Behavioral Economics Trial To Enhance Regulation of Blood Pressure (BETTER-BP)

NYU Langone Health

Status: Completed

Conditions: High Blood Pressure

Treatments: Behavioral: Control Condition; Behavioral: Regret Lottery

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT04114669

19-00952

Details and patient eligibility

About

BETTER-BP (Behavioral Economics Trial To Enhance Regulation of Blood Pressure) is a phase II, single-center, prospective, pragmatic randomized clinical trial within the New York City Health and Hospitals (NYC-H+H) system and NYU Langone Family Health Centers. The trial will recruit from 3 NYC-H+H ambulatory clinics as well as NYU Langone Family Health Centers, and will use a lottery incentive program to promote adherence to antihypertensive medication that will be delivered via smartphone for 6 months. The trial will randomize 435 patients with hypertension determined to have poor adherence (<80% adherence with antihypertensive medication), in a 2:1 (intervention:control) ratio. Baseline enrollment will occur over 36 months with an expected 12 months follow-up per participant.

Enrollment: 401 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• A diagnosis of hypertension.

• An active prescription for ≥1 antihypertensive medication (any of the following classes: thiazide diuretic, ACE inhibitor, angiotensin receptor blocker, beta blocker, calcium channel blocker, centrally acting alpha agonist, direct vasodilator).

  • 1 ambulatory systolic blood pressure ≥140 mmHg (on therapy).

• Suboptimal adherence (self-report).

Exclusion criteria

• Incarcerated
• Pregnant
• Unable to use study software (Way To Health) in English or Spanish
• Unable/unwilling to consent
• Clear barrier to technology use (e.g. visual or hearing impairment)
• Projected life expectancy <12 months

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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401 participants in 2 patient groups, including a placebo group

Regret lottery

Experimental group

Description:

Will receive a lottery incentive ("regret lottery") for 6 months

Treatment:

Behavioral: Regret Lottery

Control Condition

Placebo Comparator group

Description:

Will complete a total of 3 in-person study visits, approximately one hour each.

Treatment:

Behavioral: Control Condition