Date of Graduation

3-2021

Document Type

Capstone

Keywords

Telephone-based intervention; Medication adherence; Heart failure; Telephone based medication adherence conferences; Morisky; MMAS-8

Degree Name

Doctor of Nursing Practice (DNP)

Degree Level

Graduate

Advisor/Mentor

Patton, Susan

Committee Member

Bradley, Callie

Abstract

Cardiovascular disease (CVD) has been a significant health problem worldwide and is the leading cause of death globally. Heart failure (HF) is a chronic progressive form of CVD that affects millions of adults in the United States. The treatment for heart failure is very complex and requires an ongoing regimen of medications. In heart failure, many patients report nonadherence to their medication regimens, which leads to a magnitude of preventable deaths annually. With frequent medication nonadherence of the HF patients, there must be an intervention used to combat this problem. The use of telephone-based interventions (TBI) can modify nonadherent medication-taking behaviors in the heart failure populations. This DNP quality improvement project utilized a quasi-experimental research design to implement Telephone-based Medication Adherence conferences (TBC) at an outpatient HF specialty clinic (HFSC) in Little Rock, Arkansas. The TBC intervention was implemented in HF patients that were identified as being nonadherent with prescribed medication regimens through the use of Morisky Medication Adherence Sale 8-item survey (MMAS-8) at 1, 2, and 6-weeks following routine HF clinic visits. The goal of implementing TBC was to improve the number of medication adherent HF patients at a HFSC in Little Rock, Arkansas by 20% from baseline by March 2021. TBC reflected a statistically significant (p= .000) increase on repeated measures analysis of variance (RMANOVA) in MMAS-8 scores by more than 52% by week 6 in TBC, with an overall improvement across all week scores by 45.3%. The increased MMAS-8 scores supports the aims for this DNP project and concludes that TBC does aid in improving medication adherence; thus contributing to improved patient outcomes, decreased likelihood for HF hospital admissions, reduced healthcare cost burden, and improved mortality in the HF population.

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