A simple protocol to improve antihypertensive medication adherence in menopausal/postmenopausal women: a quality improvement project

Hypertension is a silent killer affecting more than a billion people worldwide and is a crucial risk factor for heart disease and stroke, two of the leading causes of death in adults in the United States. It is well known that enhancing medication adherence is essential for controlling hypertension. The effect of sex on the prevalence and control of hypertension is not clearly understood, but men have a higher propensity for hypertension. During the menopausal transition and after age 60, hypertension becomes more prevalent in women than in men, and women are less likely to control their hypertension than their male counterparts of the same age range. Therefore, the purpose of this quality improvement project was to improve hypertensive medication adherence and blood pressure control among menopausal and postmenopausal women at a rural primary care clinic in central Texas through patient education and implementation of an evidence-based medication adherence protocol. A pre-intervention/postintervention design was used to evaluate patient beliefs and behaviors related to medication nonadherence and blood pressure control. Ninety-five percent and 37% of women reached the project goal of a 30% increase in medication adherence score and 10 mmHg improvement in BP control, respectively. An important outcome of this project was that the implementation of an evidence-based protocol led to significant improvement in medication adherence and control of blood pressure in menopausal and postmenopausal women seeking care at this clinic.