Date of Degree

8-2025

Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Program

Nursing

Advisor

Karen Percell

Abstract

Abstract

Purpose: This project was undertaken to increase medication adherence in clients diagnosed with mental illnesses that necessitate the use of antipsychotic (second generation, atypical or first generation, typical) medications.

Background: Medication compliance in the treatment of schizophrenia, schizoaffective disorder, and bipolar disorder is essential to ensure consistent medication levels and symptom stabilization. There are many reasons clients stop taking their medications, and symptoms of metabolic syndrome are often a cause for self-discontinuation. Metabolic syndrome is a cluster of symptoms including obesity, hypertension, hyperglycemia, hypoalphalipoproteinemia, and/or hypertriglyceridemia, which increases risk for cardiovascular disease and diabetes.

Methods: This project was completed using the Iowa Model Evidence-Based Practice methodology and was completed over 12 weeks. A robust literature review found agreement among existing research indicating a positive relationship between noncompliance and client discontent with metabolic symptoms. Based on this conceptual framework, the author focused interventions aimed at eliminating unnecessary metabolic syndrome experience to increase medication compliance. A metabolic screening instrument was designed, tested, and implemented for use in the electronic medical record. Provider education was presented on metabolic syndrome including provider screening requirements and evidence-based treatment options.

Results: The electronic screening instrument that was designed and was successfully implemented to medical providers. Providers surveyed pre- and post-intervention noted the template to be helpful and useful to increase their compliance with metabolic screening. Although pre-intervention metabolic screening compliance rates were unavailable, post-intervention metabolic screening documentation in the first month was 55% on the three pre-selected units with 82% of those providers having used the screening template. More than half of clients had their evidence-based recommendation to screen quarterly for metabolic syndrome completed within the first 30 days of the project.

Conclusions: In addition to implementing an innovative electronic medical record component to improve screening and documentation by providers, the project also led to improved metabolic screenings and treatment. Although medication compliance cannot yet be appreciated, the successful implementation of the screening and treatment holds promise to reduce unwanted patient metabolic experience, likely to decrease the rate of antipsychotic noncompliance.

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