Medication Adherence: A Reimbursable Theory-Guided Evidence-Based Educational Intervention for Patients With Parkinson's Disease.

Background: Parkinson's disease is a challenging, progressive neurodegenerative process projected to affect more than 1.2 million patients by 2030, with an economic burden that will surpass $79 billion annually in the United States. Pharmacological interventions are the hallmark of treatment for symptom management for this lifelong disease. Multiple medications and a variety of dosing times have an increasingly negative effect on medication adherence. Purpose: This article will discuss medication adherence challenges, describe a theory-guided evidence-based intervention to improve medication adherence, and explore the economic implications in an outpatient clinic setting. Methods: A pilot chart review of 40 cases over 30 days found 60% of patients indicated medication nonadherence. An evidence-based practice quality improvement project was implemented using pre- and postmeasurements of physical, social, and adherence metrics separated by medication adherence teaching. The metrics used include the Parkinson's Disease Questionnaire 39, part of the International Movement Disorder Society's Unified Parkinson's Disease Rating Scale, and the Morisky, Green, Levine Scale. Results: Results were encouraging; medication adherence increased by 26%, while quality of life improved by 18%. Medication adherence improvement efforts follow the Centers for Medicare & Medicaid Services proposed guidelines to stabilize health care reimbursement and pharmaceutical economics. Implications for Practice: Consistent implementation of medication adherence teaching into the current office visit structure identifies patients at risk and improves provider-patient relationships using evidence-based adherence interventions. Any health care system can improve patient outcomes and facilitate revenue growth using medication adherence teaching coupled with the appropriate diagnostic and visit coding.