NURS FPX 8045 Assessment 7 Literature Review

NURS FPX 8045 Assessment 7 Literature Review

Name

Capella University

NURS-FPX 8045 Doctoral Writing and Professional Practice

Prof. Name

Date

Literature Review

Distinctive Elements of the Proposed Quality Improvement (QI) Project Compared to a Research Study

Existing literature extensively examines the incidence, prevalence, and pathogenesis of Type II Diabetes Mellitus (T2D) worldwide, with a particular emphasis on the American population. However, limited research focuses on non-drug adherence among T2D patients and the potential interventions for this issue (Foley et al., 2021). A five-year data analysis on drug adherence in T2D patients, conducted under the guidance of my preceptor, highlighted a lack of clarity on how to address non-drug adherence. This observation became the focus of this Quality Improvement (QI) project (Jensen et al., 2017). To address this gap, journal articles sourced from electronic databases such as PubMed, NCBI, and JSTOR will be reviewed. The project aims to answer the PICOT question and to increase awareness among T2D patients about the importance of medication adherence. Additionally, it seeks to improve the knowledge of clinical staff and physicians in managing T2D patients and aims to reduce the mortality rates associated with T2D.

Topic Scope and Purpose

This QI project focuses on reviewing literature concerning T2D patients, addressing three central themes that reflect gaps identified at my current practicum site. Each theme is crucial to the overarching argument, which targets the T2D patient population (Jensen et al., 2017). The project will analyze strengths and weaknesses, present counterarguments, provide a rebuttal, and conclude with evidence-based recommendations. The conclusion will outline future prospects for addressing non-adherence issues among T2D patients.

Identification of the Problem: Practice Gap

Clinical data from the past five years in my practicum facility revealed a significant practice gap in the adherence to prescribed diabetic medication among T2D patients. This consistent non-drug adherence behavior has been a major contributing factor to poor prognoses (Foley et al., 2021). Addressing this non-adherence issue is essential for effective intervention in my practicum setting (Jensen et al., 2017).

Argument Themes

T2D Incidence and Prevalence

Type II Diabetes Mellitus has had a profound impact on the global population, with 6.28% of individuals worldwide affected by 2017. In the U.S., the prevalence rate stands at 6,059 people per 100,000 (Khan et al., 2020). Non-adherence to prescribed medication among T2D patients ranges from 4% to 31%, leading to avoidable deaths. This theme highlights the critical need for interventions to increase awareness and adherence among T2D patients at my practicum facility.

Secondary Clinical Effects in T2D Patients

Non-adherence to prescribed medication in T2D patients can result in severe secondary clinical complications. About 56% of T2D patients face significant health challenges due to non-adherence, reinforcing the need for focused interventions (Rezaei et al., 2019). This theme directly connects with the identified problem of non-adherence and the necessity of addressing it through targeted strategies.

Proper Management of T2D

Proper management of T2D often goes beyond medication adherence. Many patients are unaware of the importance of managing their condition through non-drug interventions such as dietary modifications and physical exercise. These interventions can complement medication adherence and lead to optimal glycaemic control (Foley et al., 2021; Polonsky & Henry, 2016). This theme supports the QI project’s focus on addressing non-drug adherence among T2D patients.

Counterarguments

Some argue that adherence to prescribed medications is indispensable, especially considering the rapid metabolic changes that can be life-threatening for T2D patients (Al-Qerem et al., 2021). These views emphasize the importance of drug adherence in managing T2D, particularly when addressing age-related complications in the patient population.

Rebuttal: Intervention to Resolve the Problem

In response to the identified gap, the QI project proposes predicting non-adherence to medication among T2D patients. Identifying predictors such as lack of awareness, social and economic factors, and age can guide more effective interventions (Foley et al., 2021; Al-Qerem et al., 2021).

Recommendations and Conclusions

To improve adherence to T2D medications, it is recommended that physicians implement educational programs focusing on the severe consequences of T2D and the importance of adhering to prescribed treatments. Government support for low-income individuals is also critical, along with addressing mental, emotional, social, spiritual, developmental, and cultural needs. These interventions aim to enhance medication adherence and improve prognoses for T2D patients.

References

Al-Qerem, W., Jarab, A. S., Badinjki, M., Hyassat, D., & Qarqaz, R. (2021). Exploring variables associated with medication non-adherence in patients with type 2 diabetes mellitus. PLoS ONE, 16(8). https://doi.org/10.1371/journal.pone.0256666

Blackburn, D. F., Swidrovich, J., & Lemstra, M. (2013). Non-adherence in type 2 diabetes: Practical considerations for interpreting the literature. Patient Preference and Adherence, 7, 183–189. https://doi.org/10.2147/PPA.S30613

Foley, L., Larkin, J., Lombard-Vance, R., Murphy, A. W., Hynes, L., Galvin, E., & Molloy, G. J. (2021). Prevalence and predictors of medication non-Adherence among people living with multimorbidity: A systematic review and meta-Analysis. BMJ Open, 11(9). https://doi.org/10.1136/bmjopen-2020-044987

Jensen, M. L., Jørgensen, M. E., Hansen, E. H., Aagaard, L., & Carstensen, B. (2017). Long-term patterns of adherence to medication therapy among patients with type 2 diabetes mellitus in Denmark: The importance of initiation. PLoS ONE, 12(6). https://doi.org/10.1371/journal.pone.0179546

NURS FPX 8045 Assessment 7 Literature Review

Khan, M. A. B., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., & Kaabi, J. Al. (2020). Epidemiology of Type 2 diabetes – Global burden of disease and forecasted trends. Journal of Epidemiology and Global Health, 10(1), 107–111. https://doi.org/10.2991/JEGH.K.191028.001

Polonsky, W. H., & Henry, R. R. (2016). Poor medication adherence in type 2 diabetes: Recognizing the scope of the problem and its key contributors. Patient Preference and Adherence, 10, 1299–1306. https://doi.org/10.2147/PPA.S106821

Rezaei, M., Valiee, S., Tahan, M., Ebtekar, F., & Gheshlagh, R. G. (2019). Barriers of medication adherence in patients with type-2 diabetes: A pilot qualitative study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 12, 589–599. https://doi.org/10.2147/DMSO.S197159