High volume of medication non-adherent patients

by | Apr 4, 2025 | medicine

Select a practice problem from the list below.
• High volume of medication non-adherent patients
• Absent early childhood Autism screening in the primary care setting
• High percentage of patients with poorly controlled Hypertension
• Deficient interprofessional collaborative care planning for a Depressed patient
• High volume of patients who are no-call/no-show for appointments
• Mental health professional shortage in a rural setting
Focusing on your selected problem, conduct a search of the literature for solutions that can be developed into an improvement process.

 

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.


This question has been answered

God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

Now, I will conduct a search of the literature for solutions that can be developed into an improvement process for this problem.

Literature Search Strategy:

To find relevant literature, I will use the following search terms and strategies across reputable databases such as PubMed, Google Scholar, and potentially the Cochrane Library:

  • Keywords: “hypertension management,” “blood pressure control,” “medication adherence hypertension,” “lifestyle modification hypertension,” “patient education hypertension,” “remote monitoring hypertension,” “telehealth hypertension,” “community health workers hypertension,” “nurse-led hypertension interventions,” “pharmacist-led hypertension interventions,” “quality improvement hypertension,” “hypertension guidelines implementation,” “barriers to hypertension control,” “low-resource settings hypertension.”

Now, I will conduct a search of the literature for solutions that can be developed into an improvement process for this problem.

Literature Search Strategy:

To find relevant literature, I will use the following search terms and strategies across reputable databases such as PubMed, Google Scholar, and potentially the Cochrane Library:

  • Keywords: “hypertension management,” “blood pressure control,” “medication adherence hypertension,” “lifestyle modification hypertension,” “patient education hypertension,” “remote monitoring hypertension,” “telehealth hypertension,” “community health workers hypertension,” “nurse-led hypertension interventions,” “pharmacist-led hypertension interventions,” “quality improvement hypertension,” “hypertension guidelines implementation,” “barriers to hypertension control,” “low-resource settings hypertension.”
  • Inclusion Criteria:
    • Studies published within the last 5-7 years (to ensure contemporary approaches).
    • Focus on adult patients with hypertension.
    • Interventions aimed at improving blood pressure control and adherence to treatment.
    • Studies evaluating the effectiveness of specific interventions or strategies.
    • Consideration of studies conducted in primary care settings and low-resource environments (relevant to the context of Kenya).
  • Exclusion Criteria:
    • Studies focusing solely on the pathophysiology or diagnosis of hypertension.
    • Studies related to secondary hypertension without addressing primary management.
    • Case reports or opinion pieces without empirical data.

Initial Search Results and Emerging Themes (Based on anticipated findings):

Based on my knowledge of common challenges in hypertension management, I anticipate the literature search will reveal several recurring themes and potential solutions:

  1. Medication Adherence Interventions:

    • Simplified Regimens: Studies often highlight the benefit of once-daily dosing and combination pills in improving adherence.
    • Medication Reminders: Mobile health (mHealth) interventions like SMS reminders, apps, and automated phone calls have shown promise.
    • Patient Education and Counseling: Tailored education about hypertension, medication purpose, and potential side effects, delivered by nurses, pharmacists, or trained lay health workers, is frequently cited.
    • Motivational Interviewing: This patient-centered counseling approach can help address patient ambivalence towards medication and lifestyle changes.
    • Peer Support: Group sessions or peer mentorship programs can provide emotional and practical support for managing hypertension.

  2. Lifestyle Modification Support:

    • Dietary Interventions: Education and support for adopting healthy dietary patterns (e.g., DASH diet, reduced sodium intake) are consistently recommended.
    • Physical Activity Promotion: Strategies to encourage regular physical activity, including tailored exercise plans and community-based programs, are often evaluated.
    • Weight Management: Interventions targeting weight loss for overweight and obese hypertensive patients are common.
    • Smoking Cessation: Integrated smoking cessation support is crucial for overall cardiovascular health.

  3. Enhanced Monitoring and Follow-Up:

    • Home Blood Pressure Monitoring (HBPM): Studies support the use of HBPM with patient education and feedback to improve awareness and adherence.
    • Telehealth and Remote Monitoring: Utilizing phone calls, video consultations, and remote monitoring devices can facilitate more frequent follow-up and timely adjustments to treatment, particularly in rural or underserved areas.
    • Nurse-Led and Pharmacist-Led Clinics: Expanding the roles of nurses and pharmacists in hypertension management, including medication titration and patient education, has demonstrated positive outcomes.

  4. System-Level Interventions:

    • Standardized Protocols and Guidelines: Implementing evidence-based guidelines and protocols for hypertension management can ensure consistent and high-quality care.
    • Team-Based Care: Collaborative approaches involving physicians, nurses, pharmacists, community health workers, and other healthcare professionals can provide comprehensive support to patients.
    • Integration with Existing Healthcare Systems: Solutions need to be feasible and sustainable within the existing primary care infrastructure in Kenya.

Next Steps:

I will now proceed to conduct a focused search using the keywords and strategies outlined above. I will critically appraise the identified literature to extract key findings, evaluate the strength of evidence, and identify promising interventions that can be adapted and implemented as part of an improvement process to address the high percentage of patients with poorly controlled hypertension in a Kenyan primary care setting. The findings will inform the development of specific, measurable, achievable, relevant, and time-bound (SMART) goals and interventions for the improvement process.

This question has been answered.

Get Answer