Doctor of Nursing Practice Program

• Committee Chair Name & Credentials:
  Sharon Karp PhD, APRN, CPNP-PC, FAANP
 

 

DNP Project Abstract

Screening Adult Primary Care Patients With Type 2 Diabetes Medication Access Barriers

Purpose
This quality improvement project aimed to increase screening of type 2 diabetes mellitus (T2DM) patients for barriers to medication access, from zero to 50% by two weeks in a primary care clinic.

Methods
Using the Plan Do Study Act format as a guide, a medication access screening form was developed using published evidence on barriers to medication access. Screening forms were given to T2DM patients as part of their intake paperwork prior to a patient visit and responses recorded in their patient record. The physician evaluated the results and determined if medication assistance was needed or a change of medication.

Results
Twenty patients with T2DM were screened for barriers to medication access (11 male, 9 female, 49-88 years old). Five participants reported having issues paying for their medication (25%). All patients who reported payment issues stated being in the process of receiving assistance. Participants reported no barriers with the other screening questions: issues with transportation, medication administration issues and medication storage concerns.

Implications for Practice
Prior to project implementation, the clinic had been independently identifying patients with barriers to medication access. The close relationship between clinic and patients may have affected results. The screening form may work best for new clinic patients, new T2DM diagnoses, and those starting medications. Future projects should include larger patient populations to determine if the incidence of barriers is truly greater than was assessed during this pilot project, and be adapted for different diagnoses such as hypertension and hyperlipidemia. In addition, future projects should look at differences in responses between those with public and private insurance.