Examining the Effectiveness of Nurse-led Health Education Interventions in

Improving Medication Adherence among Elderly Patients with Chronic

Conditions

ADVERSALO, GOLDWYN A.

REYES, LIANNE MARIE F.

RIODIL, CLAIRE ANN ANGELICA

RIODIL, CHARINA AUBREY

QUINTOS, ANSELMO JR

BUQUING. SHIELA

Student

JOSEPH G. TABAN

Professor
 July 28, 2023

Population of the Study

The population targeted for this study consists of senior individuals aged 65

and above who have been diagnosed with one or more chronic conditions,

including but not limited to, diabetes, hypertension, heart disease, or respiratory

illnesses (Centers for Disease Control and Prevention [CDC], 2020). The reason

behind focusing on this demographic is due to the higher prevalence of chronic

conditions in older individuals, leading to a significant need for effective

medication management strategies. This group of elderly individuals is likely to be

receiving medical care and services from diverse healthcare environments,

including hospitals, clinics, nursing homes, and community health centers. By

diversifying the healthcare setting from which the participants are recruited, we

ensure that the research findings are applicable to a broader context and not limited

to a specific healthcare setting. Moreover, the population is intended to be diverse

in terms of gender, ethnicity, socioeconomic status, and types of chronic conditions

to account for the potential variations these factors might contribute to the

effectiveness of nurse-led health education interventions.

 Sampling Technique to be Used

The proposed study would adopt a randomized controlled trial (RCT) design

which is deemed suitable for intervention studies. Within this RCT framework, a

stratified random sampling technique will be employed. This type of sampling

entails dividing the total population into homogeneous subgroups or 'strata' based

on defining characteristics, such as the type of chronic disease, gender, ethnicity,

and socioeconomic status. Following this, participants will be randomly selected

from each stratum, ensuring that the sample reflects the characteristics of the larger

population (Babbie, 2016). By doing so, the study aims to mitigate any potential

sampling bias and enhance the validity of the findings.

Distribution of Respondents

The distribution of the respondents in this study will mirror the stratification

parameters used in the sampling technique. Efforts will be made to maintain a

balanced number of participants in each stratum to avoid skewing the

representation of any particular group. However, it's important to note that the

exact distribution might vary depending on the availability and willingness of the

participants in each stratum. For example, the number of participants with different

chronic diseases may differ based on the prevalence of these diseases in the

population. Regardless, all efforts will be made to ensure that the sample is as

representative as possible of the broader population of elderly individuals with

chronic conditions.
 Data Gathering Procedure

Data collection in this study will be a two-pronged process involving the

implementation of the nurse-led health education intervention and subsequent

collection of medication adherence data. After obtaining informed consent, eligible

participants will be randomly assigned to either the intervention or control group.

The intervention group will undergo nurse-led health education sessions tailored to

their specific needs, taking into account their particular chronic conditions,

medication regimes, and any identified barriers to medication adherence. The

control group, on the other hand, will continue to receive the standard care typical

of their healthcare setting, without the added health education sessions (Campbell,

Pieters, Mullen, 2012). Following the implementation of the interventions,

medication adherence data will be collected from all participants over a defined

period. Collection methods could include self-reporting, pill counts, and the use of

electronic medication monitoring systems, all of which have been recognized as

valid ways to assess medication adherence (Stirratt et al., 2015).

Preparing the Instrument (Questionnaire)

The main data collection instrument for this study will be a comprehensive

questionnaire designed to assess medication adherence. This questionnaire will

cover multiple aspects of medication usage, including the frequency and

consistency of taking prescribed drugs, participants' understanding of the purpose

and dosage of their medications, and any identified barriers to medication

adherence. These factors are critical in providing a holistic understanding of

medication adherence among the elderly population (Lam & Fresco, 2015). To
ensure the reliability and validity of the instrument, the questionnaire will undergo

a process of validation and piloting before being finalized for use in the study. The

questionnaire will be administered at different time points: pre-intervention,

immediately post-intervention, and at a few follow-up points post-intervention. By

doing so, it allows the researchers to track changes over time and evaluate the

long-term effects of the nurse-led health education intervention on medication

adherence.
 SURVEY QUESTIONNAIRE

Participant Demographics:

Age: _____

Gender: ( ) Male ( ) Female ( ) Prefer not to say

What is your highest level of education completed?

( ) Less than high school

( ) High school/GED

( ) Some college

( ) Bachelor's degree

( ) Graduate degree

Which of the following chronic conditions have you been diagnosed

with? (Check all that apply)

( ) Diabetes

( ) Hypertension

( ) Heart disease

( ) Respiratory illness

( ) Other (please specify): ________

 Pre-Intervention Medication Adherence

How often do you forget to take your medication?

( ) Never

( ) Rarely

( ) Sometimes

( ) Often

( ) Always

How confident are you in understanding the importance of your

medication(s)?

( ) Not confident at all

( ) Somewhat confident

( ) Neutral

( ) Very confident

( ) Completely confident
 How often do you take your medication later or earlier than the

prescribed time?

( ) Never

( ) Rarely

( ) Sometimes

( ) Often

( ) Always

How often do you skip doses?

( ) Never

( ) Rarely

( ) Sometimes

( ) Often

( ) Always

Post-Intervention Medication Adherence

Since attending the nurse-led health education sessions, how often have

you forgotten to take your medication?

( ) Never
 ( ) Rarely

( ) Sometimes

( ) Often

( ) Always

Since attending the nurse-led health education sessions, how confident

are you in understanding the importance of your medication(s)?

( ) Not confident at all

( ) Somewhat confident

( ) Neutral

( ) Very confident

( ) Completely confident

Since attending the nurse-led health education sessions, how often have

you taken your medication later or earlier than the prescribed time?

( ) Never

( ) Rarely

( ) Sometimes

( ) Often

( ) Always
 Since attending the nurse-led health education sessions, how often have

you skipped doses?

( ) Never

( ) Rarely

( ) Sometimes

( ) Often

( ) Always

Feedback on the Nurse-led Health Education Interventions

How useful have you found the nurse-led health education sessions in

helping you manage your medication(s)?

( ) Not useful at all

( ) Somewhat useful

( ) Neutral

( ) Very useful

( ) Extremely useful

Would you recommend these nurse-led health education sessions to

other individuals with similar health conditions?

( ) Yes
 ( ) No

Please provide any additional comments or feedback about the nurse-led

health education sessions: ____________

 References

Babbie, E. R. (2016). The practice of social research (14th ed.). Cengage Learning.

Campbell, N., Pieters, K., & Mullen, K. A. (2012). Patient adherence to medication

requirements for therapy of chronic diseases. Journal of Patient Compliance,

1(1), 10–24.

Centers for Disease Control and Prevention. (2020). National chronic disease

overview.

https://www.cdc.gov/chronicdisease/resources/infographic/chronic-

diseases.htm

Lam, W. Y., & Fresco, P. (2015). Medication adherence measures: An overview.

BioMed research international, 2015.

Stirratt, M. J., Dunbar-Jacob, J., Crane, H. M., Simoni, J. M., Czajkowski, S.,

Hilliard, M. E., Aikens, J. E., Hunter, C. M., Velligan, D. I., Huntley, K.,

Ogedegbe, G., Rand, C. S., Schron, E., & Nilsen, W. J. (2015). Self-report

measures of medication adherence behavior: Recommendations on optimal

use. Translational Behavioral Medicine, 5(4), 470–482.

https://doi.org/10.1007/s13142-015-0315-2