Date of Award


Document Type

Doctor of Nursing Practice (DNP)

Degree Name

Doctor of Nursing Practice (DNP)



Committee Chair

Haley Hoy

Committee Member

Joseph Kirpich


Mental illness--Treatment, Patient compliance, Patient education, Evidence-based medicine


Mental health disorders contribute to 14% of the global disease burden and approximately 30% of non-fatal disease burden, which patients make worse by non-adherence to taking their medications. Non-adherence to medications is particularly significant with mental health disorders because those disorders increase morbidity and worsen the disease. Electronic reminders are successful in improving medication adherence. This project sought to implement an evidence-based practice change in patients identified as non-adherent to anxiety and depression medications in a rural primary care practice where 60% of patients use medication for mental health. Using Bandura’s Social Cognitive Theory as a framework, patients were identified as potentially non-adherent by the pharmacy report and refill history. The DNP student then screened the patients for non-adherence and offered enrollment in the project including a complimentary electronic medication reminder device, a pill count spreadsheet, and weekly reminder texts or emails. The DNP student educated the members of the health care team in the clinic. The DNP Student screened, enrolled, and followed up with the participants. Of the 42 patients identified as potential participants within the enrollment period, 30 consented to take part. This initial project was limited to 30 participants due to the cost of the electronic reminder device. Results showed improvement in medication adherence. At the beginning of the project, 100% (n= 30) of patients enrolled in the study were identified as nonadherent by pharmacy records; at the end of the project, only 6% (n=2) remained on the potentially non-adherent list using pharmacy records. Post- project adherence surveys also showed improvement in patients who missed doses and less reliance on friends and families to remain adherent. Though not statistically significant, the results were clinically significant. An electronic reminder plays a vital role in patient adherence to medications for mental health.

Available for download on Saturday, February 08, 2025