Date of Award

Fall 2019

Project Type

Clinical Doctorate

College or School




Program or Major

Doctorate of Nursing Practice

Degree Name


First Advisor

Pamela DiNapoli


BACKGROUND: Diabetes often contributes to many co-morbid conditions and their complications. Non-adherence to medications is common in patients with chronic disease. The project aimed to improve medication adherence through the implementation of electronic messaging. The project was set in a private medical practice within a critical access hospital. Participants were patients of the practice with diabetes.

METHODS: Baseline assessment included review and documentation of HgBA1cs, prescription requests, and past medical history. The development of an intervention to improve medication adherence utilizing electronic reminders was based on Bandura’s (1989) Social Cognitive Theory and Ajzen’s (1991) Theory of Planned Behavior.

INTERVENTION: The HgBA1cs of patients with diabetes were followed for the three months before the intervention and during the three-month intervention to trend improvements in HgBA1c. Monthly prescription monitoring for the three months before the intervention and during intervention also occurred as an additional measure of adherence. Read receipts of electronic messages were also tracked.

RESULTS: There was a sample of 21 patient-participants. The median aggregate HgBA1c pre-intervention was 8.5. The median aggregate HgBA1c post-intervention was 7.7 which was a significant median aggregate change. The patients reading the messages over the twelve weeks totaled 95% and prescription requests totaled 46 pre-intervention and 37 during the intervention.

CONCLUSION: The evidence suggests that using electronic reminders can be beneficial to help improve medication adherence in participants.