A Nurse-Led Intervention in Schizophrenia Patients to Improve Medication Adherence Compliance Comprehensive Nursing Essay Sample

A Nurse-Led Intervention in Schizophrenia Patients to Improve Medication Adherence Compliance Comprehensive Nursing Essay Sample

Schizophrenia is a mental disorder that impairs thought processes and patterns, perceptions, emotional responses, and social interactions (National Institute of Mental health [NIMH], n.d.). Schizophrenia is persistent and can be severe and disabling when symptoms are not adequately managed (NIMH, n.d.). This DNP project pursues a nurse-led intervention to improve medication adherence and symptom management. A person-centered approach to healthcare when working with schizophrenia patients is recommended for achieving compliance (Salzmann-Erikson & Sjödin, 2018). Specifically, the project aims to evaluate the impact of technology with motivational interviewing on medication adherence among inpatient schizophrenia patients. This DNP Project Manuscript provides the introduction and background, the problem, the project aim and supporting objectives, and the practice question.(A Nurse-Led Intervention in Schizophrenia Patients to Improve Medication Adherence Compliance Comprehensive Nursing Essay Sample)

Problem

Various studies have shown a varying prevalence of Schizophrenia globally and in the US. The global prevalence of Schizophrenia among non-institutionalized persons ranges between 0.33% and 0.75%, while in the United States, the prevalence of Schizophrenia is 0.25% to 0.64% (NIMH, n.d.). Nonadherence to medication among Schizophrenia patients is well documented in the United States (US) and globally. Nonadherence in the US is estimated to be 70% or more, with associated comorbidities contributing to rates of nonadherence (Desai & Nayak, 2019).(A Nurse-Led Intervention in Schizophrenia Patients to Improve Medication Adherence Compliance Comprehensive Nursing Essay Sample)

Nonadherence increases the use of outpatient and hospital-related resources, while comorbidities and demographic factors exacerbate the problem. Nonadherence affects health outcomes among schizophrenia patients, increasing the risk of premature death compared to the general population. The average life lost in the US due to Schizophrenia is estimated at 28.5 years (NIMH, n.d.). The increased and under-detection of comorbid conditions, including liver disease, heart disease, and diabetes, increased the risk of premature death among schizophrenia patients. Significantly, over 50% of schizophrenia patients have co-occurring behavioral and mental health disorders. Moreover, an estimated 4.9% of individuals diagnosed with Schizophrenia commit suicide, which is higher than the general population (NIMH, n.d.).(A Nurse-Led Intervention in Schizophrenia Patients to Improve Medication Adherence Compliance Comprehensive Nursing Essay Sample)

The financial costs associated with the management of Schizophrenia increase disproportionately with co-occurring mental, physical, and behavioral health conditions. The estimated direct cost of Schizophrenia is about $ 4 billion annually and $5984 per patient (Desai et al., 2013). The indirect cost is estimated at $ 18.68 billion annually and $724664 per cost (Desai et al., 2013). The direct costs include those related to the hospital stay and medication due to worsening symptoms and general health conditions. In contrast, the indirect costs include costs due to social service needs, lost productivity, involvement of criminal justice, and issues beyond healthcare. At the practicum site, nonadherence has been reported, leading to worsening symptoms and increased inpatient stay.(A Nurse-Led Intervention in Schizophrenia Patients to Improve Medication Adherence Compliance Comprehensive Nursing Essay Sample)

Project Aim and Supporting Objectives

The primary aim of the DNP project is to e determine the impact of technology with motivational interviewing on medication adherence among inpatient schizophrenia patients. The project objectives are as follows:(A Nurse-Led Intervention in Schizophrenia Patients to Improve Medication Adherence Compliance Comprehensive Nursing Essay Sample)

1. To evaluate the role of technology on medication adherence among inpatient schizophrenia patients.
2. To assess the impact of motivational interviews on medication adherence among inpatient schizophrenia patients.
3. To compare the impact of technology with motivational interviewing on medication adherence and motivational interviewing and technology independently among inpatient schizophrenia patients.(A Nurse-Led Intervention in Schizophrenia Patients to Improve Medication Adherence Compliance Comprehensive Nursing Essay Sample)

Practice Question

The following practice question will serve as the basis of the DNP project: For adults with a history of Schizophrenia (P) in the outpatient setting, does the implementation of technology with motivational interviewing (I), compared with current practice (C), impact medication nonadherence (O) in 8-10 weeks (T)? (A Nurse-Led Intervention in Schizophrenia Patients to Improve Medication Adherence Compliance Comprehensive Nursing Essay Sample)

References

Desai, P. R., Lawson, K. A., Barner, J. C., & Rascati, K. L. (2013). Estimating the direct and indirect costs for community-dwelling patients with Schizophrenia. Journal of Pharmaceutical Health Services Research, 4(4), 187-194.(A Nurse-Led Intervention in Schizophrenia Patients to Improve Medication Adherence Compliance Comprehensive Nursing Essay Sample)

Desai, R., & Nayak, R. (2019). Effects of medication nonadherence and comorbidity on health resource utilization in Schizophrenia. Journal of Managed Care & Specialty Pharmacy, 25(1), 37-46.(A Nurse-Led Intervention in Schizophrenia Patients to Improve Medication Adherence Compliance Comprehensive Nursing Essay Sample)

National Institute of Mental health. (No date). Schizophrenia. Available at: https://www.nimh.nih.gov/health/statistics/schizophrenia (Accessed 14 January 2023) (A Nurse-Led Intervention in Schizophrenia Patients to Improve Medication Adherence Compliance Comprehensive Nursing Essay Sample)

Salzmann-Erikson, M., & Sjödin, M. (2018). A narrative meta-synthesis of how people with schizophrenia experience facilitators and barriers in using antipsychotic medication: Implications for healthcare professionals. International Journal of Nursing Studies, 85, 7-18.(A Nurse-Led Intervention in Schizophrenia Patients to Improve Medication Adherence Compliance Comprehensive Nursing Essay Sample)