁症）也将受到影响 获得检验在开发中解决的理论结构 AP 干预并检查与反应相关的患者特征 来治疗。

项目成果

Medication adherence among rural, low-income hypertensive adults: a randomized trial of a multimedia community-based intervention.

• DOI: 10.4278/ajhp.090123-quan-26
• 发表时间: 2011-07
• 期刊: American journal of health promotion : AJHP
• 作者: Martin MY;Kim YI;Kratt P;Litaker MS;Kohler CL;Schoenberger YM;Clarke SJ;Prayor-Patterson H;Tseng TS;Pisu M;Williams OD
• 通讯作者: Williams OD

'Too much trouble for what I get out of it': acceptability of cancer screening tests among low-income rural men and women in the Deep South.

“我从中得到的东西太麻烦了”：南部腹地低收入农村男性和女性对癌症筛查测试的接受程度。

• DOI: 10.1016/j.puhe.2011.09.019
• 发表时间: 2012
• 期刊: Public health
• 影响因子: 5.2
• 作者: Martin,MY;Kratt,P;Kim,Y;Schoenberger,YM;Pisu,M
• 通讯作者: Pisu,M

Taking less than prescribed: medication nonadherence and provider-patient relationships in lower-income, rural minority adults with hypertension.

• DOI: 10.1111/j.1751-7176.2010.00321.x
• 发表时间: 2010-09
• 期刊: Journal of clinical hypertension (Greenwich, Conn.)
• 作者: Martin MY;Kohler C;Kim YI;Kratt P;Schoenberger YM;Litaker MS;Prayor-Patterson HM;Clarke SJ;Andrews S;Pisu M
• 通讯作者: Pisu M

Addressing the unexpected: lessons learned from a randomized controlled trial conducted in partnership with a low-income, rural community.

解决意外问题：从与低收入农村社区合作进行的随机对照试验中吸取的经验教训。

• DOI: 10.1353/hpu.2013.0155
• 发表时间: 2013
• 期刊: Journal of health care for the poor and underserved
• 影响因子: 1.4
• 作者: Kratt,Polly;Kohler,Connie;Schoenberger,MeiM;Clarke,StephenJ;Kim,Young-il;Litaker,MarkS;Martin,MichelleY
• 通讯作者: Martin,MichelleY

Missed opportunities? Improving the care of patients with high blood pressure.

错过机会？

• DOI: 10.1038/ajh.2008.361
• 发表时间: 2009
• 期刊: American journal of hypertension
• 影响因子: 3.2
• 作者: Martin,MichelleY