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  4. Reducing Polypharmacy with Mobile Apps Among Mental Health Patients
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Reducing Polypharmacy with Mobile Apps Among Mental Health Patients

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Description

Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions, treatment failure, patient dissatisfaction, and lack of treatment control. The associated practice challenges have led to the following PICOT question. In persons with mental health issues receiving care at an outpatient mental health clinic, does engaging in mindfulness practice versus no mindfulness practice change polypharmacy use over a 3-month period?

The project purpose was to evaluate the effectiveness of Insight Timer mobile mindfulness app at helping patients self-manage distressing symptoms and reduce polypharmacy. Over three weeks, mental health clinic nurse practitioners (NPs) voluntarily recruited patients (n=12) over age 18 using as needed prescriptions (PRNs), and agreed to use Insight Timer mobile mindfulness app for adjunct symptom management. Consenting participants downloaded the mobile app, and completed a brief questionnaire measuring PRN use at the start of app use, and PRN use at their next visit. A Wilcoxon signed-rank test indicated a 10-week mindfulness app trial did not significantly lower total PRN doses compared with pre-app dosing (Z = -.534, p = .593). Paired t-tests revealed no significant change in pre (M = 65.17, SD = 28.64) versus post (M = 67.75, SD = 20.22) OQ45 life functionality results (t(11) = -.420, p = .683) (d = .121) as a result of app use.

Clinically relevant results illustrated 83.33% of participants taking greater than nine PRN doses over the study period used the app six times or more in place of medication. High PRN users employed the app frequently in place of medication regardless of total PRN doses taken. Practice implications and sustainability recommendations include incorporating mobile app use in treatment plans for high PRN users and educating NP’s on the tangible benefits of mindfulness apps in reducing polypharmacy and easing symptom distress on an ongoing basis.
Keywords: mindfulness, mhealth, mobile apps, mobile smart phone, online, RCT, behavior change, polypharmacy.

Date Created
2019-04-29
Contributors
  • Pierce, Albert (Author)
  • Guthery, Ann (Thesis advisor)
Topical Subject
  • Polypharmacy
  • Mindfulness
  • Mobile Applications
Resource Type
Text
Extent
51 pages
Language
eng
Copyright Statement
No Known Copyright
Primary Member of
Doctor of Nursing Practice (DNP) Final Projects
Peer-reviewed
No
Open Access
No
Handle
https://hdl.handle.net/2286/R.I.53154
Embargo Release Date
Fri, 05/01/2020 - 08:27
Level of coding
intermediate
Cataloging Standards
asu1
Collaborating institutions
College of Nursing and Health Innovation
System Created
  • 2019-04-29 08:57:42
System Modified
  • 2021-06-20 12:41:36
  •     
  • 1 year 7 months ago
Additional Formats
  • OAI Dublin Core
  • MODS XML

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