Medication Adherence in Patients Post Allogeneic Hematopoietic Stem Cell Transplant: The PPM Implementation Project

The goal of this quality improvement project was to increase medication adherence in patients post allogeneic hematopoietic stem cell transplant (allo-HSCT) following hospital discharge. The aim was to evaluate the impact of implementing an individualized post-transplant education intervention, grounded in Roach’s human caring attributes, on medication regimen adherence post-transplant (allo-HSCT) following hospital discharge. The intervention included use of a pill box and medication calendar (PPM). Patient-Nurse interactions were guided by conscience and occurred within an environment of trust, respect, and compassion in which the nurse connected in full presence to the patient’s situation and demonstrated skills and knowledge (competence). A prospective, single arm, instructional intervention design was used to compare medication regimen adherence pre- and post- intervention. The effectiveness of the educational approach was evaluated using the Morisky Medication Adherence Scale-8 (MMAS-8). Participants included all patients who underwent allogeneic stem cell transplantation and discharged from the project facility between June 15th, 2021 and September 15th, 2021 (n=10). Prior to the PPM intervention, 20% of patients fell into the high medication adherence category, 40% were in medium adherence, and 40% in low medication adherence category. Four to five weeks after the PPM intervention, 70% were found to be in high adherence category and 30% in the medium adherence category. A paired sample t-test conducted on mean MMAS-8 score Pre- and Post- PPM intervention was found to be statistically significant (Mean 6.725 Versus 7.675, p=0.034). Early implementation of the PPM intervention involving individualized post-transplant instruction, grounded in caring science, was beneficial for post-transplant medication adherence in allo-HSCT patients following hospital discharge. Future research studies are needed to confirm the effectiveness and generalization of the PPM intervention.