Date of Conferral

2020

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barbara Gross

Abstract

Nonadherence to psychotropic medications among patients with serious and persistent psychiatric disorders, including bipolar disorder and schizophrenia, is approximately 70%. Nonadherence is a common barrier to the treatment of individuals with mental health disorders. However, there is limited awareness of evidence-based interventions and strategies to address this problem. Therefore, the question for this project asks whether a systematic review can identify strategies to improve adherence of psychotropic medications among individuals with serious and persistent mental illness. The purpose of this systematic review was to explore the evidence-based strategies that can aid in increasing medication adherence in patients with mental health disease. Sources of evidence included online databases such as Walden University Library, PubMed, Cochrane Collaboration, PsychINFO, ProQuest, EBSCOHost, Google Scholar, and Joanna Briggs Institute. The health belief model provided foundation for this project by supporting awareness and self-efficacy of medication adherence. Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used to analyze the evidence. Findings revealed that a healthcare staff collaborated education approach targeted toward the patient or to the patient and family members was the most effective strategy to support medication adherence. Other evidence-based interventions such as home-based physical exercise programs, cognitive-behavioral and motivational strategies, blister packaging, financial incentives, and cost sharing were also found to improve adherence. This systematic review elicits positive social change in practice by facilitating adherence to psychotropic medications; thus, reducing hospitalization and comorbidity.

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