Yousey, Yvonne

Committee Member

Hessler, Karen


Nursing Practice


University of Northern Colorado

Type of Resources


Place of Publication

Greeley (Colo.)


University of Northern Colorado

Date Created



170 pages

Digital Origin

Born digital


Primary non-adherence (PNA) to bisphosphonate medications has been recently identified to be as high as 30% in patients with osteoporosis or who are at risk for hip fracture. It is known that taking a bisphosphonate is the main course of defense in lowering patient risk and decreasing the hip fracture rate by 50%. However, if patients do not take their medication, they will not receive the benefit of fracture risk reduction that comes with it. This paper explored the testing and implementation of a protocol designed to improve the PNA rate and thus improve patient outcomes. This protocol used evidenced-based information that improved the provider-patient relationship through a telephone outreach protocol aided by a computer system that identified patients who had not picked up their medications from the pharmacy. The nurse practitioner (NP) coordinator targeted each patient and then worked the list of patients at risk until all patients had been contacted. The goal was to lower the PNA rate by 20% by targeting those patients who had not picked up their medications and by changing their behavior to develop an intention to pick up and take their bisphosphonate medication. This goal was reached as the PNA rate was reduced to 3.2%, although it might have been a combination of contributing factors that led to the decrease in rate and not the telephone outreach alone. The iv protocol was successful and was accepted into practice to be replicated throughout all of the medical centers within the organization.

Degree type


Degree Name


Local Identifiers


Rights Statement

Copyright is held by the author