Feasibility of Implementing a Behavioral Health Intervention to Improve Medication Adherence in a Low Income Hypertensive Clinic Population

Low medication adherence in hypertensive adult patients presents a sizable problem in the United States for many reasons. Poor health literacy is one. This Doctor of Nursing Practice (DNP) Capstone project was undertaken to demonstrate the feasibility of implementing a behavioral health intervention to improve medication adherence among low-income hypertensive patients of a Federally Qualified Health Center (FQHC). The evidence-based education and counseling sessions were designed using components from the Health Literacy Universal Precautions Toolkit including Teach Back Method and Ask Me 3™. This intervention consisted of four one-on-one sessions; two with the clinic nurse practitioner, and two with the behavioral health specialist. A midpoint follow-up telephone encounter was also included. Thirty patients (mean age 50 years; 50% Caucasian, 31% African-American; 81% women) were recruited based on low adherence scores on the ©Morisky Medication Adherence Scale (MMAS-8-Item). Evaluation of the project revealed improvement in timely filling of prescriptions. Paired t-test analysis of baseline and 12 week follow-up scores found significantly improved medication adherence r3eported on the MMAS-8-Item tool (p=0.0000). There were also significant differences in systolic (p=0.001) and diastolic (p=0.0000) blood pressure readings over time. Participant evaluations of the program were positive. Implementation of this behavioral intervention to improve medication adherence was proven feasible, and was well-received by participants.