Date of Conferral

2016

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Patricia Schweickert

Abstract

Improving Quality-of-Life in Older Adults with Depression and Diabetes through Medication Compliance Education

by

Valreen Hinds-Beharrie

MSN, Adelphi University, 1997

BSN, Adelphi University, 1986

Project Submitted in Partial Fulfillment

of the Requirement for the Degree of

Doctor of Nursing Practice

Walden University

March 2016

Diabetes and depression are prevalent diseases that cause morbidity and mortality. Diabetes is a heterogeneous metabolic disease in which hypoglycemia is a central feature. Depression is associated with increased counter-regulatory, hormone release, and alteration in glucose transport function. Depression occurs in some individuals with diabetes and is associated with poor metabolic control, inadequate control of diet, and poor adherence to medication that can decrease quality of life. The prevalence of depression in Type 2 diabetes mellitus patients is significantly higher in the over 55-year-old population than in the general public. The purpose of this quality improvement project was to assess whether a medication compliance program would improve the quality of life of older adults diagnosed with depression and diabetes. Orem's self-care deficit theory provided a theoretical framework to guide and assist the patient with depression and diabetes to meet self-management regimen. The project question investigated whether a compliance education program could improve the quality of life of adults with depression and diabetes. A convenience sample of 28 patients diagnosed with depression and diabetes participated in the program. Outcome data were collected pre and post-intervention via the World Health Organization's Quality of Life Questionnaire and calculated using percentage difference, revealing an improvement in quality of life. There were compelling improvements in physical health (+28.5%), social relationships (+32.3%), and environment (+25%). Measurable improvements were also seen in physical health (+15.1) and in general health (+3.6). These findings may serve to influence practice and can lead to positive social change in this population by decreasing the risk of complications and improve the well-being of these dual diagnosis patients.