Previously submitted to: JMIR Research Protocols (no longer under consideration since Dec 30, 2025)
Date Submitted: Jul 14, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A targeted behavioural economics-based intervention to improve medication adherence in patients with Hypertension: the COLLABREE study protocol
ABSTRACT
Background:
Non-adherence to antihypertensive therapy is a major contributor to poor blood pressure control, increased cardiovascular risk, and higher healthcare costs. Behavioral economics suggests that financial incentives and mobile-based interventions may support behavior change, yet evidence for such strategies in Central Europe is limited.
Objective:
The COLLABREE study evaluates whether a multi-faceted mobile application with behavioral economic principles—including reminders, gamification, and financial incentives—improves medication adherence in patients with hypertension compared to standard of care.
Methods:
This multi-center, randomized, open-label trial will include 180 outpatients with hypertension taking four or more pills daily. Participants will be randomized into three groups (n = 60 per group): (A) Collabree app with contingent financial incentives, (B) Collabree app without incentives, and (C) standard of care. All participants will receive a Medication Event Monitoring System (MEMS) to objectively track adherence. The primary endpoint is the difference in mean adherence between Group A and the control group at 90 days. A co-primary endpoint compares adherence in the final vs. initial month of the intervention. Secondary outcomes include changes in blood pressure, self-reported adherence, and patient-reported feedback on the app.
Results:
Currently, participant inclusion has been nearly completed. We are undergoing data clearing and are planning data analysis. These steps are planned for autumn 2025.
Conclusions:
This study will provide evidence on whether a multi-faceted digital intervention—with or without financial incentives—can improve medication adherence in hypertensive patients. The findings may support the implementation of mobile health strategies in routine hypertension care. Clinical Trial: SNCTP000004345; ClinicalTrials.gov Identifier: NCT04708756
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