Date of Award

January 2022

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)


Yale University School of Nursing

First Advisor

Joan Kearney


Medication nonadherence has a deleterious effect on patients with chronic health conditions, as it contributes to poorer health outcomes and increased healthcare spending. This Doctor of Nursing Practice project sought to improve medication adherence in at-risk patients by enhancing patient-provider communication and improving health literacy in a large, urban, safety net hospital. Utilizing a multi-prong approach, patients were provided with a visual aid – a pill card, in conjunction with the teach-back method, to improve systolic blood pressure (SBP), diastolic blood pressure (DPB) and Hemoglobin A1c (HbA1c) over a 6-month period. Twenty-three patients participated in the project. Participant demographics, attitudes towards the intervention, and clinical indicators were analyzed. The project was well received by all who participated. Key findings included patients finding the pill card easy to use and the teach-back method helpful in learning more about their medications. All target clinical indices decreased: SBP; DBP; A1C, in keeping with current positive findings on the use of triangulated methods conducted with larger samples. This data demonstrates the need for future larger scale projects to evaluate outcomes using these methods. This protocol has the potential to be utilized as a foundational program for other safety net hospitals.


This is an Open Access Thesis.

Open Access

This Article is Open Access