Please select the eligibility criteria that correspond to the clinical trial below.
Title: Uncontrolled Hypertension: The Role of Medication Adherence and Clinical Inertia
Brief Summary: The purpose of this study is to test whether accurately measuring patients' adherence to their blood pressure medications with electronic pillbox monitors and then providing clinicians with this information can improve the clinical management of uncontrolled hypertension.


Options:
A: Inclusion Criteria:

* 18 years of age or older
* Utilize a pharmacy in Durham, Robeson, Person, Granville, or Vance County, NC
* Have coronary artery disease (CAD) documented in the medical record by one of the following:

  1. A diagnosis of unstable angina or acute myocardial infarction (ST segment elevation or non-ST segment elevation myocardial infarction)
  2. A cardiac catheterization demonstrating CAD greater than or equal to 50 narrowing of artery)
  3. Prior angioplasty
  4. Prior coronary artery stent
  5. Prior coronary artery bypass graft surgery (CABG)
* Plan to have their prescription medications filled and refilled by one of the participating pharmacies
* Prescribed aspirin or another antiplatelet, a beta-blocker and statin agent (referred to as triple therapy for this study) at discharge. If a patient has a true contraindication to any of the three medication groups in triple therapy, they will still be eligible for the study

Exclusion Criteria:

* Providers predict an anticipated hospital stay of less than 48 hours
* Patient plans to use a pharmacy outside of Durham, Robeson, Person, Granville, or Vance County, NC
* Patient is unable to give consent (cognitively impaired, does not speak English, or has altered mental status)
* Patient transferred to Cardiothoracic Surgery service for CABG
* Patient has terminal condition and may not survive until 6-month follow-up
* Patient lives in a correctional or long-term care facility
* Patient will be unable to participate in follow-up phone call (hearing impaired without caregiver who can help or does not have a phone)
* Patient is a known participant in the Duke Heart Failure Program
* Patient does not agree to use only the one Durham, Robeson, Person, Granville, or Vance County pharmacy throughout the study period
B: Inclusion criteria

* established diagnosis of hypertension
* prescribed at least one blood pressure (BP) medication
* at least two consecutive clinic visits with elevated BP according to Joint National Committee (JNC-7) guidelines (i.e., BP ≥ 140/90 mmHg or ≥ 130/80 mmHg if diabetes or chronic kidney disease)
* 18 to 80 years old
* at least one prior visit with a clinician enrolled in the study

Exclusion criteria

* severe mental illness
* resided in a long-term care facility
* unable to use the electronic adherence device due to physical or cognitive impairment
* non-English or non-Spanish speaking
* unavailable for follow-up
C: Inclusion Criteria:is African American and 18 years old or older; has active prescription for BP drug; obtains all BP drugs at the study pharmacy; is able to read and fill out short questionnaires; is able to come to pharmacy for 6 monthly pharmacy visits if needed; has screening BP between 140/90 mm Hg and 210/115 mm Hg.

Exclusion Criteria: history of organ transplant or kidney dialysis, symptoms of advanced congestive heart failure, memory impairment that interferes with daily functioning,terminal illness,pregnancy, alcohol or substance abuse problem,physician recommendation of exclusion for other condition that may require special care or limit participation in the study.
D: Inclusion Criteria:

Patients must be adult veterans. Diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder. At least one active oral antipsychotic prescription. History of poor medication compliance.

Exclusion Criteria:

Have received depot antipsychotics in the last year. Have supervised medication administration. Have not attended a VA outpatient appointment in the past 6 months, and none are scheduled,. Are prescribed Clozapine. Have a fatal illness with a life expectancy less than 2 years.

Answer: B