How to write a nursing essay on Barriers to Diabetes Treatment in a Community Primary Care Clinic (Solved)
Diabetes mellitus is a chronic condition affecting both developed and resource-limited countries. The disease causes a considerable burden to countries by increasing mortality and morbidity alongside inside healthcare costs (Lin et al., 2020). In the United States, diabetes is the leading cause of death and disproportionately affects minority groups. The effective management of diabetes mellitus involves various aspects like pharmacological treatment, education, psychosocial support, and behavioral diabetes care. There should be clear definitions of these services nationally and locally to ensure patients access diabetes management services including treatment (Khan et al., 2020). Despite the availability of various support mechanisms for patients, diabetes is still a problem for many people. Inadequate control of diabetes continues to challenge the healthcare system despite advances in technology, diagnosis, and treatment.
The rising burden of type 2 diabetes is a major concern for healthcare systems worldwide. The disease affects the functional capacities of affected individuals leading to premature mortality and many other complications (Lin et al., 2020). For instance, recent reports indicate that more than one-third of diabetes-related deaths occur among those aged below 60 years. The prevalence of the disease in the country is about 11% in African Americans and 8% in Caucasians (Lin et al., 2018). Disparities in the prevalence of the disease are significant due to genetics and other lifestyle-related factors. The prevalence of the disease in African Americans is 4 times higher than non-Hispanic Whites, and one can only imagine the mortality and morbidity rates given the socio-economic gap between the two races (Lin et al., 2018). The majority of the population is aware of treatment approaches and preventive strategies to effectively manage the disease. The presence of certain barriers like socio-economic status, poor glycemic control, and knowledge deficit makes it difficult to manage the disease. There is a need to shift the focus to addressing barriers that contribute to poor management of the disease.
The control of blood glucose, blood pressure, blood cholesterol levels, and other targets remain suboptimal for many patients with diabetes (Khan et al., 2020). One of the most important parameters that dictate the effective management of diabetes is glycemic control. Tight glycemic control of hemoglobin A1c (HbA1c) levels is observed to prevent the slow progression of complications like neuropathy, retinopathy, and nephropathy in patients with diabetes. To effectively manage diabetes, HbA1c levels should be maintained below 7% or 53 mmol/mol (Rodríguez-Gutiérrez et al., 2016). Failure of clinicians to intensify therapy to achieve this target is among the key areas that should be assessed to effectively control diabetes. Barriers that hinder clinicians from tailoring care towards achieving tight glycemic control should be identified and addressed promptly.
Although extensive actions have been taken to address the problem of type 2 diabetes, some issues arise preventing the achievement of set goals. These obstacles can originate from affected individuals, primary care settings, or national healthcare governance (Adu et al., 2019). Most routine diabetes management, especially diabetes mellitus control, is undertaken in primary care. One can argue that the existence of barriers that prevent access and delivery of services to patients in primary care clinics is a major contributor to poor diabetes management. These settings regularly attend to patients, review their charts, and utilize a shared care model for chronic disease to improve patient outcomes. Understanding factors that influence clinical behaviors is crucial in selecting and enhancing interventions to improve diabetes care practices. The unexplained variation in the delivery and outcomes of diabetes care necessitates investigations into the attributable patient, clinician, and organizational barriers to diabetes treatment.
The care of patients with diabetes encompasses new and more efficacious strategies to reduce the burden of the disease in society. Discovering the barriers limiting treatment and prevention of the disease in primary care can ensure the deployed measures are more effective. For instance, barriers to access to healthcare services like lack of health insurance hinder patients from receiving modern treatments that are costly (Adu et al., 2019). This research can help primary care providers to utilize available treatment and prevention measures across all populations. Secondly, the quality of life of people living with chronic conditions is a key priority during treatment. The majority of the affected people are at risk of developing serious health complications that endanger their life. In 2015, there was a 60% increase in the mortality rate for those with the disease compared to early 2000 (Adu et al., 2019). identifying barriers to diabetes treatment can help primary care providers and other key players to design strategies that can improve the quality of life of affected individuals.
Overview of the Problem
Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin or when the body fails to effectively use the produced insulin (World Health Organization (WHO), 2021). Type 1 diabetes represents a condition where the body does not produce sufficient insulin leading to the daily administration of artificial insulin. Type 2 diabetes is the most common and it represents a condition where the body is unable to utilize produced insulin. Individuals with diabetes, especially the elderly have an increased risk of heart attacks and strokes alongside complications like neuropathies and kidney failure (WHO, 2021). During the management of the disease, emphasis is put on lifestyle changes that can prevent the onset of the disease like healthy eating and physical activity. The most important aspect of diabetes treatment is the control of glucose levels below the minimum value. Hemoglobin A1c (HbA1c) levels are a test that is closely monitored by healthcare providers to determine if diabetes is under control (Rodríguez-Gutiérrez et al., 2016). While working towards the prevention and treatment of diabetes, various barriers exist and must be addressed to effectively minimize the burden of the disease globally.
Assessment of type 2 diabetes treatment and its prevention is vital in the primary care setting. The disease can pose serious health problems and complications to affected individuals if left untreated. Additionally, there is a significant burden of the disease on family members and society. Diabetes is one of the largest global health concerns that pose a burden to the health and socio-economic development of countries. The International Diabetes Federation (IDF) estimates that about 451 million people are affected worldwide and it is projected that 693 million will have the disease by 2045 (Lin et al., 2020). In the United States, the population of people aged 18 years and above with diabetes quadrupled from 5.5 million in 1980 to 21.9 million in 2014 (Lin et al., 2018). There are various reasons to explain these changes including lifestyle changes and challenges with healthcare access. To combat the increasing prevalence of the disease, addressing barriers to healthcare access is among the key strategies.
Primary care providers deliver the majority of care for patients with chronic conditions like diabetes. To effectively manage the disease, the healthcare system must be prepared to address barriers that originate from primary care delivery of services. For instance, healthcare centers must be ready to provide proactive, population-based patient management to effectively control the disease (Rushforth et al., 2016). The providers must have access to universal clinical information including modern strategies to manage diabetes. Additionally, the availability of support from the administration and public health sector should be consistent to deal with the disease. The increasing burden of diabetes in the country demonstrates gaps in healthcare systems. This research aims at identifying the reasons behind poor control of diabetes in primary care settings. Another key area of this research is to identify barriers to self-management of diabetes that makes it difficult for healthcare providers to intervene. The completion of this research will see the recommendation of the most appropriate approaches to manage barriers to diabetes treatment in primary care centers.
Diabetes is a disease with a significant global impact on mortality and morbidity from chronic diseases. One of the reasons why this topic is important is because it can reduce the mortality and morbidity that results from diabetes. For instance, the World Health Organization report indicates that premature mortality from diabetes increased by 5% from the year 2000 to 2016 (WHO, 2021). In 2019, diabetes was the direct cause of mortality for 1.5 million people, and 48% of these deaths occurred in people aged below 70 years (WHO, 2021). These statistics indicate that managing diabetes mellitus at early stages can greatly reduce the number of those dying prematurely from the disease. Identifying barriers to diabetes management in primary care centers is a topic that can help to address the increased mortality from chronic disease.
Everyone dealing with diabetes and other chronic diseases knows the aspect of cost and how it influences access to the required services. There has been a direct increase in the cost of managing patients with diabetes since 2002 and it is likely to be huge in the future (WHO, 2021). Identifying barriers to diabetes treatment in primary care can help to address the issue of cost in healthcare. Recent analysis shows that the cost of diabetes management increased from 11% in 2012 to 13% per individual in 2013 (Riddle & Herman, 2018). In the US, the cost of diabetes management in 2017 was $237 billion with 1 in 4 US dollars spent in managing the disease (Riddle & Herman, 2018). Identifying barriers to diabetes treatment can reduce the costs associated with the disease by reducing the number of projects designed to control the disease.
Adu, M. D., Malabu, U. H., Malau-Aduli, A., & Malau-Aduli, B. S. (2019). Enablers and barriers to effective diabetes self-management: A multi-national investigation. PloS One, 14(6), e0217771. https://doi.org/10.1371/journal.pone.0217771
Khan, M., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., & Al Kaabi, J. (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
Lin, Ji, Theodore J. Thompson, Yiling J. Cheng, Xiaohui Zhuo, Ping Zhang, Edward Gregg, and Deborah B. Rolka. “Projection of the future diabetes burden in the United States through 2060.” Population Health Metrics 16, no. 1 (2018): 1-9. https://doi.org/10.1186/s12963-018-0166-4
Lin, X., Xu, Y., Pan, X., Xu, J., Ding, Y., Sun, X., … & Shan, P. F. (2020). Global, regional, and national burden and trend of diabetes in 195 countries and territories: An analysis from 1990 to 2025. Scientific Reports, 10(1), 1-11. https://doi.org/10.1038/s41598-020-71908-9
Riddle, M. C., & Herman, W. H. (2018). The cost of diabetes care—an elephant in the room. Diabetes Care, 41(5), 929-932. https://doi.org/10.2337/dci18-0012
Rodríguez-Gutiérrez, R., & Montori, V. M. (2016). Glycemic control for patients with type 2 diabetes mellitus: Our evolving faith in the face of evidence. Circulation. Cardiovascular Quality and Outcomes, 9(5), 504–512. https://doi.org/10.1161/CIRCOUTCOMES.116.002901
Rushforth, B., McCrorie, C., Glidewell, L., Midgley, E., & Foy, R. (2016). Barriers to effective management of type 2 diabetes in primary care: Qualitative systematic review. The British Journal of General Practice : The Journal of the Royal College of General Practitioners, 66(643), e114–e127. https://doi.org/10.3399/bjgp16X683509
World Health Organization. (2021). Diabetes: Key facts. https://www.who.int/news-room/fact-sheets/detail/diabetes
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