Rush Team Explores New Telehealth Intervention to Improve Blood Pressure Medication Adherence

Over half of patients with hypertension do not take their medication as prescribed — so researchers are testing telehealth strategies to help them stay on track
A man holds up a prescription bottle to show on a video call

As rates of heart disease, especially hypertension, remain high among U.S. adults, an interdisciplinary team of health care researchers at Rush University is exploring ways to support patients in effectively managing and taking their prescription blood pressure medicines. Todd Ruppar, PhD, RN, FAHA, FAAN, John L. and Helen Kellogg Professor of Nursing, is the principal investigator of the project, “Testing Feasibility of the MASH Intervention to Improve Antihypertensive Medication Adherence,” which received funding from Rush through the 2022 President’s Collaborative Research Award.

The project will test the feasibility of the telehealth intervention called “medication adherence problem solving for hypertension” — or MASH — which has tailored program content according to participants’ reasons for not fully adhering to taking their antihypertensive medication. The intervention is designed after examining each patient’s beliefs about hypertension, medication and the barriers to taking medication. Then, intervention strategies are created that address the specific concerns to help patients stay on track with their medication.

“Improving rates of blood pressure control among adults with hypertension is a key step in reducing rates of heart attack, stroke and heart failure, as well as lowering overall mortality from cardiovascular disease,” Ruppar says. “Unfortunately, over half of patients prescribed medication for hypertension do not take their medication as prescribed, leading to a high percentage of patients who are unable to reach their target blood pressure despite being treated with antihypertensive medication. Low medication adherence has been linked with a number of problematic health outcomes, including reduced life expectancy.”

There are three aims of the project:

  • Assess the feasibility of MASH for improving blood pressure medication adherence.
  • Develop estimates of the efficacy of MASH as compared to usual care methods for improving medication adherence and lowering blood pressure over 12 weeks.
  • Obtain data needed by researchers to plan larger studies looking at the MASH program in the future.

The research award funding will enable Ruppar, he says, to work more closely with other health care providers in studying the issue, including Steven Rothschild, MD, chair of the Department of Family and Preventive Medicine, and Michael Schoeny, PhD, associate professor in the Department of Community, Systems, and Mental Health Nursing.

“This project will address a critical gap in primary care — ensuring our patients get help with their prescription regimen,” says Christine Kennedy, PhD, RN, FAAN, dean of the College of Nursing. “The work Dr. Ruppar is leading has important implications for designing better interventions to meet various challenges in daily medication approaches. ”

If successful, the MASH intervention can also serve as a model for improving medication adherence in other chronic conditions and improve health outcomes for the half of patients with chronic conditions who struggle to manage their medications.

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