Poor Medication Adherence in Type 2 Diabetes - Essay Example

"Poor Medication Adherence in Type 2 Diabetes" is a great example of a paper on Diabetes Mellitus. Type 2 Diabetes Mellitus (T2DM) is a serious ailment affecting millions of Americans today. One of the biggest challenges affecting T2DM therapy is the lack of compliance with medication for achieving glycemic control (Shams et al., 2016). Therefore, drug non-adherence presents the single most important risk factor for mortality and health degradation among T2DM patients. One of the strategies that have been proposed for reducing drug non-compliance is self-management education (Sherifali et al., 2018). Self-management education refers to dedicated education programs that assist individuals with health conditions to learn how to improve their quality of life. The implication of such an education is living a less stressful life with more energy and the ability to engage in whatever activity one desires. The suggested self-management education program is aimed at adults with T2DM.
b) Significance of the problem in terms of outcomes or statistics
Lack of drug adherence is a leading cause of preventable death among sufferers of T2DM. Poor drug adherence in patients with T2DM is a common situation that is well documented as a leading cause of inadequate glycemic control and increased mortality and morbidity among individuals with T2DM (Polonsky & Henry, 2016). Other problems associated with non-adherence to T2DM medication include increased cost of hospitalization, outpatient care, and a rise in the number of comorbid complications of the disease.
Statistically, about 45% of individuals with T2DM fail to achieve adequate glycemic control of HbA1c <7% (Qaseem et al., 2018). Studies have indicated that one of the main factors contributing to inadequate glycemic control is poor adherence to medication. Accordingly, lack of drug adherence is linked to several non-patient factors such as lack of integrated medical care in most healthcare systems., demographic factors of patients, and patient belief regarding medication. The focus of strategy for encouraging adherence to T2DM medication should include reducing the level of medication burden and taking care of patient concerns regarding negative patient beliefs regarding medication.
Improved adherence to medication can impact the quality of lives of T2DM patients while also lowering medication costs. According to Jha et al. (2012), patients with T2DM who practice medication adherence had reported a 13% reduction in the number of ER visits or risk of hospitalization. Additionally, the authors mentioned that worsening adherence was linked to a 15% increase in the levels of ER visits and hospitalization. Based on their analysis, it was quantified that improved adherence has the potential of saving the US taxpayer a total of $4.7 billion per annum. Another study conducted by Egede et al. (2012) revealed that while poor adherent patients lead to 7% lower outpatient care costs, their situation can lead to a 41% increase in outpatient care. Therefore, it's quite clear that improving drug adherence among T2DM patients can improve the level of care and health outcomes for T2DM patients while also reducing the costs of care for such patients.
c) Your PICOT question in support of the group topic
The PICOT question is an important element of evidence-based practice in nursing (Robertson, 2018). The PICOT question in support of the group question was as follows-“In the adult patient with type 2 Diabetes Mellitus (T2DM), can a month-long self-management education program delivered online lead to an improvement of the patient's self-care knowledge and achievement of daily glycemic control in comparison to standard care?
d) Purpose of your paper
The paper aims to highlight the key processes of the search strategy for identifying two critical studies for supporting the benefits of self-management education programs for adults with T2DM. They wish for the achievement of daily levels of glycemic control. Therefore, the paper is about the methods for identifying studies for supporting evidence-based practice in the management of T2DM via improved self-care based on evidence-based practices identified and instilled on patients via their month-long self-management education program
b. Levels of Evidence
a) Type of question asked
The level of evidence supporting self-management education shall be limited to positive health outcomes tied to evidence-based studies as described in two key studies of choice
b) Best evidence found to answer question
The best evidence found for answering the question is based on the level of improved patient outcomes following participation in structured self-management education programs. The best evidence employs statistical methods to gauge the level of success that’s achievable from implementing self-management education programs to achieve glycemic control.
c. Search Strategy
a. Search terms
The search strategy involved using search terms and Boolean operators to include the most important elements of the study. The key terms that were used were "self-management education," "glycemic control," "diabetes mellitus," "T2DM,", and “efficacy."
b. Databases used (you may use Google Scholar in addition to the library databases; start with the Library)
The databases that were used included EBSCOHOST, ProQuest, PsychInfo, MedLine, and Google Scholar.
c. Refinement decisions made
Refinement was achieved using a publication timeline to limit the results to studies that were less than five years old. That level of refinement was targeted to maintain the relevance and integrity of academic sources.
d. Identification of the two most relevant articles
From the analysis, the two most relevant articles that were identified from the search criteria were the works of Wichit et al. (2017) and Moreno et al. (2019). The two studies contained an element of efficacy and best evidence-based practices for achieving successful self-management education for T2DM patients.