Digital health for medication adherence among African Americans with hypertension

数字健康促进非裔美国人高血压患者的药物依从性

• 批准号: 10253402
• 负责人: Patricia Flynn Weitzman
• 金额: $ 25.65万
• 依托单位: ENVIRONMENT AND HEALTH GROUP, INC.
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-10 至 2023-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10253402
• 关键词: Address; Adherence; Adult; Affect; African American; American Heart Association; Behavior; Businesses; COVID-19; COVID-19 severity; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Clinic; Clinical; Communication; Computer software; Cultural Diversity; Dangerousness; Disease; Doctor of Philosophy; Effectiveness; Ensure; Ethnic group; Evaluation; Failure; Feedback; Geography; Goals; Guidelines; Health; Healthcare Systems; Hospitalization; Hypertension; Individual; Intervention; Knowledge; Leadership; Life Style; Link; Medical Care Team; Meta-Analysis; Minority; Modeling; Monitor; Morbidity - disease rate; Motivation; Needs Assessment; Outcome; Patients; Pharmaceutical Preparations; Phase; Physicians; Practice Management; Pre-Post Tests; Primary Health Care; Provider; Research; Research Personnel; Rest; Risk; Risk Factors; Safety; Self Efficacy; Stress; Sum; System; Testing; Text; Text Messaging; Therapeutic; Time; adherence rate; base; blood pressure reduction; cardiovascular health; clinical practice; clinically significant; comorbidity; compliance behavior; cost; demographics; design; digital; digital health; effective intervention; evaluation/testing; evidence base; health disparity; hypertension control; implementation barriers; improved; individual patient; inhibitor/antagonist; innovation; medication compliance; mobile application; mortality; multidisciplinary; pandemic disease; patient population; patient-clinician communication; personalized approach; pill; prevent; service intervention; severe COVID-19; side effect; stem; text messaging intervention; tool; trend; usability

Abstract: Under the leadership of Patricia Weitzman, PhD, a multicultural, multidisciplinary team of clinicians and researchers will collaborate to develop, formatively test, and evaluate the short-effectiveness of a digital provider platform, called Memento.HTN, that is integrated with a patient SMS text system, and designed to support medication adherence by African Americans with hypertension (HTN). HTN is more common and more destructive for African Americans than for any other ethnic group. More than half of African American adults, about 15 million people, have HTN. Furthermore, African Americans are 4 times less likely to adhere to HTN medications compared to their white counterparts. Tailored approaches to reduce the racial gap in HTN morbidity and mortality, particularly those that support medication adherence, are needed in primary care. Such approaches must overcome barriers due to cost or geographic distance that can prevent African American patients from accessing adherence support. These approaches must also overcome barriers to the delivery of adherence support that stem from healthcare systems themselves. Importantly, HTN is one of most common co-morbidities in Covid19 hospitalizations, particularly for African Americans (CDC 2020). Moreover, media coverage of a possible link between certain HTN meds, called RAAS inhibitors, and severe Covid19 outcomes may have alarmed HTN patients about the safety of their meds. As a result, the ACC (March, 2020) promptly issued guidelines recommending all patients adhere to HTN meds during the pandemic unless advised by their physicians, as there is no evidence of a link between HTN drugs and Covid19 severity. Thus, in the time of Covid19, supporting medication adherence of African Americans with HTN is extremely urgent. Memento.HTN is innovative in three key ways: 1) To our knowledge, it is the first-ever linked digital provider platform and patient SMS text system for HTN medication adherence. 2) It is culturally-tailored for African Americans with HTN. 3) It has unique monitoring functionality allowing providers to monitor individual patient adherence; support `new start' patients, who are at increased risk for non-adherence; and track group adherence rates by drug class, pill format, and patient demographics, which have never been included in any digital med adherence intervention. Thus, the Memento.HTN system greatly simplifies and facilitates provider delivery of adherence support to patients, while enhancing their clinical therapeutics. The provider platform sends patients interactive SMS-text pill reminders plus culturally-sensitive motivational, educational, spiritual/stress-supportive, and customizable texts, along with texts targeting intentional non-adherence and Covid19-related concerns. Texts go directly to patient cellphones (no mobile app needed), making the intervention accessible to patients who do not possess smartphones. Importantly, Memento allows 2-way texting communication between providers and patients, and automatically alerts providers when a patient has a clinically-significant pill lapse. We believe Memento has significant commercial potential, as EHG has already developed plans for multiple digital adherence interventions that will be marketed together to clinics serving large numbers of at-risk patients. This B2B business model can generate large increases in revenues for customers, making our products attractive from both a financial and health perspective.

摘要：在Patricia Weitzman的领导下 研究人员将合作开发，形成，测试和评估数字提供商的短效率 平台称为Memento.htn，与患者SMS文本系统集成在一起，旨在支持药物 非裔美国人遵守高血压（HTN）。 HTN对非洲人更为普遍，更具破坏性 美国人比其他任何族裔。超过一半的非洲裔美国成年人，大约1500万人 htn。此外，与白色相比，非洲裔美国人遵守HTN药物的可能性少4倍 同行。量身定制的方法来减少HTN发病率和死亡率的种族差距，尤其是那些支持的方法 在初级保健中需要药物依从性。由于成本或地理位置，这种方法必须克服障碍 可以防止非裔美国人患者获得依从性支持的距离。这些方法也必须 克服源于医疗保健系统本身的依从性支持的障碍。重要的是，HTN是 Covid19住院期间最常见的合并症之一，特别是对于非裔美国人（CDC 2020）。 此外，媒体对某些HTN药物（称为RAAS抑制剂和严重的Covid19）之间可能联系的介绍范围 结果可能使HTN患者有关其药物的安全性。结果，ACC（2020年3月）迅速 发布指南，建议所有患者在大流行期间遵守HTN药物，除非其医生建议，否则 由于没有证据表明HTN药物与COVID19严重程度之间存在联系。因此，在Covid19时期，支持 非洲裔美国人与HTN的药物依从性非常紧迫。 Memento.htn具有三个关键的创新性 方法：1）据我们所知，它是HTN的第一个链接的数字提供商平台和患者SMS文本系统 药物依从性。 2）这是对拥有HTN的非洲裔美国人的文化监管。 3）它具有独特的监控 功能使提供者可以监视个体患者的依从性；支持“新起点”患者 不遵守的风险增加；以及按毒品类，药丸格式和患者人口统计的田径遵守率， 这些从未包含在任何数字依从性干预措施中。因此，Memento.htn系统大大 简化并促进提供者向患者提供依从性支持，同时增强其临床治疗剂。 提供商平台向患者提供互动SMS-TEXT药丸提醒，以及对文化敏感的动机， 教育，精神/压力支持和可定制的文本，以及针对故意不遵守性和的文本 COVID19与COVID相关的问题。文本直接输入患者手机（无需移动应用程序），进行干预 不拥有智能手机的患者可以使用。重要的是，梅门托允许2条短信交流 在提供者和患者之间，并在患者患有临床意义的药丸失败时会自动提醒提供者。我们 相信纪念品具有巨大的商业潜力，因为EHG已经制定了多个数字的计划 依从性干预措施将共同向服务大量高危患者提供诊所。这个B2B 商业模式可以为客户带来大幅增长，从而使我们的产品从两者中吸引人 财务和健康的观点。