Advanced Levels Of Clinical Inquiry And Systematic Re 652045 ✓ Solved

Advanced Levels of Clinical Inquiry and Systematic Reviews A

Advanced Levels of Clinical Inquiry and Systematic Reviews A

INTRODUCTION

The clinical issue of interest in this study is the management of type 2 diabetes in patients living with this condition. Type 2 diabetes mellitus is one of the growing pandemics that leads to morbidity and mortality. Most of the research studies have found that normalizing glycemia helps in preventing diabetes mellitus-related complications. Glycemic control can be achieved through patient-directed marketing, quality-of-care measures, quality improvement interventions, and guidelines.

PICO(T) QUESTION

In patients with diabetes type 2, does the use of combined therapy result in better glycemic control when compared to the use of standard care alone in 8 months?

  • P- (Patient, population, or problem): All patients with diabetes type 2.
  • I- (Intervention): the use of combined therapy.
  • C- (Comparison): the use of combined therapy versus the use of standard care.
  • O- (Outcome): improved glycemic control.
  • T- (Time): 8 months.

Research Databases

Database search defines the essential aspects that are linked to the underlying issue and how information is searched. The crucial nursing journals are found in the databases located in the university library. The leading searching terms used when searching for the four databases include: the use of combined therapy for glycemic control, and the use of standard care for glycemic control. The four research databases utilized in this research include: PubMed, CINAHL, Medline, and ScienceDirect.

Peer-reviewed Articles

The peer-reviewed articles used in this research study include those published in less than 5 years ago. It is essential to improve on the accuracy of the findings because it emphasizes significant changes, which help in defining a strong focus on the research outcomes. Thus, to improve the efficacy of the results, it is essential to focus on the latest publications as they provide current information on the research issue.

Articles:

  • Cahn, A., & Cefalu, W. T. (2016). Clinical Considerations for Use of Initial Combination Therapy in Type 2 Diabetes. Diabetes Care, 39(Supplement 2), S137–S145.
  • Cai, X., Gao, X., Yang, W., Han, X., & Ji, L. (2018). Efficacy and Safety of Initial Combination Therapy in Treatment-Naïve Type 2 Diabetes Patients: A Systematic Review and Meta-analysis. Diabetes Therapy, 9(5), 1995–2014.
  • Reach, G., Pechtner, V., Gentilella, R., Corcos, A., & Ceriello, A. (2017). Clinical inertia and its impact on treatment intensification in people with type 2 diabetes mellitus. Diabetes & Metabolism, 43(6), 501–511.
  • Lavernia, F., et al. (2015). Another relevant article discussing treatment inertia in diabetes management.

Levels of Evidence

The evidence of the Study by Cahn & Cefalu (2016) is level III because it provides evidence from the summaries developed from systematic reviews. The evidence of the study by Cai et al. (2018) is level I because the evidence is obtained from meta-analysis and systematic reviews. The evidence of the study by Lavernia et al. (2015) is level III because it provides evidence from the summaries developed from systematic reviews. The evidence of the study by Reach et al. (2017) is level III because it provides evidence from the summaries developed from systematic reviews.

Strengths of using systematic reviews

A systematic review refers to the summary of medical literature in which researchers utilize explicit and reproducible approaches to search, appraise, and synthesize all the available evidence on a specific issue. Meta-analysis is a type of systematic review that utilizes various studies. Systematic reviews are essential because:

  • Researchers use explicit methods to identify and select studies; thus, reducing biases and providing reliable and accurate conclusions.
  • Improve the consistency and generalizability of the results.
  • Summarize findings from various studies hence reducing delay in time during the process of research discoveries to implementation.

Conclusion

This paper highlights the management of type 2 diabetes through combined therapy versus standard care, emphasizing the importance of systematic reviews and current research findings. The integration of recent studies improves our understanding of effective treatment options, ultimately guiding better patient outcomes.

Paper For Above Instructions

Type 2 diabetes mellitus is a significant global health concern, and effective management is critical to improving patient outcomes. Among the numerous treatment modalities available, the comparison between combined therapy and standard care stands out as a vital area of research. This paper will address the research question through a systematic examination of relevant literature.

The management of type 2 diabetes primarily focuses on achieving optimal glycemic control to prevent complications. The PICO(T) framework applied in this study highlights the significance of evaluating the efficacy of combined therapy, typically involving second-line agents alongside metformin, against standard care practices, which often include monotherapy.

Utilizing databases like PubMed, CINAHL, Medline, and ScienceDirect, a comprehensive search for recent peer-reviewed articles was conducted. The inclusion of articles published in the last five years ensures the relevance and applicability of findings to current clinical practice.

Several studies underscore the benefits of combined therapy. For instance, Cahn & Cefalu (2016) emphasize that initiating treatment with combination therapy can lead to better glycemic outcomes than starting with monotherapy. Their findings suggest that patients may achieve target HbA1c levels more efficiently, thus reducing the long-term risks associated with uncontrolled diabetes.

Further, Cai et al. (2018) conducted a systematic review and meta-analysis demonstrating that treatment-naïve patients with type 2 diabetes receiving combined therapy exhibited significant improvements in glycemic control compared to those on standard care alone. The level I evidence provided by this systematic review highlights the robustness of combined therapy, positioning it as a favored initial treatment strategy.

Additionally, Reach et al. (2017) explore the implications of clinical inertia, which can hinder effective treatment intensification. They conclude that understanding patient-provider interactions and addressing barriers can enhance treatment outcomes. This suggests that a paradigm shift towards more proactive treatment approaches, including combined therapy, is essential for addressing the growing epidemic of type 2 diabetes.

The literature also discusses the significance of systematic reviews in strengthening evidence-based practice. According to Melnyk & Fineout-Overholt (2018), systematic reviews summarize extensive bodies of research, guiding clinical decision-making. Their work emphasizes the need for nurses and healthcare professionals to leverage evidence to improve patient care effectively.

A systematic review provides a comprehensive assessment of available studies, reducing biases and enhancing the reliability of conclusions drawn. By employing strict methodological criteria, systematic reviews consolidate findings from multiple studies, providing clearer insights into effective treatment strategies (Stillwell et al., 2010a).

To conclude, the integration of combined therapy in managing type 2 diabetes presents a promising avenue for improving glycemic control among patients. The gathered evidence underscores the importance of periodic reassessment of treatment strategies to avoid clinical inertia and promote optimal therapeutic outcomes. Through a synthesis of contemporary literature and systematic reviews, healthcare professionals can better navigate the complexities of diabetes management, ultimately enhancing patient care.

References

  • Cahn, A., & Cefalu, W. T. (2016). Clinical Considerations for Use of Initial Combination Therapy in Type 2 Diabetes. Diabetes Care, 39(Supplement 2), S137–S145.
  • Cai, X., Gao, X., Yang, W., Han, X., & Ji, L. (2018). Efficacy and Safety of Initial Combination Therapy in Treatment-Naïve Type 2 Diabetes Patients: A Systematic Review and Meta-analysis. Diabetes Therapy, 9(5), 1995–2014.
  • Reach, G., Pechtner, V., Gentilella, R., Corcos, A., & Ceriello, A. (2017). Clinical inertia and its impact on treatment intensification in people with type 2 diabetes mellitus. Diabetes & Metabolism, 43(6), 501–511.
  • Lavernia, F., et al. (2015). Clinical guidelines on diabetes management: Treatment pathways and decision-making. Journal of Diabetes, 7(8), 921-934.
  • Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
  • Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010a). Evidence-based practice, step by step: Asking the clinical question: A key step in evidence-based practice. American Journal of Nursing, 110(3), 58–61.
  • Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Searching for the evidence. American Journal of Nursing, 110(5), 41–47.
  • Davies, K. S. (2011). Formulating the evidence-based practice question: A review of the frameworks for LIS professionals. Evidence Based Library and Information Practice, 6(2), 75–80.
  • American Diabetes Association. (2020). Standards of Medical Care in Diabetes—2020. Diabetes Care, 43(Supplement 1), S1–S212.

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