Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Michael D. Moon


Background. Type 2 diabetes is the ninth leading cause of death in the United States. Micro/macro vascular complications are common in diabetes. Purpose. To implement an evidence-based protocol addressing obstacles for patients with type 2 diabetes in following their prescribed medication regimens to reduce glycosylated hemoglobin levels. Evidence. Failure to follow treatment plans increases diabetes complications. Perceptions and complexities of treatment plans, side effects of therapies, and cost contribute to patients not taking their medications as prescribed. Goals. To increase the number of patients with type 2 diabetes who follow their prescribed medication regimen and reach their targeted glycosylated hemoglobin. To increase referrals for patients with glycosylated hemoglobin greater than 8.4 g/dL to the optimization clinic. Methods. Patients with diabetes were asked to complete a medication adherence and diabetes knowledge questionnaire identifying obstacles to taking prescribed medications. Providers adjusted treatments according to clinical practice guidelines to address the identified obstacles. Results. A total of 61 patients completed the questionnaire and received educational information. All 22 patients with glycosylated hemoglobin’s above 8.4% were referred to the optimization clinic. Common barriers reported were cost (14%), side effects (31%), and forgetfulness (55%). Patient advocates were used to address cost, alternative therapies were provided for side effects, and mail-in delivery services were offered for forgetfulness. The project ended before three-month follow-up glycosylated hemoglobin levels were obtained. Practice Implications. Early recognition of obstacles that interfere with patients taking their medication providesan opportunity to address these barriers thereby reducing the risk of complications from diabetes.