Develop a clinical practice question using PICO(T) that focuses on a clinical issue to improve the quality of care. : 1. As a team, you will identify a clinical problem/opportunity, draft a PICOT question. 2. Review the literature (using the articles you are reading for your weekly summaries, if possible), make recommendations.
Clinical Practice Question:
In patients with type 2 diabetes mellitus, does structured and intensive education on self-management (P) compared to standard diabetes education (C) lead to improved glycemic control (O) within a 12-month period (T)?
Introduction:
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and relative insulin deficiency (American Diabetes Association, 2019). It has become a global public health problem, with an estimated 463 million individuals affected worldwide in 2019, and this number is projected to rise to 700 million by 2045 (Saeedi et al., 2019). Poor glycemic control is a significant concern in T2DM, as persistent hyperglycemia can lead to various microvascular and macrovascular complications, such as diabetic retinopathy, nephropathy, neuropathy, cardiovascular diseases, and increased mortality rates (American Diabetes Association, 2020).
To address the need for effective management strategies in T2DM, healthcare providers have implemented various health education interventions. However, the optimal approach to delivering diabetes education remains uncertain. The aim of this study is to investigate whether structured and intensive education on self-management leads to improved glycemic control in patients with T2DM compared to standard diabetes education.
Methods:
This study will employ a systematic review of the literature using databases such as PubMed, Cochrane Library, and Scopus. The search strategy will include keywords such as “type 2 diabetes,” “self-management education,” “structured education,” “glycemic control,” and “randomized controlled trials.” The inclusion criteria will be as follows:
1. Participants: Patients diagnosed with type 2 diabetes mellitus.
2. Intervention: Structured and intensive education on self-management.
3. Comparison: Standard diabetes education.
4. Outcome: Improved glycemic control (measured by HbA1c levels) within a 12-month period.
5. Timeframe: Studies published within the last 10 years (2011-2021).
The screening process will involve two independent reviewers who will assess the titles and abstracts of the identified articles for potential eligibility. Full-text articles of the selected studies will be obtained and further evaluated for inclusion. Any disagreements will be resolved through discussion and, if necessary, consultation with a third reviewer.
Results:
Upon completing the search and screening process, the selected studies will be analyzed for relevant outcomes. Data extraction will include information on study design, sample size, participants’ characteristics, details of the interventions, duration of follow-up, and relevant outcomes. The studies will be assessed for methodological quality using the Cochrane Risk of Bias tool and the Newcastle-Ottawa Scale for nonrandomized studies. Data synthesis will be conducted using proper statistical methods, such as meta-analysis if appropriate, to obtain overall effect estimates.
Discussion:
The findings of this systematic review will contribute to the current evidence regarding the impact of structured and intensive education on self-management in patients with type 2 diabetes mellitus. If the results demonstrate a significant improvement in glycemic control, it would support the implementation of tailored education programs focused on self-management for patients with diabetes. This could potentially lead to better patient outcomes, reduced healthcare costs, and improved quality of care for individuals with T2DM.
Limitations and potential biases of the included studies will be considered in the discussion section. Additionally, recommendations will be made for future research, highlighting areas that require further investigation, such as long-term follow-up and cost-effectiveness analysis.
Conclusion:
The proposed systematic review aims to investigate the impact of structured and intensive education on self-management in patients with type 2 diabetes mellitus. By synthesizing the available evidence, this study will contribute to the understanding of effective educational interventions for improving glycemic control and ultimately enhancing the quality of care for individuals with T2DM.