First Advisor

Cullen, Patricia L.

Second Advisor

Finn, Cris

College

Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice

School

Loretto Heights School of Nursing

Document Type

Thesis - Open Access

Number of Pages

50 pages

Abstract

Executive Summary

Comparison of Home Medication Adherence in Adults Age 65 and Older After Completion of Standardized Discharge Medication Education or Non-Standardized Discharge Medication Education
Problem
The older patient (age 65 and older) is at higher risk of medication induced illness because of numerous co-morbid conditions treated with multiple medications, a standardized approach to medication education at hospital discharge can reduce adverse medication events for this at risk population (Esposito, 1995; Jack et al., 2009). The primary driving force for this project is the limited number of research studies published to date that include this specific age bracket and setting. It is clear the aging population is at risk for adverse medication events (Esposito, 1995; Holloway, 1996; Jack et al., 2009; Laugaland et al., 2012). What is unclear is what the most effective approach to meeting the educational needs of the aging population is.
Purpose
Based on this identified problem, the PICO (P, population, I, intervention, C, comparison, O, outcome) question served to focus the Capstone Project, for adults aged 65 and above, would a standardized discharge education program for medication management versus no standardized program be effective in increasing patient adherence to home medication regimen, as measured by telephone questionnaire at one week and again at three to six weeks post discharge.
Goals
The general project focus was to create a standardized discharge medication education program for older adults. The specific focus was to improve patient compliance with their complex medication regimen. The expectation, is with improved compliance there will also be a decrease in adverse events, improvement of patient self-efficacy, increase patient understanding of their medication regimen, and subsequently reduce hospital readmission rates and resource utilization.
Objectives
The primary project objective was to increase patient adherence of home medication regimen by 25% in the intervention group as evidenced by improvement in scores using a modified CASE adherence index.
Plan
The study was a two group design interventional study, one group receiving “standard” hospital discharge medication education and an “intervention” group. Participants were a convenience sample of hospital patients, chosen by chance. The education program for the intervention group included three facets of “tactile” information combined with verbal education. A pill dispenser was provided to the participants of the intervention group. A phone questionnaire was performed at one week and three to six weeks post discharge for all participants, using the modified CASE adherence index to determine medication compliance.
Outcomes, Results, and Recommendations
The intervention did not make a statistically significant difference between two group total scores overall. Question one, week one and three, showed the most improvement (p= .334 and p= .031 respectively) indicating the participants are taking their medications correctly and retaining the education at three weeks post discharge for this sample. This project provides a framework for additional research on this topic with a larger sample size and longer data collection

Date of Award

Summer 2015

Location (Creation)

Colorado (state); Denver (county); Denver (inhabited place)

Rights Statement

All content in this Collection is owned by and subject to the exclusive control of Regis University and the authors of the materials. It is available only for research purposes and may not be used in violation of copyright laws or for unlawful purposes. The materials may not be downloaded in whole or in part without permission of the copyright holder or as otherwise authorized in the “fair use” standards of the U.S. copyright laws and regulations.

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