Patient education and compliance with prescribed medication regimen

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Johns, JoAnna
Hodson Carlton, Kay, 1946-
Issue Date
Thesis (M.S.)
School of Nursing
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Patient compliance with prescribed treatment has been a problem for many years, and non-compliance leads to hospitalization and higher health care costs. Patient education has been found to be effective in increasing compliance with a variety of medical treatments in populations with chronic illnesses. This study will evaluate specific educational protocols for medication use and the effects of these protocols on compliance rates within an outpatient psychiatric population. The Health Promotion Model will be used as the theoretical framework for the study. The theoretical basis for the model is derived from the Social Learning Theory and the Social Cognitive Theory. The Health Promotion Model framework emphasizes the importance of empowering the individual in assuming an active role in shaping and maintaining health behaviors and in modifying the environment for health behaviors. Behaviors and concepts that influence behavioral decisions are identified, and the theory demonstrates how the cognitive perceptual factors are modified by situational, personal, and interpersonal factors.The convenience sample for the study will include 150 psychiatric patients who attend a community mental agency in Cape May Court House, New Jersey, and see a psychiatrist or nurse practitioner for the purpose of treating symptoms of a major mental illness as diagnosis by the criteria set forth in the DSM-IV. Inclusion criteria include men and women, age 18 or older, not brain injured, (able to comprehend verbal and written medication instructions) and able to provide informed consent. Permission will be obtained from Ball State University and the participating agency to conduct the study. Patients who agreed to participate in the study will be randomly assigned to one of three groups. Group 1 will receive medication education fact sheets without verbal instruction from the prescriber. Group 2 will receive 30 minutes of verbal instruction by the nurse practitioner or psychiatrist explaining the type of medication, usages, desired effect and side effects of the prescribed medication, and Group 3 will receive both the 30-minute verbal instruction and medication fact sheets to reinforce the verbal instruction.The data will be collected over a 6-month period and 150 patients who fit the eligibility criteria and who agree to participate in the study will be the sample. A quasi-experimental, posttest only design will be used for the study to evaluate if the particular treatment results in increased patient compliance. Compliance with prescribed medication regimen will be measured by self-report and pill counts. A medication adherence score will be calculated which represents the individual's score for the medication regimen compliance rate. Level of significance will be determined to be p= <. 05. The study is significant because increasing medication compliance will decrease health care cost and increase in quality of care. Results of the study will give health care providers needed information about educational interventions that can increase patient knowledge and understanding of medication and ultimately increase compliance with prescribed medication regimens.