Abstract 9445: Using Latent Class Analysis to Identify Antihypertensive Adherence Trajectories: The BETTER-BP Trial

• Published in: Circulation (New York, N.Y.) N.Y.), 2022-11, Vol.146 (Suppl_1), p.A9445-A9445
• Main Authors: Grant, Eleonore V, Qian, Kun, Adhikari, Samrachana, Guttierez, Yasmin, Shimbo, Daichi, Levy, Natali, Fonceva, Anamarija, Dodson, John A
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.146.suppl_1.9445

IntroductionAdherence to antihypertensive medications remains low in many patients. In this context, the BETTER-BP randomized trial was designed to test whether providing small financial rewards for medication adherence with a text message-based lottery system improves adherence and lowers blood pressure. In this preliminary analysis we characterized adherence trends from baseline to 6 months in BETTER-BP through 12/2021. MethodsParticipants were recruited from two safety-net clinics in New York City (Bellevue Hospital and NYU-Brooklyn FHC). There were 101 participants with six months of complete adherence data. Mean weekly adherence was recorded through an Adheretech electronic monitoring device. Latent class mixed methods analysis was used to determine categorizable adherence trajectory trends over six months. We then investigated factors (age, sex, insurance status, comorbidity burden, depression, self-efficacy) that predicted category membership. The analysis remained blinded to treatment arm given that full enrollment was not yet complete. ResultsThree distinct adherence trajectories were determined(1) High, persistent adherence (n=53), (2) Gradually declining adherence (n=33), and (3) Early declining non-adherence (n=15). In a multivariable analysis, only self-efficacy (based on the medication adherence self-efficacy scale [MASES]) had a significant (p=0.02) association with adherence, with mean MASES scores of 81.4, 76.3 and 72.1 for clusters (1), (2) and (3) respectively. ConclusionsIn this preliminary analysis, we found that the majority of participants had high persistent adherence, and that those with high self-efficacy were more likely to be members of this category. These results will need to be confirmed at trial completion (target sample N = 435). Figure 1. Mean participant adherence trajectory clusters over six months.