Under the leadership of Patricia Weitzman, PhD, a multicultural, multidisciplinary team of clinicians andresearchers will collaborate to develop, formatively test, and evaluate the short-effectiveness of a digital providerplatform, called Memento.HTN, that is integrated with a patient SMS text system, and designed to support medicationadherence by African Americans with hypertension (HTN). HTN is more common and more destructive for AfricanAmericans than for any other ethnic group. More than half of African American adults, about 15 million people, haveHTN. Furthermore, African Americans are 4 times less likely to adhere to HTN medications compared to their whitecounterparts. Tailored approaches to reduce the racial gap in HTN morbidity and mortality, particularly those that supportmedication adherence, are needed in primary care. Such approaches must overcome barriers due to cost or geographicdistance that can prevent African American patients from accessing adherence support. These approaches must alsoovercome barriers to the delivery of adherence support that stem from healthcare systems themselves. Importantly, HTN isone of most common co-morbidities in Covid19 hospitalizations, particularly for African Americans (CDC 2020).Moreover, media coverage of a possible link between certain HTN meds, called RAAS inhibitors, and severe Covid19outcomes may have alarmed HTN patients about the safety of their meds. As a result, the ACC (March, 2020) promptlyissued guidelines recommending all patients adhere to HTN meds during the pandemic unless advised by their physicians,as there is no evidence of a link between HTN drugs and Covid19 severity. Thus, in the time of Covid19, supportingmedication adherence of African Americans with HTN is extremely urgent. Memento.HTN is innovative in three keyways: 1) To our knowledge, it is the first-ever linked digital provider platform and patient SMS text system for HTNmedication adherence. 2) It is culturally-tailored for African Americans with HTN. 3) It has unique monitoringfunctionality allowing providers to monitor individual patient adherence; support `new start' patients, who are atincreased risk for non-adherence; and track group adherence rates by drug class, pill format, and patient demographics,which have never been included in any digital med adherence intervention. Thus, the Memento.HTN system greatlysimplifies and facilitates provider delivery of adherence support to patients, while enhancing their clinical therapeutics.The provider platform sends patients interactive SMS-text pill reminders plus culturally-sensitive motivational,educational, spiritual/stress-supportive, and customizable texts, along with texts targeting intentional non-adherence andCovid19-related concerns. Texts go directly to patient cellphones (no mobile app needed), making the interventionaccessible to patients who do not possess smartphones. Importantly, Memento allows 2-way texting communicationbetween providers and patients, and automatically alerts providers when a patient has a clinically-significant pill lapse. Webelieve Memento has significant commercial potential, as EHG has already developed plans for multiple digitaladherence interventions that will be marketed together to clinics serving large numbers of at-risk patients. This B2Bbusiness model can generate large increases in revenues for customers, making our products attractive from both afinancial and health perspective.
Public Health Relevance Statement: Narrative The proposed Phase 1 project aims to develop and test Memento.HTN, an individually-tailored, culturally- sensitive digital health intervention comprised of a provider platform and linked patient SMS system to promote medication adherence among African Americans with hypertension (HTN), a group that suffers from disproportionate HTN morbidity and mortality. Memento.HTN overcomes access barriers on the part of patients and adherence support implementation barriers on the part of healthcare teams and systems. Memento.HTN is innovative in three key ways: 1) it is the first-ever linked digital provider platform and patient SMS text system for HTN medication adherence; 2) it is culturally-tailored for African Americans with HTN; and 3) it has unique monitoring functionality allowing providers to monitor individual patient adherence, support `new start' patients, and track group adherence rates by drug class, pill format, and patient demographics.
Project Terms: Adult ; 21+ years old ; Adult Human ; adulthood ; Affect ; American Heart Association ; inhibitor/antagonist ; inhibitor ; Behavior ; Centers for Disease Control and Prevention (U.S.) ; CDC ; Centers for Disease Control ; Centers for Disease Control and Prevention ; United States Centers for Disease Control ; United States Centers for Disease Control and Prevention ; Communication ; comorbidity ; co-morbid ; co-morbidity ; Dangerousness ; Disease ; Disorder ; Pharmaceutical Preparations ; Drugs ; Medication ; Pharmaceutic Preparations ; drug/agent ; Ethnic group ; Ethnic People ; Ethnic Population ; Ethnicity People ; Ethnicity Population ; ethnicity group ; Feedback ; Geography ; Goals ; Health ; Healthcare Systems ; Health Care Systems ; Hospitalization ; Hospital Admission ; Hypertension ; Vascular Hypertensive Disease ; Vascular Hypertensive Disorder ; high blood pressure ; hyperpiesia ; hyperpiesis ; hypertensive disease ; Leadership ; Life Style ; Lifestyle ; Morbidity - disease rate ; Morbidity ; mortality ; Motivation ; Patients ; Physicians ; Pre-Post Tests ; Primary Health Care ; Primary Care ; Primary Healthcare ; Research ; Research Personnel ; Investigators ; Researchers ; Rest ; Risk ; Risk Factors ; Safety ; Computer software ; Software ; Stress ; Testing ; Time ; African American ; Afro American ; Afroamerican ; Black Populations ; black American ; Businesses ; Medical Care Team ; Health Care Team ; Healthcare Team ; Guidelines ; base ; evaluation/testing ; improved ; Clinical ; Phase ; Link ; Ensure ; Evaluation ; Failure ; Individual ; Cultural Diversity ; Multiculturalism ; Therapeutic ; tool ; Knowledge ; Clinic ; System ; Needs Assessment ; Self Efficacy ; Practice Management ; Modeling ; Intervention Strategies ; interventional strategy ; Intervention ; Meta-Analysis ; pill ; Cell Phone ; Cellular Telephone ; iPhone ; smart phone ; smartphone ; Cellular Phone ; Provider ; disparity in health ; health disparity ; Effectiveness ; preventing ; prevent ; Patient Compliance ; patient adherence ; patient cooperation ; therapy compliance ; therapy cooperation ; treatment compliance ; compliance behavior ; Address ; Adherence ; Ph.D. ; PhD ; Doctor of Philosophy ; Sum ; Monitor ; trend ; Text ; pandemic disease ; pandemic ; medication compliance ; drug adherence ; drug compliance ; medication adherence ; cost ; digital ; design ; designing ; Minority ; Outcome ; innovation ; innovate ; innovative ; clinically significant ; clinical significance ; multidisciplinary ; usability ; stem ; demographics ; service intervention ; effective intervention ; evidence base ; patient population ; hypertension control ; hypertension management ; clinical practice ; mobile application ; mobile app ; mobile device application ; cardiovascular health ; blood pressure reduction ; BP reduction ; lower BP ; lower blood pressure ; lowers blood pressure ; reduce BP ; reduce blood pressure ; reduction in BP ; reduction in blood pressure ; personalized approach ; Personalized medical approach ; individualized approach ; precision approach ; tailored approach ; individual patient ; Text Messaging ; short message service ; texting ; patient-clinician communication ; patient-doctor communication ; patient-provider communication ; side effect ; adherence rate ; COVID-19 ; COVID19 ; CV-19 ; CV19 ; corona virus disease 2019 ; coronavirus disease 2019 ; COVID-19 severity ; COVID disease severity ; COVID severity ; COVID-19 disease severity ; COVID19 disease severity ; COVID19 severity ; SARS-CoV-2 disease severity ; SARS-CoV-2 severity ; coronavirus disease 2019 disease severity ; coronavirus disease 2019 severity ; coronavirus disease severity ; severe acute respiratory syndrome coronavirus 2 disease severity ; severe acute respiratory syndrome coronavirus 2 severity ; severe COVID-19 ; life-threatening COVID ; life-threatening COVID-19 ; life-threatening SARS-CoV-2 ; life-threatening coronavirus disease ; life-threatening coronavirus disease 2019 ; life-threatening severe acute respiratory syndrome coronavirus 2 ; serious COVID ; serious COVID-19 ; serious SARS-CoV-2 ; serious coronavirus disease ; serious coronavirus disease 2019 ; serious severe acute respiratory syndrome coronavirus 2 ; severe COVID ; severe COVID19 ; severe SARS-CoV-2 ; severe coronavirus disease ; severe coronavirus disease 19 ; severe coronavirus disease 2019 ; severe severe acute respiratory syndrome coronavirus 2 ; text messaging intervention ; text based intervention ; text intervention ; digital health ; implementation barriers ; implementation challenges ;
