Study Examines Medication Adherence In High-risk, Low-income Populations

People pinch precocious humor unit were doubly arsenic apt to return their humor unit medicine regularly erstwhile offered regular chances to triumph rate rewards, yet they did not execute amended humor unit measurements than group who were not offered financial rewards, a caller study shows.

The preliminary findings from nan Behavioral Economics Trial to Enhance Regulation of Blood Pressure (BETTER-BP) were presented during a late-breaking subject convention during nan American Heart Association's Scientific Sessions 2025 successful New Orleans connected November 9 and simultaneously published arsenic a afloat manuscript successful nan Journal of nan American College of Cardiology (JACC).

"We're ever looking for ways to amended medicine adherence among our patients pinch bosom disease, and precocious humor unit is 1 of nan astir preventable consequence factors," said John A. Dodson, MD, MPH, main interrogator and lead writer of nan study. Dr. Dodson is nan head of NYU Langone's Geriatric Cardiology Program and an subordinate professor successful nan Department of Medicine's Leon H. Charney Division of Cardiology astatine NYU Langone Health.

BETTER-BP included 400 adults from 3 organization wellness clinics successful New York City. These clinics chiefly service patients pinch Medicaid and those without wellness insurance—groups that often struggle pinch uncontrolled humor unit and person trouble pursuing prescribed treatments. High humor unit is simply a awesome consequence facet for bosom attacks and strokes, and it tin often beryllium controlled done accordant medicine use.

The participants were randomly divided into 2 groups. About two-thirds were entered into a programme successful which they could triumph rate rewards for taking their humor unit medication, and nan remaining 3rd were successful a power group that didn't get this incentive. Before nan study began, everyone reported that they were not consistently taking their medicine arsenic prescribed.

To way really often participants took their pills, Dr. Dodson and nan investigation squad utilized physics pill bottles that recorded each clip nan bottles were opened, alternatively than relying connected participants to self-report. At nan commencement of nan study, nan mean systolic humor unit (the apical number successful a humor unit reading) was 139 mm Hg. For reference, nan American Heart Association's 2025 line says a normal systolic humor unit is beneath 120 mm Hg.

Participants successful nan rewards group were entered successful a regular drafting for rate prizes from $5 to $50, but only if they opened their pill vessel nan time before, showing that they took their humor unit medication. Each day, they received a matter connection astir whether they won money. If they missed a dose, nan study app sent a reminder that they could person been eligible for a reward if they had taken their medication. Those successful nan power group didn't person matter messages aliases person a chance to triumph money.

The study lasted 12 months—6 months pinch rewards, followed by 6 months without, to spot if participants' patient habits continued erstwhile nan incentives stopped.

Among nan study's cardinal findings:

• Financial incentives look to person doubled accordant medicine use. About 71 percent of participants successful nan rewards group opened their humor unit medicine regularly (at slightest 80 percent of nan clip during nan six-month study period), compared pinch 34 percent successful nan power group.
• Both groups saw akin drops successful humor pressure. After six months, mean systolic humor unit fell by 6.7 mm Hg successful nan rewards group and 5.8 mm Hg successful nan power group.
• The improvements didn't past erstwhile nan rewards stopped. After nan incentives ended, participants' medicine habits returned to what they were earlier nan study.

"Financial incentives intelligibly worked during nan study—people successful nan rewards group took their medicine overmuch much consistently," said Dr. Dodson.

But we were amazed that this didn't lead to importantly amended humor unit control. It's unclear whether participants opened nan bottles without taking nan medication, aliases if different untracked factors, for illustration different medications aliases manner behavior, affected their humor pressure. We were besides amazed that adherence dropped erstwhile nan rewards ended. This shows really analyzable behaviour changes really are. There's still a batch we request to understand astir what helps group instrumentality pinch patient habits agelong term."

John A. Dodson, Director, Geriatric Cardiology Program, NYU Langone

The study had respective limitations. The physics pill bottles tracked erstwhile participants opened their bottles, but not whether they really took their medication. Also, researchers monitored only 1 humor unit medicine per person, moreover though galore participants were prescribed aggregate narcotics to negociate their humor pressure. In addition, humor unit was measured successful session astatine conscionable 3 points—at nan commencement of nan study, astatine 6 months, and astatine 12 months (6 months aft nan rewards ended)—rather than done more-frequent location monitoring, which mightiness person produced different results.

Study details, background, and design:

• The study included 400 adults diagnosed pinch precocious humor unit who were prescribed astatine slightest 1 humor unit medicine and who had a systolic reference supra 140 mm Hg wrong nan past year.
• Of these, 265 participants were successful nan rewards group and 135 were successful nan power group.
• Participants had a median property of 57, and 60.5 percent were women. By self-reported title and ethnicity, 61.5 percent identified arsenic Hispanic, 20.3 percent arsenic Black, 3.3 percent arsenic non-Hispanic White, 2.8 percent arsenic Asian, and 12.3 percent arsenic different title aliases ethnicity.
• In summation to precocious humor pressure, 54.5 percent of participants had obesity (BMI≥30) and 46.5 percent had type 2 diabetes.
• More than 70 percent of participants were covered by Medicaid (due to having debased income aliases a disability) aliases had nary wellness insurance.

BETTER-BP was supported by nan National Heart, Lung, and Blood Institute and nan National Institutes of Health (R01HL148275).