Sunday, November 4, 2007

This presentation is part of : Nursing Information Initiatives
Using PDA Technology to Improve Adherence to Medical Regimens
Carol Heinrich, PhD, APRN, CNE1, RuthAnne Kuiper, PhD, RN1, and Sridhar Narayan, PhD2. (1) School of Nursing, University of North Carolina Wilmington, Wilmington, NC, USA, (2) Department of Computer Science, University of North Carolina Wilmington, Wilmington, NC, USA
Learning Objective #1: describe the use of PDA technology in relation to adherence to medical treatment plans.
Learning Objective #2: identify the issues related to the use of PDA technology for medication adherence in rural and urban settings.

     Health care providers need to understand the complexity of medication adherence in patients and not assume that medications are taken as prescribed, in spite of clear instructions. For many years studies have shown large discrepancies between medication prescription and adherence to the medical regimen. Medications are consumed as prescribed only about half of the time (Haynes, McDonald, Garg, & Montague, 2005). Nursing interventions that may improve medication adherence have the potential to improve functional abilities and quality of life in the elderly population (Russell, 2005). 
     The specific aims of this project were to identify specific PDA software program essentials that would remind patients of pertinent medication doses and times; identify PDA use issues encountered by well adult patients; and determine an eight week medical regimen adherence.  Initially 16 participants (5 males, 11 females) were enrolled with this project and they were 56 to 83 years of age. All participants had Mini-Mental State Examination scores above ­­­­28.  Health literacy scores measured by the Newest Vital Sign tool (range 0-6) revealed that six participants obtained scores of less than 4, which reflects inadequate health literacy.  
     The use of the PDA with OnTime Rx software was effective and easy to use for 14 participants in the project. Three women elected to discontinue the PDA use after the first week because of interference in daily activities. The remaining participants used the PDAs for the eight week pilot period. The medication adherence was 62.5%-99% (mean 86.7).  The lowest adherence was due to lack of medications, hospitalization, and prescription changes. This pilot project identified the methodological issues that would need to be addressed in a larger project. Subsequent research will include a larger sample to compare and contrast subjects to identify specific interventions and appropriate technology use for patients cared for by community health practitioners.