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Open AccessArticle

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

1
College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
2
College of Nursing, Medical University of South Carolina, Charleston, SC 29425, USA
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Author to whom correspondence should be addressed.
Academic Editor: Maged N. Kamel Boulos
J. Pers. Med. 2015, 5(4), 389-405; https://doi.org/10.3390/jpm5040389
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)
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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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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