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NURS FPX 8045 Assessment 7 Literature Review

Student Name

Capella University

NURS-FPX 8045 Doctoral Writing and Professional Practice

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Date

Literature Review

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

The literature extensively explores the incidence, prevalence, and pathogenesis of Type II Diabetes Mellitus (T2D) globally, with a specific focus on American society. However, limited research exists on non-drug adherence in T2D patients and potential interventions (Foley et al., 2021). Based on a five-year data analysis on drug adherence in T2D patients conducted under my preceptor’s guidance, a lack of clarity emerged on addressing non-drug adherence, leading to the focus of this QI project (Jensen et al., 2017). Journal articles, identified through electronic databases like PubMed, NCBI, and JSTOR, will be utilized to address the literature gap and the PICOT question. Anticipated outcomes include increased awareness among T2D patients regarding the importance of medication adherence, enhanced knowledge among clinical staff and physicians on managing T2D patients, and a significant reduction in T2D-related mortality rates.

Topic Scope and Purpose

This QI project aims to review literature on T2D patients, focusing on three central themes that reflect gaps in the literature within my current practicum facility. Each theme contributes to the major argument, targeting the T2D patient population (Jensen et al., 2017). The project will discuss strengths and weaknesses, present counterarguments, provide a rebuttal, and offer analytical recommendations. The conclusion will be evidence-based, outlining future prospects for T2D patients facing non-adherence issues.

Identification of the Problem: Practice Gap

Analysis of clinical data over the past five years in my practicum facility revealed a practice gap in non-adherence to diabetic medication among Type II diabetes patients. The consistent non-drug adherence behavior observed among T2D patients has been a significant factor in poor prognoses (Foley et al., 2021). Addressing this non-adherence issue is crucial for effective intervention at my practicum site (Jensen et al., 2017).

Argument Theme 1: T2D Incidence and Prevalence

T2D significantly impacts the global population, affecting 6.28% of the world population by 2017. In the U.S., the prevalence rate is 6059 people per 100,000 (Khan et al., 2020). Non-adherence to prescribed drugs among T2D patients ranges from 4 to 31%, contributing to avoidable deaths. This theme is essential for intervention as it addresses the awareness and adherence issues among T2D patients in my practicum facility.

Argument Theme 2: Secondary Clinical Effects in T2D Patients

Untreated or poorly managed T2D can lead to secondary clinical challenges, with 56% of patients facing difficulties due to non-adherence (Rezaei et al., 2019). This theme directly correlates with the problem statement, emphasizing the need for effective interventions to address non-adherence issues in T2D patients.

Argument Theme 3: Proper Management of T2D

Many T2D patients lack awareness of the importance of managing their condition. Non-drug interventions, including dietary changes and physical exercise, can complement medication adherence, contributing to optimal glycaemic control (Foley et al., 2021; Polonsky & Henry, 2016). This theme aligns with addressing non-drug adherence issues among T2D patients.

Counterarguments

Contrary views highlight the indispensability of adhering to prescribed drugs, especially in the face of rapid metabolic changes that could be life-threatening for diabetic patients (Al-Qerem et al., 2021). Recognizing the gap in age considerations for secondary clinical effects emphasizes the need for a comprehensive approach to non-drug adherence in the T2D population.

Rebuttal: Intervention to Resolve the Problem

To address the identified gap, predicting non-adherence to T2D drugs among patients is proposed as a strategy. Identification of predictors, such as lack of awareness, social and economic status, and age, will guide targeted interventions (Foley et al., 2021; Al-Qerem et al., 2021).

Recommendations and Conclusions

Physicians should develop educational programs, emphasizing the extreme effects of T2D and the importance of adhering to prescribed drugs. Government support for destitute individuals and addressing broader patient needs, including mental, emotional, social, spiritual, developmental, and cultural aspects, is crucial. These interventions aim to enhance adherence to T2D drugs and improve prognoses.

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

NURS FPX 8045 Assessment 7 Literature Review

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

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

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