Table 1.

Intervention Approaches to Addressing Nonadherence

Factor	Approaches to Addressing Nonadherence
Depression	Discuss importance of taking antidepressants to better address factors leading to hypertension Emphasize duration of adequate adherence needed for optimal effect
Hypertension	Assess whether symptoms such as fatigue are attributed to medications, chronic conditions, or underlying depression in collaboration with physician Help patient develop a system to refill medications before they run out
Function	Make suggestions such as involving a family member, asking pharmacist for larger labels or easily opened medication bottles Facilitate communication with the physician and pharmacist
Cognition	Involve family members in developing cognitive aids Encourage placement of prompts in the home as time cues in relation to routine activities (eg, tooth brushing at arising) for taking medications Help create memory tools to prevent forgetting to take doses
Cost of medications	Serve as liaison between patient and physician to evaluate generic alternatives to medications, free samples, filling out the necessary forms to get free medications from pharmaceutical companies Assist patient in navigating and understanding Medicare Part D
Side effects of medications	Discuss expected adverse effects of antihypertensives and antidepressants and emphasize that side effects might be worse when first starting a medicine and often ease up over time for patients beginning a new medication Provide medication-specific information on effects and discuss potential treatment options for adverse effects Discuss side effects with physician including alternatives to medication if patient is experiencing unwanted effects
Past experiences	Elicit past experiences and provide information and encouragement Discuss concerns based on past experiences with physician
System level factors (physician and structural)	Inform physician of patients’ progress or difficulties Suggest changes in medication prescriptions (eg, if a medication dosage is low, and patient has poor blood pressure control, an increase in dosage will be recommended) Communicate with physicians using various strategies adapted to each physician’s style (eg, physicians may prefer to receive e-mails)