Delivering Nursing Care: Current Factors to Consider

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It is important for patients to remember to take the prescribed treatments at all times. Studies have pointed out that in most cases patients do not stick to their medication programs. In fact, several surveys have indicated that more than a half of patients fail to carefully follow the description of their medication because they forget to do that. More studies have also revealed that many patients take a lesser dosage than recommended. It is against this context that health practitioners are expected to offer services and programs that enhance medical adherence among patients through Web-based devices, including their mobile phones, smartphones, iPads, landline telephone, or PC. Simple systems of medication reminders are significant for patients, who require assistance concerning their schedule. Application of mobile webs for medical services is beneficial in this aspect.

Literature Review

Several factors determine adherence behavior among African American men one of the main reasons being depression. African American male patients with chronic illnesses are at risk of suffering from depression and registering low adherence to medication as a result. Age also contributes to non-adherence behavior among African American men; younger men are reported to be more non-adherent compared to the older men (Lewis, Schoenthaler, and Ogedegbe 250-255).

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There is also evidence indicating that empathetic and cooperative communication with the provider plays a significant role in ensuring adherence in the male African Americans. Mobile web applications can improve African American’s communication with their providers encouraging the patients to carefully adhere to prescriptions (Saini 36-37). This is because studies have shown that hypertensive African Americans are at a favorable position in terms of accessing quality care compared to whites. This has been directly linked to their success in blood pressure control (Coombs 216-217).

Self-efficacy is also another important factor in determining adherence. It is a measure of individual patients’ confidence in remaining adherent to the prescribed medication (Lewis, Schoenthaler, and Ogedegbe 250-255). It is necessary to implement measures that increase their confidence in taking medication in compliance with the prescription.

Using mobile web apps as reminders and health education improves patient’s self-management in adhering to medication. This way, they are able to develop an adherence routine and deeper understanding of how to achieve better health through implementing health education information. Self-management involves strategies that assist patients to solve problems related to their hypertensive condition. These strategies are based on the fact that patients have a primary role in managing the condition through better health behaviors such as adherence (Coombs 216-217).

It is estimated that downloads of health-related information in the US may reach 142 million by 2016 as the use of smartphones to access health information increases. For instance, in 2011, almost seventeen million people retrieved such information through different forms of mobile technologies such as smartphones and cell phones. This was a 125 percent increase as compared to 2010. The health care system uses mobile technology apps to disseminate health plans and reminders at any time and from any location that allows recipients to receive immediately (Lewis, Schoenthaler, and Ogedegbe 250-255). It is an effective way of making health information more accessible in a convenient way. Specifically, this is essential as the population depending on Medicaid is growing.

African American patients have indicated that the existence of a trusting and genuine relationship with a provider allows them to adhere to medication and manage their treatment better. In developing good communication, patient centeredness and racially accommodative care approaches are important in offering quality care for African American males (Hekler et al. 391-400).

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Mobile web applications are the new ways of engaging and managing patients in Medicaid programs, particularly those with hypertension. Mobile technology is perceived to be widespread, cost-effective, and efficient in disseminating health information. It is also notable that health information positively impacts adherence, assists in mitigating medical mistakes, and improves general health outcomes (Bosl et al. e13).

The Potential Benefits of Addressing the Clinical Question in the Local Setting

The proliferation of mobile devices among African American male patients is promising. This is backed by the research done by Pew Internet and American Life Project indicating that the ownership of handsets in the US is higher among African Americans and Hispanics than among whites (Saini 36-37). It has also been reported that patients subscribed to text message reminder programs show more adherence to oral medication. Further, it assists them to sustain high adherence behavior over a prolonged period of time. This implies that hypertensive African American males enrolled in such programs shall register better adherence rates to medication and prevent the aggravation of the disease to more complicated situations such as strokes. 

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Poor adherence to prescribed medication may be a result of different causes. The most effective way to curb the problems that emanate from non-adherence is identifying the patients at risk of non-adherence. Mobile web applications assist the health care systems to implement stringent interventions on patients that are likely to follow the treatment regimens provided before the occurrence of the problem (Lewis et al. 199-206). The apps also enable physicians to identify African American male patients that are at risk of non-adherence. For instance, the MPR monitor app measures a thirty-day gap in a particular patient’s medical record and sends an alert to the clinician in case a patient has a gap that is greater than thirty days.

Implementation of the mobile web app among the African American male population may also save the United States an estimated $100 billion per year. The app presents authorized medical practitioners with information that is easy to review and make decisions on required action. This is particularly helpful after early detection of non-adherent patients (Bosl et al. e13). Implementation of the application also faces various challenges.

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Mobile web app interventions shall also be tailored to address the ethnic and race-based issues. It shall consider the issues such as distrust of care providers, normative beliefs, religious beliefs, and general misconceptions through health education and unbiased technology supported by instant communication with healthcare providers. This is in appreciation of the fact that understanding African American perceptions of adherence to antihypertensive medicines has a large impact on the development of appropriate interventions (Lewis et al. 199-206).

Although the digital gap between the different ethnic and racial groups in the US decreases, there is a burgeoning digital gap between the young and older patients. This is linked to differences in generational uptake of technology services that vary between the two generations (Saini 36-37). The generational divide in the adoption of technology poses a challenge to the implementation of the mobile web applications among the older African American male patients, especially because hypertension is more prevalent among the older generation than among the younger generation.

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Using the mobile web applications, patients receive guidance on how to monitor their adherence habits and prevent risks that may result from non-adherence such as stroke. They also receive information on benefits of adherence to medication as well as recommendations on dietary changes that assist them to better manage their dietary intake. It also helps African American males to get rid of misconceptions that hypertension may be treated with home-made regimens. It is an effective strategy that offers information about the etiology of hypertension to African American males. In addition, they should be given a responsibility to personally manage their condition using the knowledge they get (Hekler et al. 391-400).


Overall, mobile web applications are an efficient way of monitoring hypertensive patients’ adherence and their receipt of health education information. The technology also allows patients to get reminders of appointments from their medical practitioners, schedule appointments, receive test results through email, access electronic medical records, and use monitoring devices to monitor blood pressure levels and share that information with their doctors. This favors a beneficial communicative atmosphere and relationships between doctors and patients thus increasing positive health outcomes. It also reduces readmission to hospitals or nursing home and increases chances of positive health outcomes.

A mobile web app promotes better health outcomes because it allows physicians to get data on their patients’ prognosis without having to conduct routine checks. This allows them to have adequate time to concentrate on more serious hypertension cases requiring more intensive care. It also saves acute hypertensive patients from unnecessary trips to the physician’s office as well as saves physicians from making unproductive trips to see their patients. Mobile technology also impacts the growth of small businesses involved in communication services as more people access health information. Mobile technology is perceived to be widespread, cost-effective, and efficient in disseminating health information. Therefore, it is important that practitioners make use of this technology in not only improving the health outcomes but also making their work easier.


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