Oliveira Claúdia Jorge, José Helena Maria Guerreiro, Costa Emília Isabel Martins Teixeira da
Health School, Polytechnic Institute of Beja, 7800 Beja, Portugal.
Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3046 Coimbra, Portugal.
Nurs Rep. 2024 Jul 17;14(3):1735-1749. doi: 10.3390/nursrep14030129.
(1) Background: Medication adherence is influenced by a variety of intricate factors, presenting hurdles for nurses working to improve it among adults with chronic conditions. Pinpointing the reasons for non-adherence is crucial for customizing interventions. The objective of this quality improvement project was to improve medication adherence among adults with chronic diseases in primary healthcare by promoting evidence-based practices, identifying barriers and facilitators to compliance, and developing strategies to ensure optimal adherence through engaging the nursing team, enhancing knowledge, and evaluating the effectiveness of the implemented strategies. (2) Methods: This study was a quality improvement project that utilized the JBI Evidence Implementation framework, the Practical Application of Clinical Evidence System, and the Getting Research into Practice audit tool across three phases: (i) forming a project team and conducting a baseline audit, (ii) offering feedback via the GRiP tool, and (iii) conducting a follow-up audit to assess best practice outcomes. The study was conducted between September 2021 and March 2022 in the community care unit of Algarve Regional Health Administration, targeting adults with chronic illnesses. (3) Results: A total of 148 individuals were audited, including 8 nurses, 70 baseline patients, and 70 post-implementation patients. Initial compliance with key best practices was low, with several criteria at 0% compliance at baseline. Post-intervention, we observed significant improvements; compliance with key best practices improved dramatically, with many reaching 100%. Notable improvements included enhanced patient education on medication management, regular medication adherence assessments, and increased engagement of healthcare professionals in adherence activities. (4) Conclusions: This quality improvement project demonstrated that structured, evidence-based interventions could significantly enhance medication adherence among adults with chronic diseases. The success of the project highlights the potential of similar strategies to be applied broadly in primary healthcare settings to improve health outcomes.
(1) 背景:药物依从性受到多种复杂因素的影响,这给致力于提高慢性病成年患者药物依从性的护士带来了障碍。找出不依从的原因对于定制干预措施至关重要。本质量改进项目的目标是通过推广循证实践、识别依从性的障碍和促进因素,以及制定策略以确保最佳依从性,来提高初级医疗保健中慢性病成年患者的药物依从性,具体做法包括让护理团队参与、增强知识以及评估所实施策略的有效性。(2) 方法:本研究是一个质量改进项目,在三个阶段运用了JBI循证实施框架、临床证据系统的实际应用以及将研究转化为实践审核工具:(i) 组建项目团队并进行基线审核,(ii) 通过GRiP工具提供反馈,(iii) 进行后续审核以评估最佳实践结果。该研究于2021年9月至2022年3月在阿尔加维地区卫生管理局的社区护理单元进行,目标人群为患有慢性病的成年人。(3) 结果:总共对148人进行了审核,包括8名护士、70名基线患者和70名实施干预后的患者。最初对关键最佳实践的依从性较低,基线时几个标准的依从率为0%。干预后,我们观察到显著改善;对关键最佳实践的依从性大幅提高,许多达到了100%。显著改善包括加强了对患者的用药管理教育、定期进行药物依从性评估,以及医疗专业人员更多地参与依从性活动。(4) 结论:本质量改进项目表明,结构化的循证干预措施可显著提高慢性病成年患者的药物依从性。该项目的成功凸显了类似策略在初级医疗保健环境中广泛应用以改善健康结果的潜力。