Promoting Medication Adherence Among Older Adults With Hypertension

Over 70% of US adults 65 or older are diagnosed with hypertension, the leading cause of
cardiovascular disease and premature deaths in the world. Despite availability of effective
drugs to control blood pressure, uncontrolled blood pressure and low adherence to
antihypertensive drugs persist as major public health and clinical challenges. On average,
50% of adults adhere to chronic disease medications and lower levels of adherence are
associated with worse blood pressure control and adverse outcomes. Many barriers to adherence
are well known and have been targeted in interventions to improve medication adherence. As of
yet, no single intervention has emerged as superior or even particularly effective in
improving adherence. The investigators have recently identified unconscious, self-protective
'hidden motives' that contribute to nonadherence to chronic disease medications. There is a
critical need to expand on this insight to test the potential for targeting individuals'
'hidden motives' for low adherence using an innovative learning process called
Immunity-to-Change.

As a critical step in testing this intervention to target these 'hidden motives', the
investigators will undertake a pilot study to assess the feasibility and acceptability of the
Overcoming Immunity-to-Change intervention and determine effect sizes of the intervention on
adherence, blood pressure (BP) control, and quality of life (QOL). The investigators will
test the Immunity-to-Change intervention in a sample of nonadherent older adults with
hypertension (n=18). Another sample of nonadherent older adults with hypertension will be
monitored for comparison (n=18).