Testing a smartphone application intervention to improve medication adherence in African American female clinic patients with unstable high blood pressure: A two-group randomized control trial
The purpose of this study was to determine if selected smartphone applications could improve medication adherence in women who live with unstable high blood pressure. Participants in this study were African American and at least 18 years of age, who sought treatment for unstable high blood pressure in Harris, Fort Bend, or Waller counties in Texas. The research question addressed in this study was, “Is there a difference in medication adherence for African American women diagnosed with unstable high blood pressure from a community health clinic setting who monitor their blood pressure daily and use the OnTimeRx® smartphone application versus those who use the Omron BP786 monitor?” The theoretical framework for this two-group, posttest only, randomized control trial was an integration of the Technology Acceptance Model, Health Beliefs Model, and Bandura’s Self-Efficacy Theory. The Stroop Color and Word Test was administered pretest to screen for cognitive deficits that may interfere with the participants’ ability to operate the equipment that was used in this research study. After achieving t-scores of 30 in all three test areas, participants were consented and randomized into one of two study conditions, the control or treatment group. Instructions on the operation of the equipment and software applications were made applicable to the participant’s treatment condition. Throughout the study, all participants were contacted on a weekly basis for follow-up and to answer study-related questions. Handouts were provided as a secondary measure to augment verbal instructions. Medication adherence was measured, posttest, with the Morisky Medication Adherence Scale-8. This posttest was administered after the 67 study participants completed 28 days of the study and submitted their blood-pressure values to the primary investigator. The treatment group demonstrated significantly better medication adherence than the control group (Mann-Whitney U=393, p-value=0.037). These findings suggested smartphone technology can have a positive influence on patients with unstable high blood pressure.