Document Type

Dissertation - Open Access

Award Date


Degree Name

Doctor of Philosophy (PhD)


Graduate Nursing

First Advisor

Barbara Hobbs


Objective. The purpose of the study is to compare the outcomes of patient activation before and after pharmacogenetic care in a coordinated care population. The process of pharmacogenetic care includes the patient’s acknowledgment of medication changes which are based on their genetic profile. This study will be framed by Dorothea Orem’s Self-Care Theory and Davies and Conley’s framework of genetic influences in prescribing anti psychotropic therapy.

Background. Understanding patient’s behavioral reactions to pharmacogenetic care in terms of patient activation is important to understanding patient’s health outcomes. No published studies were identified in literature reviews conducted by this author which related to patient activation and pharmacogenetic care. There were no published studies found by the author using either, or both of, Dorothea Orem’s Self-Care Theory or Davies and Conley’s framework.

Methods. This dissertation study is designed as part of a larger study nicknamed “PGXTIME”. The study is a longitudinal, utilizing one-group, repeated measure design. Participants will complete the Patient Activation Measure-Mental health (PAM-MH) before and after having pharmacogenetic testing (PGX). Medication recommendations will be provided to the primary care provider based on current medications and genetic testing results. Standard of care in South Dakota requires patient involvement and communications regarding genetic testing. This study requires a patient’s acknowledgment that their medications are remaining the same or being modified based on pharmacogenetic testing results. Additional information will be collected regarding the number of chronic conditions, the number of mental health conditions, the number of medications utilized, coordinated care tier level and number of genetic pathways affected. A theoretical model was developed based on literature review, Orem’s model, Davies and Conley’s framework, to understand direct and indirect variable relationships.

Results. This study was stopped in January of 2016. Therefore, no study results are presented in this dissertation. Chapter one and two describe this study while chapter three describes the reason the study was stopped and how the study changed. Chapter four presents study results, and Chapter Five includes the discussion.

Library of Congress Subject Headings

Self-care, Health.
Patient compliance.
Psychotropic drugs.
Depression, Mental.


Includes bibliographical references (page 139-168)



Number of Pages



South Dakota State University


Copyright © 2016 Julie Kittelsrud