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<h4>Background</h4>H-type hypertension substantially increases cardiovascular and cerebrovascular risk in older adults, yet long-term medication adherence remains suboptimal. Beyond regimen complexity, age-related cognitive vulnerability and limited self-monitoring capacity may undermine adherence. However, few nurse-led interventions explicitly target memory-related mechanisms underlying medication-taking behavior.<h4>Objective</h4>To evaluate the effectiveness of a nurse-led, metamemory-based intervention in improving medication adherence and related cognitive and psychosocial outcomes in older adults with H-type hypertension.<h4>Methods</h4>In this 12-week, randomized controlled trial, 76 older adults with H-type hypertension were randomly assigned (1:1) to a nurse-led metamemory-based intervention or usual care. The intervention combined face-to-face sessions and remote follow-up to enhance memory strategy use, self-monitoring, and medication adherence. Primary outcomes were metamemory and medication adherence. Secondary outcomes included cognitive function, anxiety, depression, quality of life, and self-management.<h4>Results</h4>Seventy-one participants completed the trial (intervention n = 35; control n = 36). Compared with usual care, the intervention group demonstrated significantly greater improvements in metamemory (mean change: 36.7 vs. 1.7; P < .001) and medication adherence (mean change: 2.1 vs. 0.5; P < .001). Significant between-group improvements were also observed in cognitive function, anxiety, quality of life, and self-management (all P < .05). Changes in depressive symptoms were modest and not statistically significant.<h4>Conclusions</h4>A nurse-led metamemory-based intervention significantly improved medication adherence in older adults with H-type hypertension by strengthening memory self-monitoring and strategy use. These findings support metamemory as a clinically meaningful mechanism through which nursing interventions can enhance adherence in cognitively vulnerable cardiovascular populations.

Abstract: PubMed · Datensatz