Patient Medication Education for Chronic Diseases

PICOT Question

In elderly patients with chronic diseases, (I) do patient education intervention, (C) compared with only medication treatments, (O) increase their health knowledge and improve their health status (T) in a period of 6 months?

To answer the PICOT question, it is necessary to conduct a study that will observe a particular group of people with chronic diagnoses. The group must be educated as to the use of appropriate medications for six months. As people will be capable of treating themselves with particular medicaments, the results will either prove or refute the questions above.

Another sound suggestion to the study would be to make the education classes not more than twice a week. Otherwise, an informational overload might be possible in case if all this knowledge is delivered to patients who have chronic diagnoses. Also, an individual approach must be considered here because all the participants will have different diseases that require varying treatment processes and outcomes.

Evidence Synthesis

The Lancet	Study #1	Study #2	Study #3	Study #4	Study #5	Synthesis
(p) Population	Nursing professors and practitioners from the United States of America	Nursing programmers and educators employed by the Department of Medicine and Community Health Sciences, the Cumming School of Medicine, and the University of Calgary in Canada	Nursing professionals and scholars from the Patient Education Research Center, the School of Medicine, and Stanford University situated in the USA.	Medical professors from the University of Washington and employees of the Group Health Research Institute.	Nursing practitioners who work at the Department of Economics at the Canadian University of Saskatchewan.	As all the articles are performed and released by professional educators in the sphere of medicine, their observations and conclusions can be trusted and considered reliable.
(i) Intervention	Educating groups of patients to prevent the development of their chronic diseases.	Intervention 1will be enrolment in a new drug formulary (operationalized through their existing government drug insurance) that will eliminate copayments for high-value preventive medications (those which prevent myocardial infarction, strokes, hospitalizations and delay the progression of kidney and other vascular diseases) (Campbell et al., 2015).	Performance of the CDSMP (Chronic Disease Self-Management Program) will be organized to help people with serious diagnoses to overcome their health issues with the help of activities that they will be taught during the upcoming lectures.	The impacts of what is called mHealth on patients understanding and the use of appropriate medicaments.	Education of groups with diagnoses of asthma and COPD (chronic obstructive pulmonary disease).	All the interventions imply programs and courses aimed at educating people with chronic diseases.
(c) Comparison	The results regarding the patients knowledge were evaluated after the study	The participants knowledge was assessed before and after the experiment	No evaluation	The participants knowledge was assessed after the experiment	Results were evaluated at the end of the study	The major part of the conclusions was made at the end of the research.
(o) Outcome	Participant understand when it is necessary to take medications	Changes in medication self-efficacy and adherence to acquired knowledge (Campbell et al., 2015).	The study participants have enough knowledge to treat themselves	mAdherence showed positive results regarding patients self-treatment.	COPS and asthma patients can now utilize their chronic diseases. The study suggests that effective patient education and increasing access to spirometry increases the utilization of chronic disease management drugs among asthma and COPD patients (Sari & Osman, 2015).	Participants of almost all studies benefited from their education sessions.
(t) time	Not stated	6 months	Not stated	6 months	2 months	The chosen authors had enough time to answer the PICOT question.

Evaluation Table

Citation	Design	Sample size: Adequate?	Major Variables: Independent and Dependent	Study findings: Strengths and Weaknesses	Level of Evidence	Evidence Synthesis
1. Bauer, U. E., Briss, P. A., Goodman, R. A., & Bowman, B. A. (2014). Prevention of chronic disease in the 21st century: Elimination of the leading preventable causes of premature death and disability in the USA. The Lancet, 384(9937), 45-52. doi:10.1016/s0140-6736(14)60648-6	A qualitative study that evaluates results and other authors observations	The sample size is not stated. However, it can be claimed adequate because all participants had various chronic diseases, which makes a decent diversity among the sample members.	The Independent variable implies chronic disease in the patients (Bauer, Briss, Goodman, & Bowman, 2014). The dependent variable is their level of knowledge regarding self-treatment	Strengths: Identification of many factors impacted by self-treatment. Weaknesses: Many uncertainties and unmentioned facts as to the treatment of patients.	Level III	Although patients were not approached during the study, the importance of collaborative education sessions is evident as only one nurse is not able to provide appropriate knowledge to all his or her patients efficiently (Bauer et al., 2014).
2. Campbell, D. J., Tonelli, M., Hemmelgarn, B., Mitchell, C., Tsuyuki, R., Ivers, N.,& Manns, B. (2015). Assessing outcomes of enhanced chronic disease care through patient education and a value-based formulary study (ACCESS)Study protocol for a 2Ã—2 factorial randomized trial. Implementation Science, 11(1), 25-46. doi:10.1186/s13012-016-0491-6	A quasi-experimental study that assessed the patients knowledge at the end (Campbell et al., 2015).	4714 people took part in the study. Hence, the results are adequate.	The Independent variable is the difference in medical adherence (Campbell et al., 2015). Dependent variable: methods of education and analyses.	Strengths: an extended sample. Weaknesses: no weaknesses were identified in the study	Level IV	Patient interaction appears to be one of the most important factors in education practices as it helps them remember the learned information much quicker than usual.
3. Lorig, K. (2015). Chronic disease self-management program: Insights from the eye of the storm. Frontiers in Public Health, 2(1), 36-54. doi:10.3389/fpubh.2014.00253	A literature review was performed by the author	No patients participated in the study because it only implied a literature review.	The Independent variable is the location of participants (Lorig, 2015). The dependent variable is their implementation of the acquired knowledge.	Strengths: The provision of useful and unique information that was never discussed before (Lorig, 2015). Weaknesses: the lack of real-life examples.	Level IV	The evidence of the study cannot be claimed relevant because this source is the first one to discuss approaches presented in it (Lorig, 2015). However, this knowledge is useful, and hence, can be implemented in practice.
4. Hamine, S., Gerth-Guyette, E., Faulx, D., Green, B. B., & Ginsburg, A. S. (2015). Impact of mHealth chronic disease management on treatment adherence and patient outcomes: A systematic review. Journal of Medical Internet Research, 17(2), 52-88. doi:10.2196/jmir.3951	The article presents a quantitative study based on survey results.	According to the authors, sample sizes varied tremendously (from 4 to approximately 710) (Hamine, Gerth-Guyette, Faulx, Green, & Ginsburg, 2015). This example is not adequate due to the sample sizes uncertainty.	The Independent variable was presented by a wide range of study objectives, methods, and results. In turn, the dependent variable explained what were the benefits of mHealth to the patients.	Strengths: a prolonged experiment with considerations of previous studies results (Hamine et al., 2015). Weaknesses: no weaknesses were identified in the research.	Level IV	The use of m Health is now known all over the world because its efficiency in the education of old people with chronic diseases was confirmed by many European and American scholars.
5. Sari, N., & Osman, M. (2015). The effects of patient education programs on medication use among asthma and COPD patients: A propensity score matching with a difference-in-difference regression approach. BMC Health Services Research, 15(1), 91-126. doi:10.1186/s12913-015-0998-6	Using Saskatchewan administrative health databases, the impacts of the intervention on use of asthma and COPD medications were estimated for one to four years after the intervention using a difference in difference regression approach (Sari & Osman, 2015).	185 individuals with chronic diseases participated in the research, which is adequate	The Independent variable implies both the use and prices of prescription drugs (Sari & Osman, 2015). The dependent variable implies their appliance by sample members.	Strengths: focusing on a specific category of patients with chronic diseases (Sari & Osman, 2015). Weaknesses: no weaknesses were identified in the study.	Level IV	The auricle revealed the significance of adherence to appropriate medications by patients with both COPD and asthma (Sari & Osman, 2015). Otherwise, they might have to stay in hospital settings for an extended period.

References

Bauer, U. E., Briss, P. A., Goodman, R. A., & Bowman, B. A. (2014). Prevention of chronic disease in the 21st century: Elimination of the leading preventable causes of premature death and disability in the USA. The Lancet, 384(9937), 45-52. Web.

Campbell, D. J., Tonelli, M., Hemmelgarn, B., Mitchell, C., Tsuyuki, R., Ivers, N.,& Manns, B. (2015). Assessing outcomes of enhanced chronic disease care through patient education and a value-based formulary study (ACCESS)Study protocol for a 2Ã—2 factorial randomized trial. Implementation Science, 11(1), 25-46. Web.

Hamine, S., Gerth-Guyette, E., Faulx, D., Green, B. B., & Ginsburg, A. S. (2015). Impact of mHealth chronic disease management on treatment adherence and patient outcomes: A systematic review. Journal of Medical Internet Research, 17(2), 52-88. Web.

Lorig, K. (2015). Chronic disease self-management program: Insights from the eye of the storm. Frontiers in Public Health, 2(1), 36-54. Web.

Sari, N., & Osman, M. (2015). The effects of patient education programs on medication use among asthma and COPD patients: A propensity score matching with a difference-in-difference regression approach. BMC Health Services Research, 15(1), 91-126. Web.

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