Critical review of innovation prevention of Diabetes - Free Samples

Question: Discuss about the Critical review of innovation prevention of Diabetes. Answer: Introduction Chronic diseases are health abnormalities that persist over a long period of time (3 months) (Bauer et al. 2014). Diabetes is regarded as a chronic diseases occurring due to inefficiency of the pancreas to produce adequate insulin. The hormone insulin is responsible for converting blood glucose. This results in an elevation in the blood sugar levels beyond the threshold (Chiuve et al. 2012). Regardless of the geography, age and socio-economic condition, diabetes mellitus has become a major health concern. The incidence rates have reached an alarming level that calls for the need to innovate healthcare delivery solutions in this digital age. Researchers expect the youth to get empowered with their smart phones in near future, owing to which mobile health (m-Health) innovations can be implemented to take responsibility of managing the chronic health disorder. Healthcare professionals and clinicians will adorn the role of advisors and navigators, in addition to acting as medical gatekeepers of the patients. This report will describe the m-Health system and application for management and prevention of diabetes. It will also evaluate clinical evidence of the impact and future implications of these innovations. Discussion and evaluation Description of the innovation and the community SAED, a mobile diabetes management system was formulated with regards to the residents of the community for the effective prevention and management of the chronic health condition. The SAED encompasses a smart mobile based diabetes management system that is made up of components such as, wireless technologies, sensors, GPS technologies and other functional aspects (Alotaibi, Istepanian and Philip 2016). The primary objective of the system is to provide optimal healthcare services to all patients. The cost-effectiveness of this system enables it to be used by many people. It facilitates remote monitoring of the blood level conditions and records and maintains a medical history database, while enhancing patient knowledge on the disorder. Thus, the 2 major components of SAED are commonly referred to as the mobile patient or healthcare provider component, and the intelligent diabetes management component (Alotaibi, Istepanian and Philip 2016). The other mobile health technology that acts as an innovation in diabetes management is the Mobile Health Effect and Readiness Questionnaire (MHERQ). This questionnaire is a modified version of the THREQ, translated into the Arabic language (Alenazia et al. 2017). It encompasses three sections, namely, clinical data, demographics and a 5-point likert scale with 13 questions, based on the readiness of patients for use of m-Health technologies. The primary objective of this questionnaire was to evaluate the effectiveness of health monitoring services in controlling the rates of diabetes through the use of mobile devices. Another objective was therefore related to determining whether the people of KSA have technical literacy and are ready to make use of these services for improving their health (Alenazi et al. 2017). Need and rationale for the innovation Diabetes mellitus is regarded as one of the fastest-growing chronic health disorder globally (WHO 2016). The major factors that contribute to the ever-increasing rates of diabetes in the world are sedentary lifestyle, lack of physical exercise, obesity, and unhealthy diet patterns. Research studies suggest that the socio-economic changes occurring in KSA over past 4 decades have created significant impacts on the lifestyle. These changes have resulted in less healthful eating habits and a decline in physical activity levels (American Diabetes Association 2018). According to Guariguata et al. (2014) around 382 million people were suffer from diabetes, of which 23.9% reside in Saudi Arabia. Another study assessed the burden of diabetes in KSA and the prevalence rates were found to be 23.7%, and were more among males living in urban areas (Alhowaish 2013). Research evidences also indicate that diabetes mellitus accounted for 11% of the total healthcare expenses in the year 2011 (America n Diabetes Association 2013). Moreover, studies state that the estimated number of diabetic patients would reach 32% of the adult population, by the year 2020 (Guariguata et al. 2014). The total annual medical costs for diabetes were as high as $657 million in 2010 (UHO 2010). The rapidly increasing proportion of diabetes in KSA accounts for the poor general health, low quality of life, high morbidity, mortality and vascular complications. Therefore, there was a need to emphasise on screening for pre-diabetes and diabetesin order to identify the risk factors that increase susceptibility to the chronic health disorder (Al-Quwaidhi et al. 2014). This accounts for the need to implement the SAED and MHERQ techniques to manage the incidence of type-2 diabetes among people living in Saudi Arabia. Addressing the core components of Chronic Care Model The Chronic Care Model (CCM) refers to an organizational approach built with the aim of caring for individuals who suffer from chronic health conditions, in a primary care setting. The major elements of the care model includethe health-system, community, delivery system design, self-management support, clinical information system and decision support (Nundy et al. 2012). This eventually results in satisfied healthcare providers, healthier patients, and associated cost savings. The SAED mobile diabetes management intervention applied in the target population met some objectives of the CCM in that its diabetes management component represented back end operations that most commonly included data collection and storage in the database, such that it could be used in the form of decision support system. Furthermore, the database stored laboratory results, and records related to all patients, thereby offering clinical information support (Ory et al. 2013). Upon implementation, it also acted as a cost-effective healthcare solution that facilitated monitoring diabetes. Furthermore, it also facilitated self-monitoring of the condition. Thus, most of the components of the care model were addressed by SAED. On the other hand, the MHERQ when applied on the target population demonstrated an urge among the participants for the usage of data technology to cope with their condition. Furthermore, most participants showed a willingness to use mobile health technologies for i ncreasing their awareness on the disease, and directly interacting with their healthcare professionals. Thus, the MHERQ supported the need for the presence of certain components of the care model. Critical evaluation of the performance The study conducted by Alotaibi, Istepanian and Philip (2016) focused on developing an SAED for the type-2 diabetes patients of KSA in order to determine the HbA1c levels and diabetes awareness. Findings from the RCT suggested a significant reduction in HbA1c outcomes, at the end of intervention period among participants in the SAED intervention group, upon comparison with the control group. Furthermore, the mean baseline decreased from 8.76% to 7.85% in the intervention group. The results also demonstrated a remarkable improvement in knowledge and awareness of diabetes in the sample. Owing to the fact that diabetes is regarded as a chronic disease faced by individuals of the aforementioned country, the researchers illustrated the importance and effectiveness of the smart mobile management system on improving the healthcare conditions of the future generations. Furthermore, the increasing trend in the use of mobile health technology for making healthcare services more efficient and better was also followed by the researchers. Another advantage was related to determination of the effectiveness the determined the effectiveness and results on lack of intervention in the control group as well. However, the major disadvantages were related to small sample size (20 participants), lack of follow-up study and lack of information on the area in which the study was conducted. According to the study conducted by Alenazi et al. (2017) MEHRQ displayed a satisfactory response when implemented upon the target population. The advantage of the study lies in the fact that it tried to assess the readiness and levels of acceptance of mobile of telemonitoring facilities for improving diabetic status, based on a questionnaire. The study was effective in showing excellent internal consistency among the sample. Additional advantages include the response of 77% par ticipants showing willingness to use mobile health services. Moreover, 60% displayed interest to use mobile technology during holidays. Thus, the basic advantage was that most people identified the need of mobile technologies for optimal health outcomes among the patients. However, the study had its disadvantages that were associated with the presence of small sample size (30 diabetic patients), and presence of near about half of the participants displaying a lack of willingness to use telemonitoring for transferring values to other diabetic patients. Furthermore, the authors failed to describe the kind of study that was conducted. The effectiveness of SAED can be correlated with results of a systematic review that suggested significant positive impacts of self-management interventions on regulations of HbA1c levels among T-2-D patients in gulf cooperation council countries. Analysis of 8 articles, of which one was an RCT showed a statistically significant improvement in the levels of HbA1c in 5 studies. Improvements were also observed in the levels of physical activity in 4 studies. Thus, the findings were in accordance with the SAED study (Al Slamah et al. 2017). In addition, development of a mobile diabetes management system for Saudi Arabic diabetic patients, for management of diabetes and social behavior demonstrated positive impacts on knowledge promotion for diabetes and reflected positive outcomes in reducing levels of HbA1c among the patients. Results from the study also showed an improved self-efficacy among the patients on use of the SANAD (Alanzi 2014). Preliminary results suggested general acceptan ce in using m-Health system with rating among T2D patients. Further investigation showed positive impact of the SANAD in diabetic knowledge promotion and reduction of glycated hemoglobin. Thus, it can be concluded that use of self-management and mobile health technologies all over the world have shown significant improvements in diabetes management. Implications Health equity refers to study and reasons for differences that arise in the quality of the healthcare systems existing across different population (Bauer 2014). The major impact of the SAED program is the fact that it provided data to establish the effectiveness of smart phone interventions on T2D patients. The study had also made a consideration of the prevalence of smart phone technologies and levels of its usage in the Kingdom. The major impact on the providers includes self-management of the disease due to incorporation of educational tool in the program. This holds extreme relevance in remote KSA regions where lack of adequate healthcare facilities worsens the health condition of the residents. Additionally, another benefit is related to enhancement of self-monitoring that eventually reduces the mortality and morbidity rates (Logan et al. 2012). The healthcare providers are also benefitted due to the integration of clinical information with the patients. This will create better provisions for the providers to diagnose the health status and administer appropriate interventions, by going through the previous health records of the patients (Aikens et al. 2015). Similar benefits were also created by MHERQ that enabled patients to suggest that they would like to use mobile health technologies for recording their blood glucose levels by self or during holidays (Alenazia et al. 2017). This would directly benefit the doctors as they would be able to directly implement treatment methods by interacting with the patients, while reviewing the HbA1c records (Buysse, de Moor and De Maeseneer 2013). The equity implication is related to the fact that the aforementioned strategies can be applied across all regions of the world regardless of the socio-economic status, gender, ethnic or racial disparities. Thus, it will be able to enhance retention and attraction of health workers and will directly benefit people living in areas that are inaccessible to urgent healthcare facilities (Farmer and Bukhman 2012). According to recent news, the MOH has joined forces with Joslin Diabetes Centre that is associated with the Harvard Medical School, for achieving heal thcare facilities of international standards, by training health workers on use of latest diabetes management techniques (Arab News Online 2016). Opportunities for improvement The Ministry of Health (MOH), Saudi Arabia recognises the need of implementing treatment, prevention, and rehabilitation programs for ensuring inclusive health services for all residents (Celler and Sparks 2015). This is further supplemented by its efforts of formulating a National Executive Plan for 10 years (2010-2020). The plan will act as leverage for development of other intervention programs. Furthermore, the establishment of 20 specialised centres for diabetes treatment and work towards improving awareness on the disease would be beneficial (Moh.gov.sa 2018). Furthermore, there is a need to conduct more high levels of study such as, randomised control trials to determine the effectiveness of the m-Health strategies on diabetic patients. RCTs will help to evaluate the efficacy and safety of the new interventions on human health. Thus, the relevance of the innovations to patient care can be investigated accurately (Kabisch et al. 2011). Conclusion The major strengths of healthcare technologies in the KSA are care management, actionable health information, health insurance, consumer involvement and financial services. These assets are paramount to improvement of healthcare for all citizens. Therefore, there is a need to develop partnership or collaboration between the primary stakeholders for prevention of diabetes, a chronic health problem. Implementation of innovative strategies such as m-Helath, which have already been applied in other countries, will help KSA achieve significant management and prevention of diabetes by the year 2030. References Aikens, J.E., Trivedi, R., Aron, D.C. and Piette, J.D., 2015. Integrating support persons into diabetes telemonitoring to improve self-management and medication adherence.Journal of general internal medicine,30(3), pp.319-326. Al Slamah, T., Nicholl, B.I., Alslail, F.Y. and Melville, C.A., 2017. 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