Evidence map›Paper›PMID 42676786›Full record

ArticleDigital health

A targeted behavioral economics-based mobile health intervention to improve medication adherence in patients with hypertension: A three-arm randomized controlled trial.

Jan Strebel, Anjali Raja Beharelle, Michael Mayr, Valeriya Nemtsova, Joachim Zahnd, Gregoire Wuerzner, Georg Ehret, Michael Stiefel, Emrush Rexhaj, Théo Meister and 2 more

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Article in Digital health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Jan StrebelMedical Outpatient Department and Hypertension Center, ESH Hypertension Center of Excellence, University Hospital Basel, Basel, Switzerland.ORCID https://orcid.org/0009-0005-6143-9978
Anjali Raja BeharelleCollabree AG, Zurich, Switzerland.ORCID https://orcid.org/0000-0001-6000-4386
Michael MayrMedical Outpatient Department and Hypertension Center, ESH Hypertension Center of Excellence, University Hospital Basel, Basel, Switzerland.
Valeriya NemtsovaMedical Outpatient Department and Hypertension Center, ESH Hypertension Center of Excellence, University Hospital Basel, Basel, Switzerland.
Joachim ZahndService of Nephrology and Hypertension, Lausanne University Hospitaland University of Lausanne, Lausanne, Switzerland.
Gregoire WuerznerService of Nephrology and Hypertension, Lausanne University Hospitaland University of Lausanne, Lausanne, Switzerland.
Georg EhretDepartment of Cardiology, Geneva University Hospitals, Geneva, Switzerland.
Michael StiefelDepartment of Cardiology, University Hospital Zurich, Zurich, Switzerland.
Emrush RexhajDepartment of Cardiology and BioMedical Research, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.ORCID https://orcid.org/0000-0002-0834-7637
Théo MeisterDepartment of Cardiology and BioMedical Research, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Annina S VischerMedical Outpatient Department and Hypertension Center, ESH Hypertension Center of Excellence, University Hospital Basel, Basel, Switzerland.ORCID https://orcid.org/0000-0001-5188-1723
Thilo BurkardMedical Outpatient Department and Hypertension Center, ESH Hypertension Center of Excellence, University Hospital Basel, Basel, Switzerland.ORCID https://orcid.org/0000-0001-6373-9820

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Non-adherence to antihypertensive therapy remains a major barrier to optimal blood pressure (BP) control. This study evaluated whether a multi-faceted medication adherence mobile application (mApp), with or without financial incentives (FI), improves adherence and BP compared with standard care. Methods: In this multicenter, randomized, open-label trial, outpatients with hypertension taking ≥4 pills/day were randomized to (A) mApp with FI, (B) mApp without FI, or (C) standard-of-care. Adherence was measured by Medication Event Monitoring System (MEMS) dispensers. Primary endpoint was median adherence at 90 days comparing A with C; the co-primary endpoint compared adherence during month 3 versus month 1. Secondary outcomes included self-reported adherence, office and ambulatory BP over 90 and 180 days. Results: Of 219 randomized participants, 176 (80.4%) completed the 90-day visit (median age 63 years; 23% women). Median adherence at 90 days was 95.6% in A and C (p=0.551). Median change in adherence from month 1 to month 3 was 0% in A and 1.6% in C (p=0.691). No significant differences were observed for BP. Self-reported adherence did not differ between groups, although within-group analyses showed improvement over time in A (p=0.001). Conclusions: In outpatients with hypertension and unexpectedly high observed adherence and no substantial BP elevation at baseline, neither the mApp nor FI improved MEMS-measured adherence or BP. Future interventions should focus on identifying and engaging patients with low medication adherence and sufficient room for BP improvement, for whom digital strategies may have greater impact.

Indexed as

arterial hypertensionbehavioral economicsdigital healthfinancial incentivesmedication adherence

Identifiers

PMID42676786
PMCPMC13527327

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.