Digital Health, Hypertension, Treatment Adherence and Compliance
Conditions
Keywords
Personalized Medicine
Brief summary
Inadequate medication adherence (MA) in chronic conditions, including cardiovascular prevention, represents an important risk factor. The use of new IT technologies in this setting is supposed to be useful to improve patients' adherence, but currently available solutions have significant limitations, including lack of personalization and reliance on expensive ad hoc systems. This interdisciplinary project aims to verify the hypothesis that in patients on chronic antihypertensive treatment MA can be improved through the implementation of a novel digital health solution for MA monitoring and support, based on inexpensive and user-friendly, commercially available technology (voice assistant), connected with web interface for the physician. The intervention will be personalized based on the creation of Personas, intended as multidisciplinary-based representations of different user types. This approach will be tested in a randomized clinical trial.
Interventions
OTHERadherence support system based on a vocal assistant
Participants in the intervention group will receive a vocal assistant device and the instructions/support for the activation of the system at their homes. The device will remind the participant, at the times defined during set-up, which therapy should be taken and with what dosage. The participant will have 30 minutes from the first reminder to confirm vocally that the therapy has been taken, which will otherwise be considered as not having been taken. Participants in the control group will receive verbal advice from the physician about the need to follow the treatment recommendations and simple indications on possible solutions to maintain adherence, as by the usual practice of the Centre.
Sponsors
Istituti Clinici Scientifici Maugeri SpA
Politecnico di Milano
Istituto Auxologico Italiano
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult (\>18 years old) patients * History of essential hypertension * Treatment with at least one antihypertensive drug for which dedicated plasma essay is available * wireless internet connection available at patients' home * stable clinical conditions * written informed consent
Exclusion criteria
* insufficient technological literacy to manage vocal assistant * dementia or significant psychiatric disorders * conditions significantly limiting vocal communication (deafness, significant speech disorders, poor knowledge of Italian language) * pregnancy or breastfeeding * active cancer (except basal cell skin carcinoma) * upper limb amputation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Adherence (plasma essay - 3m) | after 3 months of randomized intervention | Percentage of adherent patients based on plasma essay at follow-up visit |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| adherence (pill count - 3m) | after 3 months of randomized intervention | percentage of adherent patients based on pill count adherence (AdhVA) at follow-up visit |
| adherence (voice assistant - 3m) | after 3 months of randomized intervention | percentage of adherent patients based on voice assistant adherence (AdhVA) at follow-up visit |
| adherence (questionnaire - 3m) | after 3 months of randomized intervention | percentage of adherent patients based on MARS-5I (Medication Adherence Report Scale-5 Italian version) at follow-up visit |
| Adherence (plasma essay - 5m) | after 5 months | percentage of adherent patients based on plasma essay at final visit |
| 24h Systolic Blood Pressure (5m) | after 5 months | 24-hour systolic blood pressure (ABPM) at final visit |
| adherence (voice assistant - 5m) | after 5 months | percentage of adherent patients based on voice assistant adherence (AdhVA) at final visit |
| adherence (questionnaire - 5m) | after 5 months | percentage of adherent patients based on MARS-5I at final visit |
| 24h Systolic Blood Pressure (3m) | after 3 months of randomized intervention | 24-hour systolic blood pressure (ABPM) at follow-up visit |
| adherence (pill count - 5m) | after 5 months | percentage of adherent patients based on pill count adherence (AdhVA) at final visit |
Countries
Italy
Contacts
Primary ContactGrzegorz Bilo, MD, PhD
Backup ContactLucia Zanotti, Bsc, PhD
Outcome results
None listed