Running Head: RE-ADMISSION RATES BASED ON MEDICATION COMPLIANCE 1

Re-admission Rates Based on Antipsychotic Medication Compliance

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Question 1

Clinical Question

Schizophrenia patients are commonly characterized by health outcomes such as lack of self-

care and dignity that escalate their conditions. Multiple studies postulate that proper medication

use by schizophrenia patients an essential factor that contribute to better patients’ outcomes and

reduced rates of hospital re-admission. Re-admission rates are considered as the number of times

patients revisit hospitals within less than thirty days after their previous visit unplanned

(Bakstein et al., 2019). It is a common case with patients suffering from schizophrenia that have

gradually increased in the past years especially among elderly aged raising concerns within the

healthcare sector for both patients and the facilities. The article focus on explaining how

antipsychotic medication compliance in Schizophrenia patients leads to lower hospital re-

admissions rates within 30 days among the elderly aged population.

According to Bennett et al. (2018) patients who are not compliant to their medication have a

poor prognosis compared to those that are compliant. Of all re-admission hospitalization in the

United States, a range of 35% to 60% is as a result of medication in compliance which translates

to over $100 billion to the healthcare cost from the re-admission penalties and causes challenges

in identifying patients at risks of re-admission (Ayyagari et al., 2019). Most of the predictive

models used to identify the risk of re-admission use medication compliance as a social variable

in predicting the risk of patients from re-admissions within 30 days after their medical visit

(Bennett et al., 2018). Most of the patients get reluctant when they get discharged from the

hospital with some isolating themselves which triggers psychological trauma and hinders the

ability to relate with others. Thus, with antipsychotic medication compliances, such cases can be

prevented and patients encourage adapting to new environments, eating habits, mood control,
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and health interaction behaviors. Nurse educators highly facilitate in ensuring that these patients

are well trained on how they should live and relate with others outside the hospital setting and

how nurses can follow up on patients’ medication. It is essential to understand that schizophrenia

patients need time and friendly environments to stay alongside adherence to their medication. 

For the last year’s majority of healthcare providers used to retain Schizophrenia patients in

nursing homes to offer maximum monitoring and follow up. However, re-admission reports

showed that 60% of patients discharged returned with a similar complication within less than 30

days after discharged (Ayyagari et al., 2019). It was clear that these patients depended on nurses’

supervision on medication and behavior monitoring. Nurses need to encourage and train patients

to build self-confidence and adjust to new environments. Schizophrenia patients can easily be

affected by new environments especially those under depression and mood disorder, thus need to

be gradually introduced to a new environment and encouraged to interact with others and control

their behavior alongside adhering to their medication appropriately. 

Evidence

In assessing how effective medication compliance can reduce the rates of hospital re-

admission the following articles can adequately answer the question. Both articles involve

studies carried out under different populations and time frames to test the effects of medication

compliance on rates of hospital re-admission. 

The first article, “Using social cognitive theory to predict medication compliance behavior in

patients with depression in the southern United States in 2016 in a cross-sectional study”, uses

cognitive theory to test the impacts of medication compliance among patients suffering

depression. Among all other interventions tested, patients were advised to take medication of

depression which is influenced by the environment the patients stay (Bennett et al., 2018).
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Therefore, it is important to ensure that schizophrenia patients adjust first to the environment

they are in to adhere to medication and avoid destruction and stress during medication. 

The second article, “Impact of comprehensive medication management on hospital re-

admission rates”, applies a cohort study to evaluate the impacts of compressive medication

management on hospital re-admission rates. Retrospective electronic medical records data are

evaluated to identify patients’ admission before medication therapy management and compared

to reports of re-admission for both comprehensive medication management and comparator

cohort. The study reports that patients that received compressive medication management

registered significantly lower rate of re-admission compared to those who did not (Budlong et

al., 2018). 

Question 2

Picot Question

Picot question will facilitate to figure out the key purpose of the paper which is to explain

how antipsychotic medication compliance in Schizophrenia patients leads to lower hospital re-

admissions rates within 30 days among the elderly aged population. Therefore, the picot question

for the paper will be, “Does antipsychotic medication compliance in schizophrenia patients

reduces the rates of hospital re-admission within 30 days especially among the aged patients

compared to patient’s retention in nursing homes?”

P- The nursing concern from the question is re-admission rates of schizophrenia patients who

are registering a rapid increase over the years among the aged population.

I- antipsychotic medication compliance proves to be a suitable intervention to reduce the

accelerating rates of re-admission. 

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C- The current intervention used is the retention of the patients in nursing homes, which has

had no positive impact on the increasing rates of re-admission. 

C- The intervention effectiveness can be measured through re-admission records of the

patients in comparison to the previous records under the use of alternative interventions.

 T- Evaluations will be conducted after 30 days, approximately 6 weeks.

Question 3

Picot Question Standard Format

In schizophrenia patients aging 65 and older, does antipsychotic medication compliance

compared to retention in nursing homes influence the rates of hospital re-admission over 6

weeks?

P- Schizophrenia patients aging 65 and older

I- Antipsychotic medication compliance

C- Retention in nursing homes

O- Rates of hospital re-admission

T- 6 weeks

Question 4

Literature Search Terms

Schizophrenia illness

Antipsychotic Medication Compliance

Re-admission rate

Rates re-admissions for Schizophrenia patients

How antipsychotic medication compliance affects the rate of re-admission for Schizophrenia

patients
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Question 5

Nursing Theory

Nurse educators commonly use scientific evidence and validated data to construct reassuring

frameworks for improving patients’ care and health progress. The theories propose strategies and

methods that are applied to educating future healthcare providers on how to handle health

problems and issues. Self-care and interpersonal relation nursing theories can be in cooperated to

ensure that Schizophrenia patients resume their normal lives and adhere to their antipsychotic

medication appropriately. Self-care nursing theory focuses on ensuring that the patients develop

the ability to self-responsible and sufficient for theory healthcare under the supervision of nurses.

Nurse educators offer enough information to the patients to ensure that they are well

knowledgeable about their situation and can provide adequate self-care even outside the hospital

(Hussein & Osuji, 2017). 

Interpersonal relation theory centers on developing mutual respect between the patient and

nurse. Mutual respect builds an open and transparent relationship between the patient and the

nurse. Nurses can adequately attend to patients only under mutual respect and patients to need to

feel involved in their treatment and medication process especially the aged with schizophrenia

illness (Bakstein et al., 2019). In most cases, schizophrenia illnesses withdrawal the patients

from the real world ad builds an isolated dreamland occupied with pain, negligence, and

rejection. Thus, this kind of relationship help patients accepts their condition and fully

participates in improving through medication. 

Conclusion

The increasing rates of hospital re-admission are a great deal in the health field. It is the

responsibility of nurse educators to ensure that they offer adequate training and education to
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healthcare providers and patients on intervention measures to reduce the rates. Research shows

that proper medication management can facilitate in solving and preventing the issue by

campaigning for medication compliance and offering a friendly environment to schizophrenia

patients. The PICOT questions help analyses the effectiveness of medical compliance in

reducing re-admission rates and channels way for future research on other interventions that can

be used to reduce the rates for Schizophrenia and other illnesses. 

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References
Ayyagari, R., Thomason, D., Mu, F., Philbin, M., & Carroll, B. (2019). Association of

antipsychotic treatment switching in patients with schizophrenia, bipolar, and major

depressive disorders. Journal of medical economics, 1-9. Hussein, M. H., & Osuji, J. (2017).

Bridging the theory-practice dichotomy in nursing: The role of nurse educators. J Nurs Educ

Pract, 7(3), 20-5.

Bakstein, E., Mladá, K., Fárková, E., Kolenič, M., Španiel, F., Manková, D., ... & Hajek, T.

(2019). Cross‐sectional and within‐subject seasonality and regularity of hospitalizations–a

population study in mood disorders and schizophrenia. Bipolar Disorders.

Bennett, B., Sharma, M., Bennett, R., Mawson, A. R., Buxbaum, S. G., & Sung, J. H. (2018).

Using social cognitive theory to predict medication compliance behavior in patients with

depression in southern United States in 2016 in a cross-sectional study. Journal of caring

sciences, 7(1), 1.

Budlong, H., Brummel, A., Rhodes, A., & Nici, H. (2018). Impact of comprehensive medication

management on hospital readmission rates. Population health management, 21(5), 395-400.