Title: Telephone reminders to improve medication adherence in a community mental health clinic
Abstract:
Problem: Medication non-adherence is a significant problem in a mid-size outpatient psychiatric mental health rehabilitation clinic in a large metropolitan area. It is estimated that approximately 60% of adult patients at this clinic with serious mental illness do not adhere to prescribed psychotropic medication regimen with 25% of them citing forgetfulness as the primary reason.
Purpose: The purpose of this quality improvement project is to increase psychotropic medication adherence among adult patients with serious mental illness in this outpatient behavioral health services clinic by implementing and measuring the provision of telephone reminders, an evidence-based, research supported practice change.
Methods: A telephone reminder initiative is being implemented over 15 weeks in the fall of 2024. The clinic serves approximately 700 adult patients with serious mental illness. Patients included in the project are those who have opted to receive telephone reminders. The project involves educating all staff on the implementation of the telephone reminder project and training community support workers in the use of a telephone script to be used when making calls. Training took place in-person, virtually, or via email communication. Prior to implementation, staff completed a survey attesting to the completion of training. Stakeholders include one psychiatrist, four advanced practice registered nurses, five therapists, 55 community support workers, and 19 clinicians. Data on attempts made, reasons attempts were not made, calls completed, and reasons calls were not completed is being collected and analyzed weekly using run charts.
Preliminary Results: The initial data on the number of telephone reminder calls made is encouraging as patients are being called and reminded to take their medication. Of the 505 telephone reminder calls attempted, 359 (71%) were completed and 146 (29%) were not completed either because patients did not answer their phone or the number was unreachable (i.e., nonfunctional, defective, or inactive number). There is no available data on telephone reminder calls not attempted in these preliminary results.
Preliminary Conclusions: Initial results reveal that staff are making timid progress with making telephone reminder calls. Despite being supportive and expressing moderate satisfaction with the process, they indicate that making phone calls adds an extra burden to their workload.
