Medication adherence in adults with chronic disease in an outpatient rural clinic: a best practice implementation project

ABSTRACT Introduction: Chronic diseases account for a substantial number of deaths, disabilities, and increased health care costs in the US, especially in rural areas. Chronic diseases often require self-administration of treatment and result in adherence problems, which can lead to poor patient outcomes. Objective: This best practice implementation project aimed to improve medication adherence among adults with chronic disease in an outpatient clinic in the rural Southern US. Methods: This project used the JBI evidence implementation audit and feedback framework to identify best practices, barriers to adherence, and implementation strategies. A JBI Best Practice Evidence Summary was used to identify eight best practice recommendations for promoting medication adherence, which were used to develop audit criteria. Upon completion of the baseline audit, barriers were identified, and processes were implemented to address gaps in adherence to best practices. A follow-up audit was completed, and the results were compared. Results: The pre-audit data revealed variable compliance with best practices. To improve compliance, improvement strategies were developed, including educating staff on best practices for medication adherence, making scheduling adjustments to give providers more time with patients, and providing patients with resources about their prescribed medication. The post-audit showed improvements in five criteria of the eight. Conclusions: Small, low-cost changes to staff workflow and patient needs improved medication counseling adherence. Future initiatives could include digital tools such as automated reminders and patient self-management apps. Spanish abstract: https://links.lww.com/IJEBH/A663