BACKGROUND Medication nonadherence contributes to hospitalization and mortality, yet there have been few interventions tested that improve adherence and reduce hospitalization and mortality in heart failure (HF). OBJECTIVE To determine whether an education intervention improved medication adherence and cardiac event-free survival. METHODS A randomized controlled trial was conducted on 82 HF patients. The intervention was based on the Theory of Planned Behavior (TPB) and included feedback of medication-taking behavior using the Medication Event Monitoring System (MEMS). Patients were assigned to one of three groups: 1) theory-based education plus MEMS feedback (PLUS), 2) theory-based education only (LITE), or 3) a usual care control group. Cardiac events were collected for 9 months. RESULTS Patients in both intervention groups were more adherent over follow-up compared to control group. In Cox regression, patients in either intervention group had a longer event-free survival compared to those in the control group before and after controlling age, marital status, financial status, ejection fraction, New York Heart Association functional class, angiotensin-converting enzyme inhibitor use, and presence or absence of a significant other during the intervention (p < .05). CONCLUSION Use of an intervention based on the TPB improves medication adherence and outcomes in patients with HF, and as such, offers promise as a clinically applicable intervention to help patients with HF adhere to their prescribed regimen.

Kindergarten children's knowledge and perceptions of alcohol, tobacco, and other drugs (ATODs) were assessed and the congruence between parent ATOD use and children's knowledge of ATODs was examined. Data were collected during the pre-intervention phase of an ATOD prevention trial with 5- and 6-year-old children and their parents. Three elementary schools were randomly selected from a population of 15 high-risk elementary schools in Lexington, Ky., (n = 126 parent-child dyads). Children were interviewed about their knowledge, feelings, and attitudes toward ATODs using the Child Drug Awareness Inventory. Parents self-reported ATOD use. Almost all (95%) kindergarten children recognized cigarettes; 56% correctly identified alcoholic beverages; and 17% recognized at least one illicit drug. Minority children were almost four times more likely to recognize illicit drugs than were non-minority children. Children's knowledge of ATODs was not correlated with the parents' reported drug use. ATOD prevention programs for young children merit greater emphasis.

No abstract

There are numerous advantages to basing nursing practice on evidence. Improvements in the quality of patient care, better patient outcomes, decreased healthcare costs, and enhanced work satisfaction for nurses have been described in the literature. Baptist Health Lexington, a community hospital, has experienced a successful 5-year journey integrating evidence-based practice as a result of the development of the Baptist Health Lexington Evidence-Based Practice Model. This journey is described below. Yearly activities, examples of projects, and clinical outcomes are presented.