PROBLEM
Healthcare professionals categorize a chronic disease as one lasting for more than three months. Type 2 diabetes lasts significantly longer making it a chronic illness. The disease’s prevalence has increased globally over the last decade making it one of the most common chronic disorders (CDC, 2014). The increase has been followed by a subsequent rise in mortality and morbidity rates connected to the disease’s complications thus the need for better control of the ailment.
Patients with the condition mostly receive treatment in the primary healthcare settings. As a result, they do not get the required attention as these settings are overwhelmed (Qiao, 2012). The patients suffer from a neurological, nephrological, ophthalmological, and vascular complication (Edelman & Henry, 2011). Complications result in renal failure, coronary heart disease stroke, and blindness. People with poorly controlled diabetes type 2 often receive medical intervention targeted at achieving good glycemic control (Edelman & Henry, 2011). However, Jeavons (2006) finds the effectiveness of this strategy is undermined by the reluctance of both the patients and doctors especially in cases where maximal oral treatment has not been successful. Therefore, better disease management strategies are needed to combat the increasing social and personal cost of therapy.
A new disease management program is proving effective in Germany, which involves workshops and regular meeting up between the patients and the doctors. During the workshops, patients share real life experiences that showcase the incorporation of their healthier behaviors in their lives. The results of these intervention efforts have seen a decrease in the mortality rates of patients. Patients in the chronic management program have seen been reported to have improved glycosylated hemoglobin A1c (HbA1c). Research on the program observed that apart from the improved HbA1c amounts, the level of glucose, and cholesterol in serum significantly reduced. These programs conversely vary in their level of effectiveness, design and amount of resources. In spite of the evidenced effectiveness, the program suffers from economic restrictions. Nonetheless, the benefits of the program outweigh the challenges faced.
Research background
The PICOT for this paper was: For patients with poorly controlled type 2 diabetes in primary care setting does the implementation of a chronic disease management program versus every six months follow-up visits impact glycemic values?
PICOT: P- (Population): Patients with poorly controlled type 2 diabetes in primary care settings
I- (issue of interest): The impact of chronic disease management on the glycemic values.
C- (Comparison group): No group of interest for comparison.
O- (Outcome): optimal glycemic levels and reduced levels of A1C.
T- (Time frame): A period of 6 months after the execution of management program.
Research Methodology
- Rigorous research in various databases: EBSCOhost, PubMed, Google Scholar, and Research Gate.
- Search items: type 2 diabetes, Chronic disease management, the impacts of type 2 diabetes, the prevalence rate of diabetes, poorly controlled diabetic patients, glycemic values in diabetic conditions, morbidity and mortality of type 2 diabetes, and interventional strategies in diabetic management.
- Studies limited to the last five years.
- The total numbers of articles obtained from the search were ten.
- They addressed issues such as evidence-based disease management like frequent follow-ups and chronic illness management. Other articles majored on the practical guidelines for managing type 2 diabetes.
- Observational studies, on the other hand, played an important role in bringing out the various impacts of diabetes intervention on patients.
- Randomized control trials were found in some studies to solidify the results of the intervention.
- The findings of the research proved that glycemic levels peaked within six months in patients undergoing chronic disease management.
Table 1: Major findings
Source: (CDC, 2016)
Strengths
- Researchers ensured that appropriate sampling procedures were used. e.g. purposive sampling and random sampling.
- Studies used comprised of both quantitative and qualitative researches, which were keen on answering the question for this research
- All studies used samples that were carefully chosen to meet this study’s objectives
Weaknesses
- Inaccuracy in information collected, which led to biasness, especially for non-experimental studies
- The researcher only used a limited number of secondary studies
Confidence
While the data used in this study was based on secondary research, there was a low risk of bias. Therefore, the researcher can have confidence in the presented results.
SUMMARY
- There has been a tremendous increase in the number of patient’s suffering from type 2 diabetes.
- This rise has led to the overload of the primary care settings as it is where the patients get treated.
- Some treatments have proved ineffective all together while others though capable do not provide the required amount of care for the patients.
- Therefore, chronic disorder management has been introduced in various countries, and studies show that it is the best solution so far. It is nevertheless faced with financial problems.
References
Campbell, D., Sargious, P., Lewanczuk, R., McBrien, K., Tonelli, M., Hemmelgarn, B., &
Manns, B. (2013). Use of chronic disease management programs for diabetes In Alberta’s primary care networks. Canadian Family Physician, 59 (2), e86-92. Retrieved from http://www.cfp.ca/content/59/2/e86.long
CDC. (2014). Diabetes tests. Retrieved from https://www.cdc.gov/features/diabetesfactsheet/
CDC. (2016). CDC’s chronic prevention system. Retrieved from https://www.cdc.gov/chronicdisease/about/prevention.htm
Edelman, S., & Henry, R. (2011). Diagnosis and management of type 2 diabetes. West Islip, N.Y.: Professional Communities
Frei, A., Herzog, S., Woitzek, K., Held, U., Senn, O., Rosemann, T., & Chmiel, C. (2012). Characteristics of poorly controlled Type 2 diabetes patients in Swiss primary care. Cardiovasc Diabetol, 11(1), 70. doi:10.1186/1475-2840-11-70
Hu, M., Zhou, Z., Zeng, F., & Sun, Z. (2012). Effects of Frequency of Follow-Up on Quality of Life of Type 2 Diabetes Patients on Oral Hypoglycemics. Diabetes Technology & Therapeutics, 14(9), 777-782. doi:10.1089/dia.2012.0037
Jeavons, D. (2006). Patients with Poorly controlled diabetes in primary care: healthcare clinicians’ belief and attitudes. Postgraduate Medical Journal, 82(967), 347-350. Doi:10.1136/pgmj.2005.039545
Qaio, Q. (2012). Epidemiology of type 2 diabetes. Sharjah, United Arab Emirates: Bentham Books.
