Abstract
Objective: To evaluate the impact of a 6-week text message reminder intervention on adherence to blood pressure therapy among older adult males with hypertension residing in a continuing care retirement community. Background: Hypertension afflicts approximately 45% of U.S. adults, exacerbating cardiovascular morbidity and mortality, with suboptimal medication adherence representing a primary impediment to effective management. In Florida, prevalence reaches 48.7% among adults aged 45-79. Evidence indicates that digital interventions, including SMS reminders, can enhance adherence by up to 15% and attenuate systolic blood pressure by approximately 4 mmHg. Methods: A quasi-experimental pre-post design included nine Caucasian men aged 78-91 residing in the independent-living facility. Six participants completed the intervention, receiving biweekly SMS reminders grounded in the Health Belief Model to promote medication adherence, appointment attendance, and dietary changes. Therapy adherence was measured using the 14-item Hill-Bone Compliance to High Blood Pressure Therapy Scale, along with pre- and post- intervention assessments of blood pressure, heart rate, and weight. Data were analyzed using descriptive statistics. Results: Mean Hill-Bone scores improved from 49.5 to 47.8, with lower scores signifying better adherence. Systolic blood pressure demonstrated a statistically significant increase (p = 0.047). In contrast, diastolic blood pressure did not change significantly (p = 0.688) and exhibited no consistent directional pattern. Additionally, a minimal reduction in mean post-intervention weight was observed (-0.1 pounds). Qualitative feedback revealed that reminders bolstered habitual behaviors, though participants noted familiarity with the conveyed information. Conclusions: SMS reminders can be a viable, cost-effective modality for improving hypertension therapy adherence in older adults. Improvements in blood pressure therapy adherence were significant but did not have a significant impact on post-intervention blood pressure readings. Possible multiple confounding factors, such as situational stressors and ongoing workflow changes within the organization, may have an impact on post-intervention blood pressure readings