From the Guidelines
Assessing medication adherence would be the most helpful information in deciding the next interventions for EC. When a patient with diabetes returns with an elevated A1C of 9.2% and symptoms of polyuria and polydipsia (increased urination and thirst), understanding whether they are taking their prescribed medications as directed is crucial 1. Poor medication adherence is a common cause of uncontrolled diabetes, and identifying this issue would allow for targeted interventions such as simplifying the medication regimen, addressing barriers to adherence, or providing education about the importance of consistent medication use. While assessing physical activity, food intake, and screening for depression are all important components of diabetes management, medication adherence directly impacts glycemic control and should be addressed first when symptoms of hyperglycemia are present. Understanding EC's medication-taking behavior provides the foundation for any additional interventions that may be needed to improve their diabetes control and prevent complications. Some key considerations for EC's treatment plan, as outlined in the standards of care in diabetes-2024, include the use of combination therapy or more potent glucose-lowering agents when A1C is ≥1.5% above the individualized glycemic goal, and the potential benefits of GLP-1 RAs and tirzepatide in improving glycemic control and reducing cardiovascular risk 1. However, assessing medication adherence is the first step in determining the best course of action for EC, as it will inform whether adjustments to the medication regimen or other interventions are needed to achieve optimal glycemic control.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Assessing Additional Information for EC's Interventions
To decide on the next interventions for EC, it is crucial to gather more information about her current situation. The following points highlight the most helpful additional information:
- Assessing medication adherence: This is a critical aspect, as studies have shown that non-adherence to medication is a significant issue in patients with chronic illnesses, including diabetes 2, 3, 4, 5. Assessing EC's medication adherence can help identify any potential issues with her current treatment plan.
- Factors affecting adherence: Research has identified various factors that can affect adherence, including patient-perceived barriers, type of delivery device, and cost of medication 6. Understanding these factors can help healthcare providers develop targeted interventions to improve EC's adherence.
- Patient education and support: Studies have emphasized the importance of patient education and support in improving medication adherence 2, 5. Assessing EC's understanding of her medication regimen and providing additional education and support can help improve her adherence.
- Monitoring and follow-up: Regular monitoring and follow-up can help identify any issues with EC's medication adherence and allow for timely interventions 2, 4. This can include regular check-ins with healthcare providers, monitoring of blood glucose levels, and adjustments to her medication regimen as needed.
Comparison of Options
The options for assessing additional information for EC's interventions are:
- Assessing medication adherence: This is a crucial aspect of EC's care, as non-adherence can have significant consequences for her health 2, 3.
- Assessing daily physical activity: While physical activity is an important aspect of diabetes management, it may not be directly related to EC's current issue with medication adherence.
- Assessing 24-hour food intake: Similar to physical activity, food intake is important for diabetes management, but it may not be directly related to EC's medication adherence.
- Assessing patient for depression: Depression can be a comorbidity with diabetes, but it may not be directly related to EC's current issue with medication adherence.
Based on the available evidence, assessing medication adherence is the most critical aspect of EC's care at this time 2, 3, 4, 5, 6.