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J. Pers. Med. 2015, 5(4), 389-405; doi:10.3390/jpm5040389

Evaluation of an mHealth Medication Regimen Self-Management Program for African American and Hispanic Uncontrolled Hypertensives

College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
College of Nursing, Medical University of South Carolina, Charleston, SC 29425, USA
Author to whom correspondence should be addressed.
Academic Editor: Maged N. Kamel Boulos
Received: 28 August 2015 / Revised: 3 November 2015 / Accepted: 6 November 2015 / Published: 17 November 2015
(This article belongs to the Special Issue Smart, Personalized Digital Health and Medicine)
View Full-Text   |   Download PDF [668 KB, uploaded 17 November 2015]   |  


African Americans and Hispanics have disproportionate rates of uncontrolled essential hypertension (EH) compared to Non-Hispanic Whites. Medication non-adherence (MNA) is the leading modifiable behavior to improved blood pressure (BP) control. The Smartphone Medication Adherence Stops Hypertension (SMASH) program was developed using a patient-centered, theory-guided, iterative design process. Electronic medication trays provided reminder signals, and Short Message Service [SMS] messaging reminded subjects to monitor BP with Bluetooth-enabled monitors. Motivational and reinforcement text messages were sent to participants based upon levels of adherence. Thirty-eight African-American (18) and Hispanic (20) uncontrolled hypertensives completed clinic-based anthropometric and resting BP evaluations prior to randomization, and again at months 1, 3 and 6. Generalized linear mixed modeling (GLMM) revealed statistically significant time-by-treatment interactions (p < 0.0001) indicating significant reductions in resting systolic blood pressure (SBP) and diastolic blood pressure (DBP) for the SMASH group vs. the standard care (SC) control group across all time points. 70.6% of SMASH subjects vs. 15.8% of the SC group reached BP control (< 140/90 mmH) at month 1 (p < 0.001). At month 6, 94.4% of the SMASH vs. 41.2% of the SC group exhibited controlled BP (p < 0.003). Our findings provide encouraging evidence that efficacious mHealth, chronic disease, medical regimen, self-management programs can be developed following principles of patient-centered, theory-guided design. View Full-Text
Keywords: mHealth; iterative design; essential hypertension; patient centered mHealth; iterative design; essential hypertension; patient centered

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Davidson, T.M.; McGillicuddy, J.; Mueller, M.; Brunner-Jackson, B.; Favella, A.; Anderson, A.; Torres, M.; Ruggiero, K.J.; Treiber, F.A. Evaluation of an mHealth Medication Regimen Self-Management Program for African American and Hispanic Uncontrolled Hypertensives. J. Pers. Med. 2015, 5, 389-405.

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