Application of Adult-Learning Principles to Patient Instructions: A Usability Study for an Exenatide Once-Weekly Injection Device
- Gayle Lorenzi, RN, CDE,
- Barbara Schreiner, PhD,
- Joachim Osther and
- Marilyn Boardman, PharmD
More than 23 million individuals in the United States have diabetes, and ∼ 90% of those have type 2 diabetes. An important aspect of successful disease management for type 2 diabetes is effective use of the numerous pharmacological interventions that are available to target the metabolic defects contributing to the underlying pathology.1 After lifestyle modification and metformin, clinicians may consider many factors when selecting additional therapies. These include efficacy, safety, side effects, treatment complexity (i.e., dosing, administration, and convenience), unique patient characteristics (e.g., physical and cognitive capabilities, understanding of disease, comorbidities, and self-care involvement), and cost. Importantly, patients' ability to initiate and continue using a prescribed therapy is heavily dependent on the education they receive about the disease and its recommended treatments.2
Self-Management of Chronic Disease
Self-management education is an integral component of diabetes care and is emphasized in the American Diabetes Association's Standards of Medical Care in Diabetes3 and in the Chronic Care Model.4,5 Data support the positive impact of self-management education on quality of life, glycemic control, and psychological factors.6–9 Furthermore, self-management education raises patient awareness of the impact of poor disease management on the occurrence of disease-related complications, premature mortality, and morbidity.10
However, few patients are actually educated by trained professionals or have access to diabetes education training programs.11–14 Often, patients must rely on sources such as the Internet, lay and promotional materials, and peers to supplement the education received from providers who must balance patient needs with severe time and resource constraints.15 In addition, individual characteristics such as language, literacy, vision, comprehension of the need for a therapy, and willingness to try alternatives to managing the disease will influence understanding and subsequent use of any prescribed therapy.16,17
Education Principles
These education challenges also apply …
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