Peers and Technology for Adherence, Access, Accountability, and Analytics (PT4A)

Conditions studied

Cardiovascular Disease, Hypertension

About this study

Peer-based medication delivery decreases the cost of transportation and the opportunity cost of travel while HIT can support peer activities by facilitating targeted adherence counseling, teleconsultation, synchronization of clinical care, and pharmacy activities. The investigators have implemented a pilot program of door-to-door peer-based medication delivery and HIT in western Kenya, and preliminary data indicate improved adherence and blood pressure. However, the effectiveness of this implementation strategy is not fully established. Therefore, the objective of the study is to use the PRECEDE-PROCEED framework to conduct transdisciplinary implementation research to test the hypothesis that integrating peer delivery of medications with HIT (PT4A) improves medication adherence and reduces blood pressure among patients with uncontrolled hypertension in western Kenya.

Interventions

• Other: Peer Delivery of Medications — Door-to-door peer delivery of medications within patients' communities will be implemented.
• Other: Health Information Technology (HIT) Platform — The HIT platform provides: 1) tailored counseling strategies through decision support; 2) teleconsultation support for clinician-peer-patient interactions; 3) medication refill tracking to enhance accountability of the peer delivery process; and 4) analytics to improve medication supply chain by generating patient-level drug consumption data.

Primary outcomes

• Mean Change in SBP from Baseline to Month 12 (Baseline, Month 12)
• Pill Count Adherence Ratio (PCAR) at Month 12 (Month 12)
• Number of Patient E-Signatures (Up to Month 12)
• Number of Completed HIT Forms (Up to Month 12)