A quality improvement project: Evaluation of teach-back training on medication adherence in hypertensive older veterans

Abstract

<p>Hypertension remains one of the most common yet uncontrolled chronic diseases among older adults. Medication adherence is a vital part in managing uncontrolled hypertension. The purpose of this QI project was to evaluate the effectiveness of using the teach-back method on improving anti-hypertension medication adherence of hypertensive older adult patients age 65 to 75 with at least two uncontrolled blood pressure readings during their most recent clinic visit in the past 6 months. Medication adherence was assessed using the Hill-Bone Medication Adherence Scale (HB-MAS) before and after the intervention. Health literacy scores were also recorded prior to the intervention using the Rapid Estimate of Adult Literacy in Medicine - Short Form (REALM-SF). Blood pressure readings and HB-MAS scores were summarized by teach-back intervention periods. Changes in HB-MAS scores and blood pressure measures after the intervention were calculated (post – pre) and summarized descriptively. The effectiveness of using the teach-back method in improving the adherence of medication was demonstrated. The results showed a statistically significant improvement in medication adherence of p-value = 0.0001 with a mean (SD) difference of -1.4 (2.65), on the HB-MAS scale, which represented an 11% reduction in the mean HB-MAS score from baseline.</p> <p>Currently, there are very few studies that aim to evaluate health literacy and medication adherence consistently, even though both are required at an adequate level for treatment adherence and adequate patient outcomes. Teach-back is a tool that can be used in small time increments in an outpatient setting to increase adherence and close patient-provider communication gaps.</p>