Improving Adherence and Outcomes by Artificial Intelligence-Adapted Text Messages

Completed · Not applicable

Conditions studied: Medication Non-adherence

In brief

Uncontrolled hypertension is a major cause of morbidity and mortality and many patients fail to take their antihypertensive medication as prescribed. The investigators propose to use artificial intelligence (AI) to allow short message service (SMS or text messages) interventions to adapt to patients' adherence needs and substantially improve medication taking. The aims of the study are to: (1) develop AI methods for adaptive decision-making in human-centered environments and demonstrate the feasibility of the resulting AI-enhanced SMS medication adherence intervention, (2) demonstrate that the intervention can "learn" by adapting the SMS message stream according to patients' medication taking over time, and (3) examine potential intervention impact as measured by improvements in medication adherence and systolic blood pressures. The investigators will recruit 100 patients with uncontrolled hypertension and antihypertensive medication non-adherence. Adherence and other covariates will be measured via surveys at baseline, 3- and 6 months; blood pressures will be measured at baseline and 6 months. Participants will be given an electronic pill-bottle adherence monitor. Participants will receive SMS messages designed to motivate antihypertensive medication adherence. Message content and frequency will adapt automatically using AI algorithms designed to automatically optimize expected pill bottle opening. For Aim 1, the first 25 patients will be enrolled to develop and test alternative RL algorithms and fine-tune the system parameters. For Aim 2, the investigators will examine changes in the probability distribution over message-types and compare that distribution with patients' reasons for non-adherence reported at baseline. For Aim 3, the investigators will examine changes in self-reported medication non-adherence and blood pressure and automatically-reported pill bottle openings. This pilot study will establish the feasibility and potential impact of this novel approach to mobile health messaging for self-management support. The results will be used to support an R01 application for a larger and more definitive trial of intervention impacts.

Key facts

Study ID: NCT02454660
Run by: University of Michigan
People needed: 49
Starts: 2015-05-01
Expected to finish: 2016-11-04
Last updated by the study team: 2017-04-11

Who can join

Age: 21 and older. Sex: any. Healthy volunteers: accepted.

You may qualify if…

Patient must have Priority Health Care Health Insurance Coverage
Patient must have PDC of < 0.5 for anti-hypertensive medications

You may not qualify if…

No hypertension medicine currently taken
Patient doesn't text message (no cell phone) in an average week
No access to the internet
Patient has heart failure which makes it difficult to catch breath and move around
Patient uses artificial oxygen to breathe
Patient is currently under treatment for cancer
Patient currently has kidney disease that requires dialysis
Patient self reports a mental health diagnosis (from a health professional)
Patient reports having schizophrenia
Patient reports currently being treated bipolar disorder or manic-depressive illness or schizophrenia
Patients reports ever been diagnosed with dementia or Alzheimer's disease

Where it is running

University of Michigan College of Pharmacy — Ann Arbor, Michigan, United States
Spectrum Health — Grand Rapids, Michigan, United States

Full record on ClinicalTrials.gov

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