A 47-Year-Old Man Comes to the Office for Follow-Up of Recently

question 66

Multiple Choice

A 47-year-old man comes to the office for follow-up of recently diagnosed hypertension.  He was prescribed a generic formulation of lisinopril a month ago.  Inspection of the patient's pill bottle shows 15 tablets remaining of an original 30-tablet supply.  Medical history is otherwise unremarkable, and he is taking no other medications.  Blood pressure measurement shows no significant improvement from his blood pressure a month ago.  Serum chemistry panel, including potassium and creatinine, is also unchanged from prior results.  The patient reports no adverse effects from the medication but often forgets to take it.  Which of the following would be most helpful in improving this patient's medication adherence?

• A)Ask the patient's wife to give him daily reminders to take his medication
• B)Change to a half-pill twice a day to increase the opportunities to take his medication
• C)Change to a well-known, brand-name antihypertensive drug that increases financial commitment
• D)Counsel the patient on the risks of uncontrolled hypertension
• E)Recommend placing the medication on the bathroom counter next to his toothbrush

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