Date on Paper


Document Type

Doctoral Paper



Committee Chair

Mary DeLetter

Committee Member

Sara Robertson

Author's Keywords

Hypertension; medication adherence, non-adherence, pictograms, pill card


Non-adherence with prescribed hypertension (HTN) treatment significantly increases the risk for cardiovascular disease and stroke, leading to increased morbidity, mortality, and burden to the health care system. HTN affects one in three American adults and costs the health care system approximately $48.6 billion annually in direct (providers/health professionals fees, hospital services, prescription medications) and indirect (premature mortality) medical expenses (CDC, 2018; 2016). This quality improvement (QI) project implemented a personalized pictogram pill card intervention for adults with HTN at an urban, federally-qualified health care clinic in west Louisville. Pictogram pill cards were provided to hypertensive adults with medium and low adherence score on the Morisky, Green, and Levine (MGL) Medication Adherence Scale (1986). Medication count at Day 1 was compared to Day 30 count to determine the percentage of adherence. In a sample of 10 patients, nine showed improved medication adherence following the pill card intervention. Mean adherence score was 99.16 ± 2.37. This evidence-based intervention using pictograms in medication instructions was a valuable tool to improve adherence to antihypertensive medications in patients with HTN.

Included in

Nursing Commons