US patients who fail to take their medications as prescribed exact a staggering economic and social cost.¹ A McKinsey study of people with hypertension (high blood pressure) suggests that a better understanding of the attitudes of patients could improve programs designed to increase their adherence to treatment regimens—an outcome that would save both lives and money. Creat-ing and implementing these programs will require the combined efforts of physicians, patients, pharmaceutical companies, payers, and other health care stakeholders.

Hypertension afflicts 65 million people in the United States, fully half of whom don't adhere to their drug therapies.² The usual interventions—for example, electronic reminders or easy-to-open packaging—tend to improve adherence only in the short term, largely because a one-size-fits-all approach fails to address the underlying causes of the way patients behave. To improve upon these programs, we surveyed 810 hypertensive patients and supplemented their responses with interviews and focus groups.³ We also asked patients about two other chronic asymptomatic medical conditions—type 2 diabetes and high cholesterol.

We explored five themes: the patients' level of involvement and perceived control over their health, their knowledge of hypertension and its treatment, their level of concern about the disease, their beliefs about the...