The purpose of this study is to pilot test a behavioral medication adherence (MA) intervention compared to control condition in older adults with low adherence to medication for hypercholesterolemia.

This study will answer the following primary research question:

1. What is the estimated effect size of a behavioral MA intervention on MA rates in older adults who are poorly adherent to statin medications?

   The study will also explore the following secondary research questions:

2. What is the estimated effect size of a behavioral MA intervention on low-density lipoprotein cholesterol (LDL-C) levels in older adults?

3. What is the estimated effect size of a behavioral MA intervention on high-density lipoprotein cholesterol (HDL-C) levels in older adults?

4. What is the feasibility of successfully testing this intervention protocol in a population of older adults with low adherence to statin medications?

Inclusion Criteria:

• Age 60 or older at the time of study entry,
• Take a once-daily prescription statin medication for ≥ 6 months with no changes to statin prescription for at least 30 days prior to study entry,
• A score of ≤ 9 on the Short Blessed Test,
• Participants must self-administer his or her own medications without prompts from any other person or device.
• Baseline medication adherence rate of ≤ 90%.
• Participants agree to complete all study contacts and measurements, including the use of a special medication bottle with a Medication Event Monitoring System (MEMS) cap for the duration of the study.
• Able to open and close MEMS caps.

Exclusion Criteria:

• Participant's medications are managed by someone other than the participant
• Participant is unable or unwilling to use MEMS caps.