Xinxin Tang

Graduation Semester and Year

2016

Language

English

Document Type

Dissertation

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Maureen R Courtney

Abstract

Background: Medication adherence reduces morbidity, premature mortality, and healthcare costs related to CHD treatment. Therefore, a patient-centered intervention for both staff and patients was conducted to improve medication adherence in an outpatient setting. 4 Methodology: A pilot study was conducted utilizing a quasi-experimental, pre-post, one group design. Study participants completed an eight-item modified Medication Adherence Scale (MMAS-8) questionnaire to measure self-reported medication adherence before and after the intervention, which consisted of an interview and six weekly follow-up counseling sessions. The study compared the difference in MMAS-8 scores before and after the intervention. The Statistical Package for the Social Science (SPSS) software was used to conduct a correlation analysis and a Wilcoxon signed-rank test to explore whether the mean scores achieved on the MMAS-8 scale had significantly changed after the intervention. Results: A total of 50 patients was initially assessed, and 22 participants with low medication adherence were recruited and completed the intervention. Among the 22 participants, Spearman's correlation found no significant relationship between demographics and pretest and posttest scores. The correlation between the number of telephone counseling sessions and the postintervention MMAS-8 score was also evaluated using Spearman's correlation coefficient. The correlation was not statistically significant at the 95% confidence interval but was statistically significant at the 90% confidence interval (p = .094). Spearman's correlation analysis used to evaluate the correlation between the spoken language (English or Spanish) and the preintervention or postintervention MMAS-8 score indicated no statistical significance. A Wilcoxon signed-rank test indicated an average 3.12 point increase in pre-intervention scores from M = 3.37 to post-intervention scores M = 6.59, which was statistically significant (p < .0001). In addition, 95% of participants (21) reported that participating in the telephone sessions positively affected their compliance with taking medications. Conclusions: This study examined the effectiveness of a patient-centered strategy inclusive of an individualized interview and follow-up telephone counseling to increase medication adherence. The findings suggest that this form of intervention has a positive and measureable impact on medication compliance among patients with CHD and carries implications particularly for those who have limited physical access to healthcare facilities. However, these pilot test results only measured short-term outcomes. Further study is warranted to assess the long-term impact of this form of intervention on medication adherence and patient outcomes.

Disciplines

Medicine and Health Sciences | Nursing

Comments

Degree granted by The University of Texas at Arlington

Download

Included in

Nursing Commons

Share

COinS