Cullen, Patricia L.
Rueckert-Hartman College for Health Professions
Doctor of Nursing Practice
Loretto Heights School of Nursing
Thesis - Open Access
Number of Pages
Comparison of Home Medication Adherence in Adults Age 65 and Older After Completion of Standardized Discharge Medication Education or Non-Standardized Discharge Medication Education
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.
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.
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.
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.
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
© Jill Weller
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Weller, Jill, "Comparison of Home Medication Adherence in Adults Age 65 and Older After Completion of Standardized Discharge Medication Education or Non-Standardized Discharge Medication Education" (2015). Student Publications. 676.