Date Available

4-26-2023

Year of Publication

2023

Degree Name

Doctor of Nursing Practice

Advisor

Dr. Angela Grubbs

Committee Member

Dr. Elizabeth Tovar

Co-Director of Graduate Studies

Dr. Lori Fugate

Abstract

Background Medication non-adherence is prevalent among fifty percent of the United States population. This behavior leads to increased morbidity and mortality as well as increased healthcare costs for both the patient and the healthcare system. More than two-thirds of nonadherence exists in those aged over 65 years old who are diagnosed with Multiple Chronic Conditions (MCC). Several studies have researched and trialed interventions to improve rates of adherence, limit poor health outcomes, and decrease overall cost of care. The patient portal is an interactive tool which encourages participation of the patient in their healthcare management. Implementation of this tool has been associated with overall better adherence to treatment as well as increased patient satisfaction.

Purpose The purpose of this project was to provide an evidence-based educational approach to improve medication adherence in those with multiple chronic conditions.

Methods A quasi experimental study was performed to provide patient portal education and to then observe the relationship of subsequent medication adherence. A pre-chart review was conducted, which determined participants meeting specific inclusion criteria. Education regarding online portal use was then administered to eligible patients during their scheduled clinic visit. Finally, a post chart review was completed months later to determine rates of medication adherence after the educational intervention had been delivered. This data was compared to post interventional surveys in order to assess the relationship between patient portal use and medication adherence as well as to evaluate patient’s perceived benefits and barriers of the technology.

Results A total of four patients completed portal education. Three patients were present in order to complete a post-educational survey three months later. Of the three eligible participants, medication adherence increased from 66.7% to 100% with 100% of the patients using MyChart.

Conclusion Addressing medication adherence should be a priority to providers at every encounter to efficiently sustain the health and wellbeing of patients. For those at high risk of medication nonadherence, such as those with MCC, providers should recall that encouraging patients to be active on patient portals shares a positive relationship with maintaining prescribed adherence to treatment.

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