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Document Type

DNP - University Access Only

Award Date


Degree Name

Doctor of Nursing Practice (DNP)


Graduate Nursing

First Advisor

Robin Arends


teach-back, health literacy, communication, medication adherence, chronic disease, home-health


Introduction: Medication nonadherence is a significant and persistent healthcare concern, specifically for chronic disease patients. Complications stemming from nonadherence may include over-prescription of medications, uncontrolled symptoms of chronic disease, increased hospitalizations, and decreased satisfaction. Low health literacy and inadequate communication play a noteworthy role in medication nonadherence. Evidence Summary: Teach-back, a health literacy-based communication tool, has been utilized in medication education for chronic disease patients and positively associated with improvement of numerous health outcomes, including medication adherence. Adherence to Refills and Medications Scale (ARMS) is a valid and reliable tool identified in the literature to appropriately measure adherence in chronic disease patients with varying health literacy levels. Gaps: Gaps in the evidence include lack of randomized controlled trials (RCT), studies testing teach-back toolkits, consistent application of teach-back interventions, and teach-back in home health settings. Recommendations for Practice: Implementing a teach-back medication education intervention is anticipated to improve medication adherence for home health patients with chronic disease, specifically heart failure (HF), chronic obstructive pulmonary disease (COPD), and/or diabetes mellitus type 2 (DM2). Teach-back could be applied to multiple diagnoses, health self-care outcomes, and other facility settings.

Library of Congress Subject Headings

Patient compliance.
Drugs -- Administration.
Health education.
Health literacy.



Number of Pages



South Dakota State University


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