FINAL PROGRESS REPORT TITLE: Text Messaging to Improve Hypertension Medication Adherence in African Americans PRINCIPAL INVESTIGATOR:

Purpose: This two-phased study sought to develop (Phase I) and test (Phase II) BPMED, a text message system to improve medication adherence in African Americans with uncontrolled Hypertension (HTN). Scope: In the US, almost 78 million adults ≥20 years of age have hypertension (HTN), a key risk factor for heart disease and stroke. HTN is a condition in which there exists tremendous health disparities. African Americans suffer from greater disease severity, earlier onset, and more HTN-related complications than age-matched Whites. Although HTN can be effectively managed with medication, adherence to antihypertensive medication regimens is poor. Text messaging is a promising strategy to improve medication adherence. Methods: In Phase I, we conducted formative research through focus groups with target end users to help develop BPMED. In Phase II, we conducted a one-month pilot RCT of BPMED compared to usual care. We hypothesized that BPMED participants would demonstrate improvements over usual care for measures of medication adherence, medication adherence self-efficacy, and blood pressure. Results: Both usual care and intervention groups showed slight improvements in medication adherence and blood pressure at one-month follow-up, but differences between groups were not significant, suggesting BPMED did not have an effect on primary or secondary outcomes at one-month follow-up. Despite lack of significant effect, BPMED participants self-report overwhelming satisfaction with BPMED, perceptions of greater adherence to antihypertensive medication regimens, and perceptions of overall health improvements. Further study of the BPMED program with a larger sample size and longer-term follow-up is warranted.