Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Pharmacist Intervention for Monitoring and Treating Hypertension Using Bidirectional Texting
Brief Summary: Bidirectional texting is an effective way to collect home blood pressure (BP) measurements from subjects, but collecting BP measurements and sending them to physicians does not necessarily lead to decreased BP. Pharmacist interventions have been successful in decreasing subject BP. However, pharmacists are expensive, and in successful interventions, spent a substantial amount of time collecting home BP measurements. In this study, a proven pharmacist intervention will be added to a bidirectional texting program to determine if a combined pharmacist-bidirectional texting intervention is successful at decreasing subject BP and increasing subject BP treatment intensification in a cost-effective manner. This study will be a cluster-randomized, controlled trial of a new intervention.


Options:
A: Inclusion Criteria:

* Diagnosis of uncontrolled hypertension,
* prescribed a medication to lower blood pressure,
* have a regular primary care physician at Durham VA Medical Center, and
* be a veteran. For Sustainability portion the patient must have participated in an intervention arm of primary study.

Exclusion Criteria:

* Hospitalized in past 3 months for stroke,
* heart attack,
* surgery for blocked arteries,
* diagnosed with metastatic cancer or treated with dialysis,
* have a diagnosis of dementia or a hearing impairment which prevents them from being able to hear/speak on the telephone, and
* creatinine serum lab which exceed 2.5.
B: Inclusion Criteria:

* Filled and poorly adherent (defined as a PDC \< 80%) to medication for hyperlipidemia, hypertension, or diabetes
* Suboptimal average adherence to all of the qualifying medications that a patient has filled (defined as combined (average of averages) PDC \< 80%)
* For patients with hypertension or diabetes, poor or worsening disease control (according to relevant clinical targets)

Exclusion Criteria:

* Patients with \<6 months of continuous enrolment in the health plan
* Patients with no available contact information
C: Inclusion Criteria:

* Fluent in English or Spanish
* Have a clinic measured blood pressure of \> or = 145 mmHg and/or \> or = 95 mmHg at two previous clinic visits or one previous clinic visit and on the day of enrollment
* Must be a patient at Family Medicine, River Crossings, Scott Blvd, or Muscatine University of Iowa Clinics
* Live in a zip code that is scored as a 4-10 on the Rural-Urban Commuting Area codes

Exclusion Criteria:

* Currently pregnant or planning to become pregnant in the next year
* Upper arm circumference greater than 50 cm (20 in)
* Prisoner status
* Unable to provide own informed consent
D: Inclusion Criteria:

1. age 21 years or older
2. a clinical diagnosis of hypertension with uncontrolled BP in the previous three months, currently taking or about to take anti-hypertensive medications
3. received high school or above level of education
4. active user of smart phone (Android or Apple) and mobile Apps
5. the average of three BP measurements during the screening visit at the CHC is ≥ 140/90 mm Hg, or ≥ 130/80 mm Hg if the patient has diabetes or renal diseases;
6. being able to give informed consent.

Exclusion Criteria:

* acute coronary syndrome
* heart failure
* cardiac arrhythmia
* stroke within the past three months
* renal failure
* cancer
* dementia, severe or acute psychiatric illness, pregnancy or intention to be pregnant in the next 18 months, and hospitalization within 3 months.
* additional exclusion criteria include participation in another clinical trial, arm
* circumference \>32 centimeters that may affect the accuracy of BP measurement due to cuff size limit of the tele-monitor's, and unwillingness to comply with the 12 month intervention duration.

Answer: C