The effectiveness of a nursing discharge programme to improve medication adherence and patient satisfaction in the psychiatric intensive care unit

• Published in: Journal of clinical nursing 2017-12, Vol.26 (23-24), p.4456-4466
• Main Authors: Virgolesi, Michele, Pucciarelli, Gianluca, Colantoni, Anna Maria, D'Andrea, Fabio, Di Donato, Barbara, Giorgi, Fabio, Landi, Lidia, Salustri, Eleonora, Turci, Carlo, Proietti, Maria Grazia
• Format: Article
• Language: English
• Subjects: Adult; Chronic Disease - therapy; communication; compliance; Discharge; Female; Humans; Intensive Care Units; Male; medication; Medication Adherence - psychology; Middle Aged; nurse; Nurse-Patient Relations; Nursing; Nursing care; patient; Patient compliance; Patient Discharge - standards; Patient Satisfaction; Prospective Studies; Psychiatric Department, Hospital; Psychiatric-mental health nursing; Psychotropic drugs; Surveys and Questionnaires
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/jocn.13776

Aims and objectives To observe the extent to which a nursing discharge plan is effective in promoting therapeutic adherence and improving patient satisfaction with their treatment based on information interventions provided by nursing staff, direct hospital medication distribution and follow‐up telephone calls. Background Patient adherence is a fundamental requirement for the treatment of chronic diseases. Among psychiatric patients, adherence to the prescribed course of treatment allows patients to keep the symptoms of their disease under control, allowing for improvements in the management of their condition, minimising the risks of relapse and reducing the number of hospitalisations. Design This study uses a prospective correlational design. Methods The Morisky Medication Adherence Scale, the Satisfaction with Information about Medicine Scale and the General Satisfaction Questionnaire were used. Results Of the 135 patients enrolled in the study, 57% of the sample was female, and, on average, patients were aged 33 years. About 72.9% were unmarried, and 88.1% were educated at less than high school level. This study showed that patients who received more information on their health status and on what would be done for them after their hospitalisation had a higher adherence to treatment. In addition, patients who were more satisfied with the nursing care provided had a higher rate of adherence to their treatment plan. Conclusions The interpersonal and educational nursing intervention improves adherence to a treatment plan by allowing patients to express themselves not only as individuals who rely on health care but also as protagonists able to effectively manage their disease and to empower themselves by acquiring disease management skills. Relevance to clinical practice A patient–nurse communication programme could help to analyse the individual patient circumstances that might become barriers to adherence and to apply nursing interventions that promote better patient adherence.