Interprofessional Health Promotion

Interprofessional collaboration has become a key approach in managing patients today. This approach involves the collective expertise of diverse healthcare professionals working together to provide comprehensive patient care (Nurchis et al., 2022). Healthcare teams can leverage the unique perspectives, skills, and knowledge of individuals such as physicians, nurses, pharmacists, and allied health professionals to address patient needs. During the management of adult populations, interprofessional collaboration is crucial because it promotes effective communication, shared decision-making, and coordinated efforts (Szafran et al., 2019). This discussion focuses on the use of interprofessional approaches to manage adult conditions using clinical practice guidelines.

Topic

The topic chosen for this discussion is type 2 diabetes mellitus among the adult population. This condition presents a significant and growing health challenge worldwide, affecting individuals across various age groups, including young, middle, and older adults. Type 2 diabetes in young adults aged 40 years and below is considered more aggressive because of its long-term complications. It can cause complications like heart disease, kidney failure, and nerve damage leading to decreased quality of life (Nurchis et al., 2022). The onset of type 2 diabetes is most common in middle-aged individuals who are 45 to 64 years old. Data shows that about 14% of Americans aged 45 to 64 years are diagnosed with the disease each year. For older adults, this disease is often associated with complications and increased mortality rates. Diabetes management in this population is also complicated by factors like polypharmacy and co-morbidity (Nurchis et al., 2022). By addressing the diverse needs of these three populations, healthcare providers can work towards enhancing overall outcomes.

Epidemiology

Type 2 diabetes is the most common type affecting about 90 to 95% of people with diabetes in the United States (American Diabetes Association, 2024). The prevalence of the disease has increased over the years despite efforts to manage the disease. Data shows that the prevalence of the disease is 11.6% with over 38 million Americans observed to live with the disease (American Diabetes Association, 2024). This data shows a slight increase in prevalence from 11.3% in 2022 meaning that more people are developing the disease annually. The incidence of the disease has also increased and it is observed that about 1.2 million cases are diagnosed each year. Consequently, it is observed that 8.7 million cases remain undiagnosed, and 95% of them have type 2 diabetes (American Diabetes Association, 2024). The mortality rate of type 2 diabetes is another key epidemiological factor to consider when planning care for the adult population. Diabetes is the eighth leading cause of death in the US with over 100,000 deaths recorded annually.

Given the marked increase in conditions like overweight and obesity, there is a concern for the increase in prevalence, incidence, and mortality across all age groups. The prevalence of diabetes among young adults is 4.8% (American Diabetes Association, 2024). The prevalence and incidence increase with age and about 29.2% of those aged 65 years and older have type 2 diabetes. The middle adults also have a significant diabetes prevalence rate of 18.9%. the incidence rate among young adults is 3% compared to 10.1% in middle adults and 6.8% in older adults (American Diabetes Association, 2024). The risk factors associated with the development of this disease include smoking, overweight/obesity, physical inactivity, and race.

Interventions

The American Diabetes Association (ADA) publishes guidelines for the management of type 2 diabetes. The standards of care are developed by a multidisciplinary committee using evidence-based research approaches. The first criteria addressed by the ADA involves guidelines for screening and diagnosis of type 2 diabetes. The association recommends screening for high-risk individuals using tests like HbA1c and oral glucose tolerance tests (American Diabetes Association, 2023). For example, individuals with a history of cardiovascular disease, hypertension, and prediabetes should be tested. Those with A1C levels above 5.7% should be tested annually (American Diabetes Association, 2023). Individuals with gestational diabetes should get tested every three years while every other individual should begin testing after 35 years.

The second criterion highlighted in the ADA guidelines is lifestyle management of type 2 diabetes. The guideline requires providers to refer adults with overweight/obesity to intensive behavior change. The program should include reducing weight of at least 7% of initial body weight through reduced-calorie intake and moderate-intensity exercise of about 150 minutes per week (American Diabetes Association, 2023). The other criterion in the guideline is the pharmacological treatment of those diagnosed with the disease. The first line treatment agent should be metformin especially those aged 25 to 59 years (American Diabetes Association, 2023). Other pharmacological agents may also be used, although none has been approved by FDA.

Tina Jones Respiratory Shadow Health Transcript

Interprofessional Collaboration

Interprofessional collaboration is essential for the comprehensive management of type 2 diabetes. This approach has the potential to ease healthcare processes, and improve patient outcomes and care continuity (Szafran et al., 2019). The first way teams can work to improve diabetes care involves physicians and nurses. For example, these teams can work to prescribe medication, monitor acute patients, and refer patients appropriately. The utilization of clinical practice guidelines can be an important resource when these teams work together. The second example involves collaboration between physicians and pharmacists to ensure the management of medications (Nurchis et al., 2022). For example, the physician can prescribe medication and the pharmacist will ensure the drugs are dispensed and appropriate education given to the patient.

Collaboration between nurses, physicians, and dieticians is another approach that can be used to ensure effective weight management (Nurchis et al., 2022). For example, nurses and physicians can organize a health education program and ask the dietician to provide education about healthy food choices and exercise. The utilization of resources like weight management apps can help the team and the patient to achieve desired outcomes (Szafran et al., 2019). Lastly, collaboration between nurses, physicians  and social workers/payers can help to manage type 2 diabetes. For example, nurses and physicians can refer patients who are unable to buy drugs to the social worker for help. The social worker can communicate with the payers to ensure uninsured patients receive medication at a cheaper cost.

Summary

In summary, interprofessional collaboration involves healthcare professionals from diverse backgrounds working together to provide comprehensive care to patients. The collaborative approach to type 2 diabetes management involves nurses, physicians, nutritionists, social workers, payers, and diabetes educators (Szafran et al., 2019). A collaborative approach is important because it can improve patient outcomes, enhance patient satisfaction, and optimize the utilization of resources (Nurchis et al., 2022). Interprofessional collaboration can also help to reduce the risk of complications and improve the overall quality of life for individuals with diabetes.

References

American Diabetes Association. (2023). Standards of care in diabetes—2023 abridged for primary care providers. Clinical Diabetes, 41(1), 4-31.

https://doi.org/10.2337/cd23-as01

American Diabetes Association. (2024). About diabetes: Statistics about diabetes. https://diabetes.org/about-diabetes/statistics/about-diabetes#:~:text=Deaths,a%20total%20of%20399%2C401%20certificates.

Nurchis, M. C., Sessa, G., Pascucci, D., Sassano, M., Lombi, L., & Damiani, G. (2022). Interprofessional collaboration and diabetes management in primary care: A systematic review and meta-analysis of patient-reported outcomes. Journal of Personalized Medicine, 12(4), 643.

https://doi.org/10.3390/jpm12040643

Szafran, O., Kennett, S. L., Bell, N. R., & Torti, J. M. (2019). Interprofessional collaboration in diabetes care: Perceptions of family physicians practicing in or not in a primary health care team. BMC Family Practice, 20, 1-10. https://doi.org/10.1186/s12875-019-0932-9