Outcomes of Psychoeducation and a Text Messaging Adherence Intervention Among Individuals With Hypertension and Bipolar Disorder

Abstract

Objective: This study evaluated the feasibility, acceptability, and preliminary efficacy of psychoeducation plus an automated text-messaging intervention (iTAB-CV) to improve adherence for antihypertensives and bipolar disorder medication. Methods: Following a psychoeducation program, iTAB-CV was administered for two months. In month one, participants received one educational/motivational and one mood rating text daily. In month two, medication reminders were added. Results: The sample (n=38) was 74% African-Americans, 53% women, with a mean age of 51.53±9.06. Antihypertensive non-adherence decreased from 43%±23% to 21%±26% at 12 weeks [χ 2 = 34.6, df= 3, p< 0.001]. SBP decreased from 144.8±15.5 mmHg to 136.0±17.8 mmHg (χ 2 = 17.6, df=3, p< 0.001). Retention was 100%. Conclusions: In this uncontrolled trial, participants were highly engaged and medication adherence and reduced SBP were sustained following psychoeducation plus iTAB-CV. Since iTAB-CV is automated and delivered remotely, it has potential to reach a large and challenging population.

Real-World Patterns of Utilization and Costs Associated with Second-Generation Oral Antipsychotic Medication for the Treatment of Bipolar Disorder: A Literature Review

“…In a 2018 retrospective study, published outside the date range for this review, analyses showed patients newly initiated on antipsychotic medication who were fully adherent (PDC ≥80%) for ≥6 months had significantly lower adjusted rates of psychiatric hospitalization (6.0%) compared to those who were partially adherent (8.3%, PDC ≥40% and <80%) or nonadherent (8.8%, PDC <40%). 48 To this end, building upon interventions targeted to other factors associated with nonadherence, such as simplifying medication regimens, 38 , 49 , 50 programming medication reminders, 44 , 51 and programs to strengthen the patient-clinician therapeutic alliance 5 , 6 , 44 need to be a research priority as well as part of ongoing clinical management of patients.…”

The Effect of Social Cognitive Theory-Based Psychoeducation Towards Depression and Blood Pressure of Ischemic Stroke Patients

“…This is supported by research conducted by (Hadidi, 2016) proving that psychoeducation has a significant effect on reducing systole and diastole. This is supported by research conducted by (Levin et al, 2019) proving that giving psycho-education can improve the compliance of hypertensive patients in doing therapy and can reduce blood pressure. Several studies have shown that the management of hypertension with a non-pharmacological therapeutic approach including weight loss, alcohol, sodium and tobacco restriction, exercise and relaxation are mandatory interventions that must be performed on each therapy in hypertension patients (Smeltzer & Bare, 2014).…”

A randomized controlled trial of customized adherence enhancement (CAE-E): study protocol for a hybrid effectiveness-implementation project

“…A recent large clinical trial demonstrated limited long-term adherence advantage for passive medication aids (e.g., 7-day pill organizer, pill cap displaying time since last dose), a category into which eCAP TM would fall [65]. Experience with eCAP TM in a pilot BD and hypertension adherence study [66] conducted by members of the study team yielded substantially less missing data using the eCAP TM than the Medication Event Monitoring System (MEMS) [32]. Adding an extra financial incentive for bringing in the eCAP TM or scanning it using the free eCAP TM app on the participant's phone ($10 per visit) optimizes use of automated pill monitoring.…”

“…Adding an extra financial incentive for bringing in the eCAP TM or scanning it using the free eCAP TM app on the participant's phone ($10 per visit) optimizes use of automated pill monitoring. Notably, in the previously mentioned iTAB-CV R21 project using eCAPs TM , 31/38 participants (81.6%) brought their eCAP TM to all 3 study visits over a 6-month period [66]. To optimize generalizability, individuals who use medisets or pillminders to manage multiple medications will not be excluded from the study.…”