Date of Award

Summer 7-28-2023

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Ginger Hawkins, DNP, RN, NEA-BC, CPHQ

Second Advisor

Jessica Comstock, DNP, RN, APRN, AGACNP-BC


Practice Problem: Medication adherence is a major concern in healthcare as it is a contributing factor to uncontrolled hypertension and resistant hypertension. Uncontrolled hypertension can lead to strokes, heart attacks, kidney failure, and even death.

PICOT: The PICOT question that guided this project was in Medicare Advantage members with hypertension located in Kansas, who were admitted to the hospital or emergency room identified by stratification (P), does care management utilization using hypertension clinical guidelines (I), compared to the stand-alone hypertension clinical practice guideline (C), improve medication adherence (O) over 10 weeks (T)?

Evidence: Hypertension is one of the leading preventable causes of death. Medication adherence is around 50% in half of individuals diagnosed with hypertension and annual cost of unnecessary visits for hypertension is in the billions. A care management program is a cost-effective way to help individuals with a chronic condition manage their health and medications, decreasing the rate of complications.

Intervention: A care management program utilizes medical professionals to assist members with chronic diseases, such as hypertension, to become more knowledgeable and autonomous with their healthcare. This program provides members with support in ensuring medications are taken and their chronic condition is being monitored to prevent complications and unnecessary emergency room and re-hospitalization visits.

Outcome: There was a lack of data due to the lack of participant participation, therefore, no blood pressure data was collected. The emergency room visits or re-hospitalization, including financial reports, were not available. Medication adherence percentages did not show any clinical significance.

Conclusion: It was difficult to assess clinical significance due to lack of data at the closure of this pilot program.


Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice

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This work is licensed under a Creative Commons Attribution 4.0 License.