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Post-Test

According to a report in The American Journal of Managed Care in 2009, “Even though many excellent options exist for patients with diabetes, most are not meeting their glycemic goals.” This same report notes that “The healthcare system up to this point has not been able to combat the diet and lifestyle trends that have led to the prevalence of this disease.” The World Health Organization suggests that in the United States, dietary instructions may be adhered to by between 52-70%, exercise recommendations by 26-52%, and oral medications by 15-80%.
Adherence Barriers:
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•Most patients do not meet glucose control goals
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•Factors not always in patient control:
Aging, costs, insurance
•Relationship factors
Provide-patient
Family/support network-patient
•Patient medical conditions

 

 
 
Studies to date have identified many barriers to treatment adherence in diabetes. While we will limit our discussion to diabetes in this course, it should be noted that there is much in common with adherence to treatments in other disease states. Those items that are not determined by the client with diabetes include barriers such as cost and older age. Underinsurance can lead to decisions based on economic concerns rather than health needs. Other factors include items that make it difficult for clients to implement needed changes, such as a failure of the recommended treatments to fulfill patient health belief models, poor caregiver and patient relationships, and difficult family dynamics. In addition, depression, personality or other psychiatric disorders, and drug abuse can affect adherence to therapies.
Non-adherence can lead to adverse outcomes. Recurrent diabetic crisis, increased health care costs, and progression to irreversible vascular damage have been related to therapy non-adherence. Effective assessment of non-adherence issues and support for adherence to therapies can improve outcomes and reduce unnecessary health care costs.

http://www.guidelines.gov/summary/summary.aspx?ss=15&doc_id=14696&nbr=&string=

 

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