Abstract

This Quality Improvement Project (QIP) assessed the effect of a multi-component evidence-based (EB) Medication Adherence Intervention on adherence at a nurse-managed, student-run free clinic treating medically vulnerable adults aged >18 years who lacked health insurance and financial resources, had language barriers, low academic, health literacy, and understanding levels. The clinic staff lacked a process for screening, managing, and documenting non-adherence, estimated to be >50% by the stakeholders. Vulnerable patients, at risk for health disparities, known to need added time and attention (Viswanathan et al., 2012) did not receive adherence aid. Johnson's (2002) Medication Adherence Model (MAM) describes the process patients go through to adhere, e.g., purposeful action, pattern behavior, and feedback. MAM's concepts helped design, guide, and infer the intervention effects on adherence. The intervention involved: a) a designed online educational module to train staff on adherence and the QIP, b) a change to the clinic's care process, and c) two 1-hr case management (CM) patient educational sessions, 4-weeks apart, on disease, medications, self-management, provider communication, and adhering-aiding tools. Adherence rates improved by 141% and blood pressure (B/P) and blood sugar finger sticks (BSFS) levels decreased in two months.

Author Details

Virgie Stella Delgado, DNP, MSN Ed., BSN, RN, PHN, DSD, Adjunct Faculty/Lecturer-Community Health

Sigma Membership

Omega Gamma

Lead Author Affiliation

California State University San Marcos, San Marcos, California, USA

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Quantitative Research

Keywords:

Free Clinic, Vulnerable Patients, Medication Adherence, Self-management, Literacy, Medication Non-adherence, Medication Education, Multi-component Adherence Intervention

Advisor

Linda Royer

Degree

DNP

Degree Grantor

Capella University

Degree Year

2019

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Self-submission

Date of Issue

2019-06-25

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