Andie's Non-Adherence Summary

Diabetes has recently become a focal point of health care systems around the world due to its high prevalence and the severity of secondary complications caused by the disease. Over the course of my project on diabetes, I have had the opportunity to speak with a group of diabetics to understand from a patient’s perspective how diabetes is managed in a rural community. While I found that while some patients ignored treatment and refused to make any dietary changes, the majority of the patients I interviewed were well-informed and actively managing diabetes in their everyday life.

The majority of people will decide to change their health behavior throughout their lifetime. The reasons for the change might be quite different from individual to individual. Some may be motivated to take action after experiencing a life threatening illness, while others are proactive and change their health behavior to decrease the risks of developing a potential disease. However, even if the reasons for the change are valid and well understood, there is a great possibility that one will not follow set goals long term. Stacy Carter, an assistant of professor and an author of the Social Validity Manual, expresses her opinion about people implementing a scientifically proven health behavior change treatment in their routine, “if it's something that is going to cause them a lot of effort, or is difficult to implement, then they probably are not going to use it for long” (Cranford, 2011). Use number superscript 1

Diabetes is a serious medical condition that can also be a risk factor for the development of many different diseases and conditions including dementia, heart disease, and CVA. Thus, effective management of diabetes is very important. Patient compliance can be difficult to achieve if the person affected with diabetes is not educated about the illness or treatment, has not fully accepted the diagnosis or its severity, will not change habits or believes that the prescribed treatment regime is too difficult or ineffective, has cultural beliefs conflicting with the treatment regime, experiences stressful events, lacks social support, or suffers from psychiatric issues unrelated to diabetes (Gerard, Griffin, & Fitzpatrick, 2010). As one may expect, adequate education programs are essential tools when dealing with diabetics. Solid education will provide the patient with information as well as teaching the necessary skills to manage the disorder. The primary focus of any diabetes education program must be to empower patients as a part of the multidisciplinary team. This team should be focused at integrating diabetes into the lives of the patients and this focus should be based on the decisions made by the patient, otherwise the treatment plan can be looked on as forced (Gerald et al., 2010). Every patient stricken with diabetes has the right to benefit from an education program of this type. First, basic education and facts should be administered directly following the diagnosis of

Diabetes has become an epidemic in today’s society. Diabetes affects almost every system in the body, and with an estimated 346 million people in the world with diabetes, healthcare has been heavily affected by the disease (Ramasamy, Shrivastava, P., & Shrivastava, S., 2013). One of the biggest issues for healthcare workers when it comes to diabetes, is that it is such a complicated disease. With so many different systems being affected, medical professionals have had to learn how the disease process works, what causes diabetes to work through the systems, and the best treatments to address all these issues. Through much research, the healthcare system has grown very knowledgeable on diabetes. One important aspect of treating diabetes has been in the introduction of diabetic education. In the past, nurses and dieticians had been responsible for educating patients on diabetes, but now that role is also extended to other people in the healthcare team, including the patient (Tomky, 2013). In fact, patients taking an active role in the education process, including learning to self-care has now become a priority in diabetes treatment. The following paper will discuss diabetic education, the importance of self-care and how this affects a patient’s compliance.

Patient Adherence: There is no known cure for chronic disease, the progressive nature of chronic disease the patient and family must adjust to continual treatment changes, and the chronic disease continues throughout the patient’s lifetime developmental and lifestyle changes often influence or pose additional challenges to the person with a chronic

The confounding factor is that people do not always respond to information and make choices based on common rationale. For example research demonstrates that 1 in 5 prescriptions go unfilled after a treatment plan has been provided by a physician. Among patients being treated for chronic conditions such as diabetes, medication adherence is actually lowest. NEHI research estimates cost of medication non-adherence at 290 billion dollars annually in the U.S. The National Diabetes Prevention Program cites nearly 29 million people in the U.S. have diabetes which cost the U.S. healthcare system 176 billion dollars in 2012, despite diabetes being largely preventable with diet, exercise and not smoking. These and other examples such as missed physician appointments, misuse of emergency care services, and lack of commitment to healthier lifestyles demonstrates complexity in managing the human aspect of healthcare. If population health management programs are to be successful they must be able to effectively support various risk cohorts of patients in making decisions to maximize benefits from healthcare services. As healthcare organizations increase focus on keeping patients healthy, many organizations are questioning the most effective use of technology and support services to enable better decisions regarding health

Whilst nursing this particular female it was apparent that when her mental health deteriorated so did her management of diabetes, Walker & Rodgers (2010) state that one in five people with diabetes are likely to suffer from depression (pg 186) .The biggest pre-disposing complication that exacerbated Lizzies long term conditions was her medication non-compliance and her inability to give consent for treatment that would promote her recovery and prevent hospital admission. The definition of compliance is a term used to describe how well a patient’s behaviour is following medical advice (The free dictionary, 2008).A shared decision was made that established that Lizzie lacked capacity and safeguarding provisions were implemented to

My paternal grandmother, Lucille, has many chronic conditions, yet we decided to focus on her diabetes for the majority of questions concerning her health and wellness. When asked, Lucille could not remember when she was first diagnosed with diabetes, but does remember when she “switched from taking pills to taking insulin.” She began taking insulin the spring of 2009 after her doctor decided it was time to switch. She has had two incidences where her blood sugar was so low that she could not even call out for help. Both times were in the night and thankfully at that time her husband (my grandfather) found her and was able to get the necessary help. After these incidences, she switched to taking her insulin in the morning instead of before bed.

Noreen and Janevic (2013) believe that the success of patients’ preventive and curative interventions depends on the individual’s willingness to take responsibility for and maintain the necessary behaviors. Sadly, studies have shown that there is poor adherence to recommended changes in lifestyle and behaviors including attending scheduled appointments for treatments (which are missed 35% of the time) and compliance prescribed medication. Due to the evidence of subpar participation in preventive care such as screening and immunization efforts, behavioral scientist have dedicated more research to studying and identifying what determines individual’s health behaviors. This is how individual theories of health behavioral change were developed.

My teaching on primary prevention of type II diabetes adheres to HP2020 objectives D-1 to D-16 on diabetes, specifically objective D-1 that deals with reducing the annual number of new cases of diagnosed diabetes in the population. (Target is a 10% improvement from the baseline of 8.0 new cases of diabetes per 1,000 population aged 18 to 84 years occurred in the past 12 months to the target of 7.2 new cases per 1,000 population aged 18 to 84 years). Education on the preventive measures needed to be taken by an at-risk population tackles this issue of reducing the annual number of cases.

Boskey (2014) concludes that a person’s willingness to change their health behaviors includes perceived susceptibility, perceived severity, perceived barriers, and cues to action and self-efficacy. For example, Carpenter (2010) report the Health Belief Model stipulates that a change may occur if individuals see an adverse health outcome to be severe and perceive them to be vulnerable to it. Other perceptions include benefits of behaviors that reduce the likelihood of that outcome to be high, and the barriers to adopting those behaviors low (Carter, 2010). Furthermore, the HBM addresses the relationship between a person’s beliefs and behaviors. It provides a way of understanding and predicting how clients will behave about their health and how they will comply with healthcare therapies (Boskey, 2014).

Living with diabetes poses many challenges for patients in areas like nutrition, glycemic monitoring and medication adherence. In fact, patients with diabetes

First, the HBM insist individuals are likely to change behavior if they believe they are susceptible to certain condition, and the condition is severe enough. Cues to action provide a guide for individual to engage in the healthy behaviors. Benefits must overrule barriers, and the individual must have confidence that he or she can engage in this healthy behavior for the change to occur. To illustrate, one of the diabetes healthy people 2020 objective is to “Increase the proportion of adults with diabetes who perform self-blood glucose-monitoring at least once daily”

The review of literature section will define diabetes and prediabetes, identify the prevalence and major risk factors for diabetes, and present behavioral changes that can reduced the risk of developing diabetes. This section discusses the types of presentations and teaching methods that have been utilized in diabetes prevention and the health belief model. The final paragraphs in the review of literature present the learning theory and delivery method of instructional designs, which are ideal for a diabetes prevention program.

Diabetes is associated with wide range of complications such as chronic renal failure, blindness, amputations, heart disease, high blood pressure, stroke, and neuropathy (Alotabi, A., et al., 2016). There is no known cure for diabetes, but the disease can be controlled through health management that includes multiple perspectives of care such as medications, blood glucose monitoring, diet, nutrition, screening for long-term complications and regular physical activity (Alotabi, A., et al., 2016). Managing diabetes may be complicated and requires the knowledge and skills of both healthcare providers and the clients. Studies have shown that to prevent or delay diabetic complications due to diabetes, counseling and other lifestyle interventions are the effective therapy. Even with many policies set up for diabetes, 8.1 million Americans are undiagnosed with diabetes mellitus, and approximately 86 million Americans ages 20 and older have blood glucose levels that considerably increase their risk of developing Diabetes Mellitus in the next several years (CDC, 2015). For diabetes care to be successful there needs to be a good understanding of the disease and management by both patients and healthcare providers,