Behavioral Economics and Medication Adherence for Hypertension: A Randomized Clinical Trial
Primary result · Adequate adherenceResult — go to the resultAdjusted relative risk 2.04 95% CI 1.58–2.63Authors' conclusion
In a diverse safety-net population, the BETTER-BP intervention doubled the rate of adequate antihypertensive medication adherence but did not reduce SBP at 6 months.
Study context
- Population
- Adults with hypertension on ≥1 antihypertensive medication, systolic blood pressure (SBP) >140 mm Hg and poor self-reported adherence, New York City safety-net clinics
- Participants
- 400 adults
- Comparison
- mHealth incentive lottery vs control
- Interventionn = 265
- Controln = 135reference
- Primary endpoint
- Clinical: change in SBP; process: adequate antihypertensive medication adherence (≥80% days adherent)
- Follow-up
- 6 months
Methodological details3 safety-net clinics
- 3 safety-net clinics
Primary result
Adequate adherence
Adjusted relative risk
2.04
95% CI 1.58–2.63
By group
Intervention
- Adequate adherence
- 71%
- Mean SBP change
- −6.7 mm Hg
Control
- Adequate adherence
- 34%
- Mean SBP change
- −5.8 mm Hg
Adequate adherence
Intervention71%
Control34%
Mean SBP change
Intervention−6.7 mm Hg
Control−5.8 mm Hg
Intervention vs Control
adjusted RR 2.04 (95% CI 1.58–2.63)
As reported in the abstract
Further findings
| Outcome | Intervention | Control | Adjusted RR (95% CI) | |
|---|---|---|---|---|
| Adequate adherence · 6 to 12 months | 31% | 26% | 1.17 (0.83–1.65) | |
| 0.512Adjusted relative risk (log scale) |
Original publication
Behavioral Economics and Medication Adherence for Hypertension: A Randomized Clinical Trial. J Am Coll Cardiol. Published 18 November 2025. doi:10.
Summarised from the published abstract; every number is checked against it