Date of Degree

Summer 2025

Document Type

DNP Scholarly Project

Academic Department

School of Nursing

Degree Type

Doctoral

Degree Name

Doctor of Nursing Practice

First Advisor

Dr. Angela Morehead

Second Advisor

Dr. Amanda Graham

Abstract

At an outpatient clinic in Southern California, a 77% medication adherence rate was observed in August 2024 among clients with ADHD. Medication nonadherence in ADHD clients may result in difficulty reaching therapeutic levels, leading to adverse outcomes, such as family disruptions, substance addiction, injuries, criminal occurrences, and even suicide. The project aims to reduce the number of ADHD clients who are noncompliant with their medications and surpass the national benchmark of 80% medication adherence. Evidence has suggested that MRAs may improve medication nonadherence among ADHD clients. Current research has supported the use of MRAs for various chronic diseases including diabetes and cardiovascular disease. The Plan-Do-Study-Act framework was used to resolve problems that occurred during implementation, and small tests of change were conducted to improve the accuracy of the results. The clients who participated in the project were adolescents and adults. Geriatric clients were excluded from the project. Nurse practitioners distributed the MRA educational flyers and followed up with each client in 30 days. A total of 22 clients returned for their 30-day follow-up appointment. One client didn’t refill their medication, and another reported a stoppage in their medication. The results were a 91% medication adherence rate for March 2025, a 14% improvement from the initial adherence rate in August 2024. The use of MRAs is a patient-centered, evidence-based approach that focuses on improving treatment outcomes and safety. Nurses should consider using this quality improvement tool in other specialties. An electronic distribution method to deliver the MRA can improve operational efficiency.

Rights

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