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PICOT and the Patient Population
PICOT: Among adult patients with type 2 diabetes in a nursing home, will the translation of Nelson et al’s research on the use of telehealth text messages compared to the current practice improve HbA1c levels in 12 weeks?
As highlighted in the PICOT, the selected patient population is adults with type 2 diabetes in a nursing home. Commonly, nursing homes have many adults with or at risk of diabetes due to advanced age, depression, and other factors. Effective and sustainable interventions are necessary since diabetes in older adults is associated with high mortality, reduced functional status, and increased vulnerability to cardiovascular complications (Asiimwe et al., 2020). Interventions should be tailored to the patient’s needs.
Several characteristics may impact socioeconomic/sociopolitical factors. For instance, high rates of diabetes affect people’s productivity hence lowering their income. Unproductive people are also unemployable, which may increase unemployment rates. From a sociopolitical dimension, type 2 diabetes increases healthcare costs by about $9,601 per person annually (American Diabetes Association, 2023). Such cost-related outcomes necessitate policies and advocacy initiatives at the community and national levels to protect populations. To achieve this goal, healthcare organizations should partner with government and community-based stakeholders to initiate sustainable health promotion programs.
These factors can influence patient outcomes and the financial viability of the organization in the community in multiple ways. When people understand the risks of type 2 diabetes, they will likely embrace programs that reduce the rates. For instance, they would be more positive to tailored messaging via telehealth, which is associated with diabetes medication adherence and improved hemoglobin levels (Dobson et al., 2020; Nelson et al., 2021). Advocacy, policies, and partnership can help the organization sustain its community programs due to a communal approach to a health problem. Such an approach reduces spending hence improving financial viability. Community-based approaches align with the norms of the U.S. healthcare system since they ensure health problems are addressed at the local levels. They further ensure that patients and populations understand their health problems, participate actively in health programs and that interventions are tailored to address patients’ needs.
American Diabetes Association. (2023). The cost of diabetes. https://diabetes.org/about-us/statistics/cost-diabetes#:~:text=People%20with%20diagnosed%20diabetes%20incur,in%20the%20absence%20of%20diabetes.
Asiimwe, D., Mauti, G. O., & Kiconco, R. (2020). Prevalence and risk factors associated with type 2 diabetes in elderly patients aged 45-80 years at Kanungu District. Journal of Diabetes Research, 2020, 1-5. https://doi.org/10.1155/2020/5152146
Dobson, R., Whittaker, R., Jiang, Y., McNamara, C., Shepherd, M., Maddison, R., … & Murphy, R. (2020). Long‐term follow‐up of a randomized controlled trial of a text‐message diabetes self‐management support programme, SMS4BG. Diabetic Medicine, 37(2), 311-318. https://doi.org/10.1111/dme.14182
Nelson, L. A., Greevy, R. A., Spieker, A., Wallston, K. A., Elasy, T. A., Kripalani, S., Gentry, C., Bergner, E. M., LeStourgeon, L. M., Williamson, S. E., & Mayberry, L. S. (2021). Effects of a tailored text messaging intervention among diverse adults with type 2 Diabetes: Evidence from the 15-Month REACH randomized controlled trial. Diabetes Care, 44(1), 26–34. https://doi.org/10.2337/dc20-0961
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