DNP 820 Literature Evaluation Table – DPI Intervention
Literature Evaluation Table – DPI Intervention
Learner Name:
Instructions: Use this table to evaluate and record the literature gathered for your DPI Project.Refer to the assignment instructions for guidance on completing the various sections. Empirical research articles must be published within 5 years of your anticipated graduation date. Add or delete rows as needed.
PICOT-D Question: Among patients aged 35 and above with T2DM in an outpatient clinic, will the translation of Vaughan et al., (2021) Diabetes Self-management Education & Support tool with weekly telehealth calls compared to current practice reduce HbA1c levels to below 6.5% within 8 weeks?
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Table 1: Primary Quantitative Research – Intervention (5 Articles)
APA Reference (Include the GCU permalink or working link used to access the article.)Research Questions/ Hypothesis, and Purpose/Aim of StudyType of Primary Research DesignResearch Methodology Setting/Sample (Type, country, number of participants in study) Methods (instruments used; state if instruments can be used in the DPI project)How was the data collected?Interpretation of Data (State p-value: acceptable range is p= 0.000 – p= 0.05) Outcomes/ Key Findings (Succinctly states all study results applicable to the DPI Project.)Limitations of Study and BiasesRecommendations for Future Research Explanation of How the Article Supports Your Proposed InterventionVaughan, E. M., Hyman, D. J., Naik, A. D., Samson, S. L., Razjouyan, J., & Foreyt, J. P. (2021). A telehealth-supported, I ntegrated care with CHWs, and ME dication-access (TIME) Program for Diabetes Improves HbA1c: a Randomized Clinical Trial. Journal of general internal medicine, 36(2), 455-463. https://doi.org/10.1007/s11606-020-06017-4 The main of this study was to study the impacts of a telehealth-supported intervention program on individuals’ HbA1c levels as compared to the usual care.The study design used is a randomized controlled trialSample/Setting: A total of eighty-nine participants were recruited to take part in the study. The individuals must have been at least eighteen years of age and diagnosed with diabetes type 2. This research was done in a nonprofit clinic in Houston, Texas Methods: As earlier indicated, this study was a randomized controlled trial. The intervention group received an intervention named TIME which consisted of a healthcare expert mobile health communication with the participants for a year, community health worker-led group visits for half a year, and a weakly telehealth (video conferencing) coaching and training of the participants on diabetes management. The targeted primary outcome was changed in HbA1c levels. Mental stress management/ relaxation techniques survey is one of the instruments used. This instrument can be applied in the project. Data collection: data was collected through survey and chart reviewsThe individuals in the intervention group recorded a decrease in HbA1c levels from baseline to six months (p-value of 0.002). More patients in the intervention than control also achieved more than half of HbA1c reductions( p-value of <0.001).The key findings that are applicable to the DPI project are the evident improved glycemic control upon the application of the telehealth intervention to offer support in helping patients improve their glycemic control medication adherence, address concerns, and answer questions regarding diabetes care and management.One of the study’s limitations is that the sample size used was moderate and not sufficient. The study could not assess long-term analyses such as behavioral health roles due to the duration of the study, which was short.The researchers recommended the need for a further cost ad variable analysis of the TIME intervention using optimization strategies. Studies should be done that can improve outcome sustainability.The article supports the proposed intervention in that by using TIME intervention which has telehealth calls as part of the components; the patients were able to achieve significant reductions in HbA1c levels.Dong, Y., Wang, P., Dai, Z., Liu, K., Jin, Y., Li, A., … & Zheng, J. (2018). Increased self-care activities and glycemic control rate in relation to health education via Wechat among diabetes patients: A randomized clinical trial. Medicine, 97(50). https://dx.doi.org/10.1097%2FMD.0000000000013632 The aim of the study was to examine the relationship between WeChat platform-based health intervention with glycemic control among patients with diabetes.The study design used is a randomized controlled trialSample/Setting: The researchers recruited a total of one hundred and twenty patients to participate in the study. The study was conducted at a hospital in Hainan medical university in China. Methods: This study was a randomized controlled trial with sixty participants randomized into the control group and the remaining sixty into the intervention group. The participants in the intervention group received usual care and educational intervention based on the WeChat platform. The trained nurses sent educational text messages to patients and collected questions from them on the messaging platform. On the other hand, the patients in the control group only received conventional diabetes care. The self-administered questionnaire was used. Data collection: data was collected through the use of questionnairesThere was a statistically significant difference in HbA1c levels between the intervention and control groups (p-value of <0.05).From the analysis, it was revealed that the use of the telehealth platform led to a significant reduction in HbA1c levels hence better glycemic control.Various weaknesses exist in the research. The data on self-care activities were self-reported hence may lead to bias. The findings may also lack generalizability as participants were drawn from a single hospital.Future studies should consider a multicenter approach to improve generalizability.This article supports the proposed intervention since it shows that the application of telehealth leads to a significant improvement in glycemic control.Sun, C., Sun, L., Xi, S., Zhang, H., Wang, H., Feng, Y., … & Wang, G. (2019). Mobile phone–based telemedicine practice in older Chinese patients with type 2 diabetes mellitus: a randomized controlled trial. JMIR mHealth and uHealth, 7(1), e10664. https://doi.org/10.2196/10664 The purpose of this research was to explore the use of mobile phone-based telemedicine applications for managing diabetes type 2 among older patients.The study design used is a randomized controlled trialSample/Setting: A total of 91 individuals were recruited to take part in the study, with 44 randomized into the intervention group while 47 were placed in the control group. The research was carried out at Jilin University in China. Methods: As earlier indicated, this research was a randomized controlled trial with intervention and control groups. The patients in the intervention groups got education regarding physical exercise, healthy diet, and medication adherence delivered through a mobile health telemedicine system and glucometer, which could transmit relevant data. On the other hand, the patients in the control group got routine care without any additional intervention. Both sets of patients were then followed at 3-month intervals. One of the instruments used in this research was the survey. The survey is also applicable in the research. Data collection: Data was collected through questionnaires.Decreased HbA1c levels in the control group after six months (p-value of <0.05).Among the key findings is that the use of the intervention led to a significant improvement in the HbA1c levels among patients in the intervention group. Therefore, the use of the mobile phone-based telehealth application is efficacious in improving glycemic control.Various weaknesses and biases are evident in this study. For example, the researchers did not consider factors such as family history and environmental factors which can significantly impact diabetes care.The researchers recommended the use of more accurate data collection methods.This study supports the project since it has shown that the use of mobile phone-based intervention was effective in improving glycemic control among patients with diabetes.Fortmann, A. L., Gallo, L. C., Garcia, M. I., Taleb, M., Euyoque, J. A., Clark, T., … & Philis-Tsimikas, A. (2017). Dulce Digital: an mHealth SMS-based intervention improves glycemic control in Hispanics with type 2 diabetes. Diabetes Care, 40(10), 1349-1355. https://doi.org/10.2337/dc17-0230The main aim of this study was to evaluate the impact of a Dulce digital intervention (call to action, educational and motivational text messages) on diabetes outcomes as compared to the usual care.The study design used in this research is also a randomized controlled trial.Sample/setting: A total of 126 participants were recruited and randomized to either the control or intervention groups. The participants were between 18-75 years old. The setting was Riverside and San Diego counties with predominantly ethnic minorities and low-income persons. Methods: This was a randomized controlled trial entailing diabetes self-management education and support based on text messaging. The intervention was named Dulce Digital intervention which entailed a package of call-to-action, educational and motivational messages for a period of six months. The targeted outcomes include body mass index, blood pressure, lipids, and HbA1c. One of the instruments used in this study includes questionnaires. Data collection: Data was mainly collected using questionnaires at baseline, after three months, and after six monthsThe patients in the intervention group showed a significantly higher reduction in the HbA1c levels over time as compared to those in the usual care (p=0.03)There are various key findings in this study relevant to the DPI project. For example, there was a more significant reduction in the HbA1c levels among patients in the intervention group as compared to the ones in the usual care group. Therefore, the use of low-cost text messaging using mobile phones was observed to significantly improve diabetes outcomes.The study also has various limitations. For instance, there is a possibility that the individuals who remained in the study were more engaged, as reflected in higher attrition in the intervention group. No cost-effectiveness of the project was explored.One of the recommendations is that future research should explore how sustainable the improved glycemic control can be beyond six months. The other recommendation is that a similar study should be done to include populations at risk of diabetes.This study supports the intervention in that the researchers used telehealth in the form of text messaging as an intervention for diabetes self-management education and support among patients with diabetes. The intervention led to better glycemic control among patients with diabetes. Therefore, its shows that the proposed intervention can succeed in the chosen population.Warren, R., Carlisle, K., Mihala, G., & Scuffham, P. A. (2018). Effects of telemonitoring on glycaemic control and healthcare costs in type 2 diabetes: a randomized controlled trial. Journal of telemedicine and telecare, 24(9), 586-595. https://doi.org/10.1177%2F1357633X17723943 This study aimed at examining the impact of telehealth intervention on glycemic control and cost-saving among patients living with diabetes.The study design used is a randomized controlled trial.Sample/Setting: This study recruited a total of one hundred and twenty-six participants to take part in the study, where sixty-three participants were randomized into the control group. The remaining sixty-three were randomized into the intervention group. The participant must have attained the age of 18 years by the time of recruitment, been diagnosed with type 2 diabetes, and have access to broadband internet to be included in the study. The study was conducted in Queensland, Australia. Methods: This was randomized controlled research with HbA1c being the primary outcome. The intervention group received a telehealth intervention which was composed of video calling with the healthcare expert and the use of a tablet computer to access diabetes information and send various measurements through the internet to a database. Such data was used by the healthcare expert to formulate care plans, education, and self-management strategies. A Depression screening questionnaire (Kessler Psychological Distress Scale) and a quality of life questionnaire (12-Item Short Form Survey) were instruments used in this research. These instruments can be applied in the project. Data Collection: Data was collected from hospital records. GPs and care coordinators also collected data at baseline and after six monthsreduction in the HbA1c levels in the intervention group (p-value of 0.004)Various findings in this research are relevant to the project. For example, upon the implementation of the telehealth program, there was an improved glycemic control among the patients in the control group.This study also has various weaknesses and biases. The researchers failed to obtain the originally calculated sample size, leading to a smaller sample size and bias. Another weakness is a possible selection bias.The researchers recommend that similar studies be done in the future using larger sample sizes for more credible results.This research also supports the project since the findings indicate that the use of telehealth positively impacts glycemic control among patients with diabetes.
Table 2: Additional Primary and Secondary Quantitative Research (10 Articles)
APA Reference (Include the GCU permalink or working link used to access the article.)Research Questions/ Hypothesis, and Purpose/Aim of StudyType of Primary or Secondary Research DesignResearch Methodology Setting/Sample (Type, country, number of participants in study) Methods (instruments used; state if instruments can be used in the DPI project)How was the data collected?Interpretation of Data (State p-value: acceptable range is p= 0.000 – p= 0.05)Outcomes/ Key Findings (Succinctly states all study results applicable to the DPI Project.)Limitations of Study and BiasesRecommendations for Future Research Explanation of How the Article Supports Your Proposed DPI ProjectAsante, E., Bam, V., Diji, A. K. A., Lomotey, A. Y., Owusu Boateng, A., Sarfo-Kantanka, O., … & Adjei, D. (2020). Pilot mobile phone intervention in promoting type 2 diabetes management in an urban area in Ghana: a randomized controlled trial. The Diabetes Educator, 46(5), 455-464. https://doi.org/10.1177%2F0145721720954070 This study purposed to examine the impact and feasibility of a nurse-led mobile phone intervention among patients with diabetes in self-management practice adherence and glycemic control.This study was a pilot randomized controlled trial that compared a mobile phone call intervention to usual diabetes care.Sample/Setting: This study had a total of sixty patients who were randomized in either the experimental or the control group in half. The research was conducted in a teaching hospital in Kumasi, Ghana. Methods: The research was a pilot randomized controlled trial with mobile phone calls (telehealth calls) as the major intervention. While the patients in the control group received usual care, the intervention group got usual care integrated with phone calls. The number of mobile phone calls received was sixteen. While the primary outcome was the A1C, the secondary outcomes were self-management and self-reported medication adherence. One of the instruments used in this study is the self-management adherence questionnaire tool which was applied in assessing the patients’ self-care and adherence to blood glucose checking, foot care, medication, exercise, and diet. This instrument can also be applied in the DPI project. Data collection: Data was mainly collected using a questionnaire.There was a significant reduction in A1C in the intervention group as compared to the control group (p-value is 0.004)Various outcomes are applicable to the DPI project. For example, upon the use of the intervention after twelve weeks, the patients in the intervention showed a significantly lower A1C than the control group who only received usual care.The study has various limitations. For example, the study may suffer from a lack of generalizability as it only included patients with raised AIC of more than 7% and on oral medication. Therefore it may not apply in all samples. The study also used questionable measuring instruments.The study recommends undertaking future studies that incorporate other aspects such as lipid profiles. Future trials should also include qualitative evaluations to engage patients and staff in focused groups discussions or interviews to shed more light on the intervention’s mechanism of action, challenges, and success perspectives.This study supports the proposed DPI project since it shows that the use of telehealth calls to teach and reinforce diabetes self-management practices leads to better outcomes such as glycemic control among patients with diabetes.Poppe, L., De Bourdeaudhuij, I., Verloigne, M., Shadid, S., Van Cauwenberg, J., Compernolle, S., & Crombez, G. (2019). Efficacy of a Self-Regulation–Based Electronic and Mobile Health Intervention Targeting an Active Lifestyle in Adults Having Type 2 Diabetes and in Adults Aged 50 Years or Older: Two Randomized Controlled Trials. Journal of medical Internet research, 21(8), e13363. https://doi.org/10.2196/13363. The aim of this study was to test the impact of mobile health and electronic health intervention (MyPlan 2.0) on physical activity and sedentary behavior among patients with diabetes.The research design used in this study was a randomized controlled trialSample/Setting: This study comprised of two randomized controlled styles, with the first trial having a sample size of fifty-four while the second one had sixty-three participants. The study was carried out in Damian General Hospital and Ghent University Hospital, Ostend in Belgium. Methods: The study recruited patients of at least 50 years. The participants were allowed to choose whether to for increasing physical activity or decrease sedentary behavior. The individuals were randomly assigned with a ratio of 2:1 to the waiting-list control group or intervention group. Among the primary outcomes were self-reported and objectively measured physical activity and sedentary behavior. The study also uses various instruments such as the international physical activity questionnaire the Longitudinal Aging Study Amsterdam Sedentary behavior questionnaire. These instruments can also be applied in the project. Data collection: The collection of data was accomplished through face-to-face assessments.A decrease in time spent sitting in the intervention group as compared to the control group (p-value of 0.09). Increase in physical exercise (p, value of 0.049). Breaks from sedentary time (p values of 0.005.Some of the observed key findings include: The researchers observed that there was a more significant decrease in the time spent sitting down in the intervention group as compared to the control group and an increase in physical activity. Those who were in the sedentary behavior intervention group showed more increase in breaking from sedentary behavior as compared to the control group.This study has various limitations, such as no power analysis for the randomized controlled trial two. The sample size was limited, and they only had a waiting list instead of a placebo control group.One of the recommendations is that similar studies should be undertaken but with larger sample sizes for more valid results.This study supports the proposed project in that it shows the efficacy of using a mobile health intervention in producing better diabetes-related health outcomes among patients with diabetes.Yang, Y., Lee, E. Y., Kim, H. S., Lee, S. H., Yoon, K. H., & Cho, J. H. (2020). Effect of a Mobile Phone-Based Glucose-Monitoring and Feedback System for Type 2 Diabetes Management in Multiple Primary Care Clinic Settings: Cluster Randomized Controlled Trial. JMIR mHealth and uHealth, 8(2), e16266. https://doi.org/10.2196/16266The aim of this study was to examine the clinical applicability and efficacy of a feedback system for managing diabetes based on mobile phone glucose monitoring.The study design used in the research was a randomized controlled trialSample/Setting: a total of two hundred and forty-seven participants were recruited to participate in the study, with 97 randomized into the control group while the remaining 150 were randomized into the intervention group. The study was performed in large cities in South Korea, such as Seoul. Methods: The study was multicenter cluster randomized controlled trials that cover a total of thirteen primary care clinics. Participants in the control group and intervention group were offered face-to-face consultation with the physicians regarding diabetes management. The patients in the intervention group were prompted to upload the results from daily self-monitoring of blood glucose results using the mobile phone. The clinicians then sent short feedback messages to patients after reviewing the results. Some of the instruments used include the Morisky Medication Adherence Scale and the Diabetes Treatment Satisfaction Questionnaire status version. Data collection: data was mainly collected through the use of questionnaires.HbA1c improvement (p-value of 0.03), fasting plasma glucose (p value of 0.005)Various key findings support this study. For example, by the third month, there was more improvement on HbA1c values and fasting among the intervention group as compared to the control group. The intervention group also showed superior medication adherence and reduction in blood pressure.The study had a notable difference in age at baseline between the control group and intervention group hence a possibility of bias. The variations in the medical team could also lead to bias. The time used for follow-up was also short.One of the recommendations is that future studies targeting the use of mobile phone-based diabetes management systems should use longer study periods to provide better evidence.This study also supports the project in that it demonstrates that the use of mobile phones/telehealth leads to better outcomes among patients with diabetes.Hansen, C. R., Perrild, H., Koefoed, B. G., & Zander, M. (2018). Video consultations as add-on to standard care among patients with type 2 diabetes not responding to standard regimens: a randomized controlled trial. European journal of endocrinology, 176(6), 727-736. https://doi.org/10.1530/eje-16-0811 This research aimed at examining whether video consultations integrated with blood pressure, weight, and blood glucose measurements can positively impact glycemic control among patients with diabetes type 2,The study design used in this research is a randomized controlled trialSample/Setting: This study was performed in Copenhagen, Denmark, with participants drawn from three different hospitals. A total of one hundred and sixty-five patients were recruited and randomized in ratio 1:1 to the intervention groups and the control groups. Methods: Having randomized the participants into either an intervention or control group, the study lasted for 32 weeks. The intervention was composed of monthly video conferences with the participants tasked with uploading blood sugar, weight, and blood pressure measurements. Both the intervention and the control group were followed up to six months after the end of the intervention. The main outcome of focus was HbA1c after a period of eight months. One of the tools used in this research is the Short Form 36 version 1 (SF-36) questionnaire. The tools were used in assessing the quality of life, waist/hip ratio, BMI, lipid levels, and changes in blood pressure. These tools can also be applied in the DPI project. Data Collection: The main research data were weight, blood pressure, and blood sugar measurements were recorded by patients and uploaded to the database HbA1c improvement (p-value of 0.022),Upon analysis of the data, this research revealed key findings that support the project. The videoconferences integrated with normal diabetes care resulted in a significant reduction of HbA1c when compared to standard care alone.This study also had various weaknesses and biases. For example, more frequent contact with healthcare professionals could have had enhanced outcomes. Again the regulation of medication such as insulin use during the video calls would have led to the enhanced effect.The researchers recommend that future studies should focus on meeting patients’ needs as alternative approaches. In addition, this research showed some issues with non-attendance and non-compliance to the intervention; therefore, future studies should focus on addressing non-attendance and non-compliance.This research supports the proposed intervention in that the application of the video calls integrated with the usual or standard diabetes care led to significant improvements in HbA1c control in the intervention group.Sarayani A, MashayekM, Nosrati M, Jahangard-Rafsanjani Z, Javadi M, Saadat N, et al. Efficacy of a telephone-based intervention among patients with type-2 diabetes; a randomized controlled trial in pharmacy practice. Int J Clin Pharm 2018 Apr;40(2):345-353. https://doi.org/10.1007/s11096-018-0593-0 The main aim of this study was to examine the impact of telephone-based intervention in improving clinical outcomes and care in type-2 diabetes management.The study design used is a randomized controlled trial.Sample/Setting: The study recruited a total of one hundred patients, with fifty each randomized into the control and the intervention group. The research was conducted at Tehran University of Medical Sciences in Iran. Methods: The res
