Trial results for the Smartphone Medication Adherence Stops Hypertension (SMASH) program, investigating medication adherence and blood pressure control in African American hypertensives, were posted on ClinicalTrials.gov on 2025-06-13. The SMASH group achieved a mean medication adherence of 80.3% compared to 27.5% in the enhanced standard care group.
Background
Hypertension, or high blood pressure, is a major risk factor for cardiovascular disease, stroke, and kidney disease. Effective management often relies on consistent medication adherence, which can be a significant challenge for many patients. Medication non-adherence is particularly prevalent in certain populations, including African Americans, contributing to disparities in blood pressure control. This trial aimed to address this by evaluating a patient-centered health technology program designed to improve adherence and ultimately, blood pressure outcomes.
Trial design
This was a two-arm Randomized Controlled Trial (RCT) designed to assess the efficacy of the Smartphone Medication Adherence Stops Hypertension (SMASH) mobile health (mHealth) program. The trial enrolled a total of 204 participants and investigated conditions including Hypertension and Medication Non-Adherence. Participants were African-American hypertension patients with no other known chronic diseases, who were found to have uncontrolled hypertension and medication non-adherence via electronic device monitoring. They were randomized to either the SMASH group or an enhanced standard care (SC) program. The SMASH group received reminders in the form of auditory and visual cues.
Key results
The study reported on several key measurements:
- Percent of Subjects Meeting JNC8 Guidelines for BP Control:
- In the SMASH group, 97 participants met the guidelines.
- In the Enhanced SC group, 106 participants met the guidelines.
- Percent of Participants With Medication Adherence to >.90" as Accurate and Appropriate:
- In the SMASH group, the mean adherence was 80.3 (Standard Deviation 9.5) percentage of participants.
- In the Enhanced SC group, the mean adherence was 27.5 (Standard Deviation 29.4) percentage of participants.
What this means
The results indicate that the SMASH mobile health program significantly improved medication adherence among African American patients with hypertension, achieving a mean adherence of 80.3% compared to 27.5% in the enhanced standard care group. This substantial increase in adherence is a critical step towards better blood pressure control and reducing the risk of hypertension-related complications. While the number of participants meeting JNC8 guidelines for BP control was similar between groups, improved adherence is a strong indicator of the intervention's potential to foster better long-term health outcomes and empower patients in managing their condition.
Source
The information for these trial results was obtained from ClinicalTrials.gov, a public database of clinical studies. The results for the study NCT03454308, titled "Patient Centered Health Technology Medication Adherence Program for African American Hypertensives", were posted on 2025-06-13 on clinicaltrials.gov.