Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Date of Graduation


Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing


Erika Metzler Sawin PhD, RN, FNP-BC

Yeside Ojo, DNP, PMHNP-BC, FNP-C


Background: Bipolar disorder (BD) is the fifth leading course of disability in the world, contributing to many co-morbid conditions and complications. Non-adherence to medication is prevalent in patients with BD. The aim of the project was to use an evidence-based technological intervention to enhance medication adherence in BD patients between 18- 65 years old at an outpatient behavioral health clinic.

Methods: Baseline assessment included a pre Morisky Medication Adherence (MMAS-4) questionnaire. The development of an intervention to improve medication adherence was based on Johnson’s (2002) Medication Adherence Model (MAM).

Interventions: Participants downloaded the Medisafe app, registered medications and set reminder notifications. The App reminded participants to take medications daily among other benefits. Patient participants were monitored on the app platform for 2 months and were provided a Post MMAS-4. The Pre-intervention and post-test mean scores were compared to determine whether the use of the mobile app reminder improved participants’ adherence to medication.

Results: Mean pre-intervention MMAS-4 was 1.17 (SD = 1.19) and mean post-intervention MMAS-4 was 3.17 (SD = 1.11). Mean post-intervention MMAS-4 was significantly higher than pre-intervention, Mdiff = 2.00, t(11) = ­­­-4.90, p < .001. This indicates that the Mobile app intervention increased medication adherence, as measured by the MMAS-4. The mean satisfaction score for the Mobile app was 3.82, with a range between 2.50 and 5.00. There was a significant correlation between post-intervention MMAS-4 and satisfaction, r(10) = .70, p = .012.

Conclusion: The findings implied that the use of the mobile app reminder significantly increased medication adherence among the 12 participants by more than 80% and participants were satisfied with using the mobile app.



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