Key result
The COACHMAN technology-based intervention did not significantly improve blood pressure control or health-related quality of life compared to enhanced usual care in African Americans with hypertension over 12 weeks.
Why the study?
Behavioral interventions evaluating technology adoption to support self-management have been understudied in African Americans with hypertension.
Does a community and technology-based intervention (COACHMAN) improve blood pressure control and health-related quality of life in African Americans with hypertension?
RCT (n=60)
Open-label
Computer-number generator (1:1 allocation)
No
Does a community and technology-based intervention (COACHMAN) improve blood pressure control and health-related quality of life in African Americans with hypertension?
Answers are grounded in this paper and cite their sources.
A 12-week technology-based self-management intervention improved medication adherence but did not significantly reduce blood pressure compared to enhanced usual care in African Americans with hypertension.
Purpose: Adoption of technology has increased to support self-managing chronic diseases. However, behavioral interventions evaluating such technology have been understudied in African Americans with hypertension. The aim of this study was to explore a community and technology-based intervention for hypertension self-management (COACHMAN) intervention on blood pressure (BP) control and health-related quality of life (HRQoL) in African Americans with hypertension. Methods: Sixty African Americans (mean age 60; 75% females) who were prescribed antihypertensive medications and owning a smartphone were randomized to the COACHMAN (n = 30) or enhanced usual care (n = 30) group for 12 weeks. COACHMAN is comprised of four components: web-based education, home BP monitoring, medication management application, and nurse counseling. Hypertension knowledge, self-efficacy, technology adoption/use, medication adherence, BP, and HRQoL scores were assessed. Results: Mean systolic and diastolic BP at baseline was 150.49 (SD = 13.89) and 86.80 (SD = 13.39), respectively. After completing the 3-month intervention to improve hypertension self-management, the groups did not significantly differ in BP control and HRQoL. Clinically relevant BP reduction was observed in the intervention group. Paired t -test showed that mean medication-taking adherence scores significantly improved in the intervention group ( P = 0.023) compared to the control group ( P = 0.075). Conclusion: Using technology may have a positive impact on supporting hypertension self-management, particularly in medication-taking adherence. Further research is warranted in a larger sample and should include standardization of medication management to isolate the effects of behavioral interventions on changes in BP. Clinicaltrials.gov Identifier: NCT03722667.
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Still et al. (2020) conducted an RCT in Hypertension (n=60). COACHMAN (community and technology-based approach for hypertension self-management) vs. Enhanced usual care was evaluated on Change in systolic and diastolic blood pressure from baseline to 12 weeks. The COACHMAN technology-based intervention did not significantly improve blood pressure control or health-related quality of life compared to enhanced usual care in African Americans with hypertension over 12 weeks.
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