Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-11-2024

Graduate Advisor

Vanessa Loyd, PhD, DNP, RN

Committee

Wilma J. Calvert, PhD, MPE, MS(N), RN

Janelle Burskey, MSN, RN

Abstract

Abstract

Problem: Limited English Proficiency (LEP), which includes Arabic speakers, presents challenges in healthcare and can impact medication reconciliation and adherence. Interdisciplinary collaboration involving patients and interpreters is crucial for improving medication reconciliation and adherence. This project aimed to examine the impact of an interdisciplinary medication reconciliation approach on medication adherence with Arabic-speaking patients ages 18-99 over three months.

Methods: This quality improvement (QI) pilot project utilized a descriptive cohort design. A translated validated Morisky, Green, and Levine (MGL) adherence survey consisting of four questions was administered pre- and post-implementation to a convenience sample of Arabic-speaking patients 18 years or older but under 99 years old, prescribed two or more medications and had an in-person interpreter. Data collected included demographic data, patient surveys, the number of medications prescribed, and interventions recommended by pharmacists.

Results: There were (N=29) who participated in completing the initial survey, there were (n=15; 52%) who did not meet with the pharmacist for initial medication reconciliation, (n=14; 48%) completed the initial medication reconciliation with the pharmacist; (n=9, 64%) patients met with the pharmacist and completed a medication reconciliation visit but did not come back for a follow-up and to complete the post-survey, (n=5; 17%) returned for a one-month follow-up visit. The number of medications pre-reconciliation (n=5) (M=18.80; SD= 6.140) and the number of medications post-reconciliation (M=16.40; SD =6.025) decreased by 2.40. Interventions provided by the pharmacist included medication education, medication changes, pillboxes, and refill support. The MGL survey resulted in a (p-value = .248). This result may be due to the small sample size.

Implications for Practice: Early identification of medication reconciliation utilizing an interdisciplinary approach and interventions recommended by a pharmacist could benefit patient education and medication adherence, especially in the LEP population.

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