The purpose of this study is to determine the effectiveness of interventions to improve adherence to medication and healthier lifestyle choices on blood pressure over a 6 month period in a group of people at high risk for recurrent stroke events. The participants have already had a stroke or TIA, and have uncontrolled blood pressure, as well as problems with memory and problem-solving, or miss taking medications, or who do not believe in the effectiveness of their medications. Interventions focus on motivational interviewing, adherence counseling with memory cuing, and self-monitoring of blood pressure.

• randomized, controlled trial at 4 sites
• measurement of blood pressure, missed pills, self-efficacy rating at baseline and 6 months
• contacting family pharmacists to evaluate prescription renewal patterns at baseline and 6 months

Inclusion Criteria:

• diagnosis of stroke or TIA
• hypertension
• Montreal Cognitive Assessment score less than 26
• self report of missed pills
• self-efficacy rating less than 100%

Exclusion Criteria:

• inability to give informed consent
• 18 years of age or younger

clients recruited from Stroke Prevention Clinics in Ontario with diagnosis of Stroke or TIA, Hypertension, and cognitive deficits as indicated by MoCA score < 26, self-efficacy rating < 100%, and self-report of missed pills; English speaking; able to give informed consent; older than 18 years of age