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N/A N=400 Randomized Treatment

Behavioral Economics Trial To Enhance Regulation of Blood Pressure (BETTER-BP)

High Blood Pressure

Enrolled (actual)
400
Serious AEs
11.0%
Results posted
May 2026
Primary outcome: Primary: Change in Systolic Blood Pressure (SBP) — -6.7; -5.8 mmHg

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Control Condition (Behavioral); Regret Lottery (Behavioral)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
NYU Langone Health
Primary completion
May 2025

Outcome Measures

OutcomeResultp-value
PRIMARY
Change in Systolic Blood Pressure (SBP)
-0.2; 3.6
PRIMARY
Change in Systolic Blood Pressure (SBP)
-0.2; 3.6
SECONDARY
Percentage of Participants With Adequate Antihypertensive Adherence
31; 26
SECONDARY
Percentage of Participants With Adequate Antihypertensive Adherence
31; 26

Summary

BETTER-BP (Behavioral Economics Trial To Enhance Regulation of Blood Pressure) is a phase II, single-center, prospective, pragmatic randomized clinical trial within the New York City Health and Hospitals (NYC-H+H) system and NYU Langone Family Health Centers. The trial will recruit from 3 NYC-H+H ambulatory clinics as well as NYU Langone Family Health Centers, and will use a lottery incentive program to promote adherence to antihypertensive medication that will be delivered via smartphone for 6 months. The trial will randomize 435 patients with hypertension determined to have poor adherence (<80% adherence with antihypertensive medication), in a 2:1 (intervention:control) ratio. Baseline enrollment will occur over 36 months with an expected 12 months follow-up per participant.

Eligibility Criteria

Inclusion Criteria

  • A diagnosis of hypertension.
  • An active prescription for ≥1 antihypertensive medication (any of the following classes: thiazide diuretic, ACE inhibitor, angiotensin receptor blocker, beta blocker, calcium channel blocker, centrally acting alpha agonist, direct vasodilator).
  • 1 ambulatory systolic blood pressure ≥140 mmHg (on therapy).
  • Suboptimal adherence (self-report).

Exclusion Criteria

  • Incarcerated
  • Pregnant
  • Unable to use study software (Way To Health) in English or Spanish
  • Unable/unwilling to consent
  • Clear barrier to technology use (e.g. visual or hearing impairment)
  • Projected life expectancy <12 months
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04114669). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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