EVIDENCE-BASED PROJECT, PART 4: RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE
Chronic Pain in the Elderly Patient Population
Tiara Sank
Dr, Usama Saleh
Essentials of Evidence-Based Practice
Walden University Date
introduction
Clinical Issue: Chronic pain in the elderly patient population: Treatment and management strategies.
Symptoms: Chronic pain, ability to move limited, course of mind negatively affected.
Current Practices: Medications, physical therapy, and psychological support are typical measures.
Challenges: Drug-interaction between drugs, compliance to therapeutic regimen.
Objective: What is currently known about efficient management and how can it be utilized?
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Development of the pico(t) question
PICO(T) Framework: PICO: The mnemonic for identifying the four elements of a final study question is PICO, for Population, Intervention, Comparison, Outcome, Time.
Population: They include patients with chronic pain and those who are elderly.
Intervention: In this study, a multimodal approach of managing pain was used to encompass both physical and medical aspects.
Comparison: Standard pharmacological treatment.
Outcome: Diminished facets of the pain scale, enhanced well being status.
Time Frame: Table 2: Based on the survey of over a period of 6 months.
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Pico(t) question:
‘What is the difference in pain levels and quality of life 6 months after elderly chronic pain patients had adopted a multimodal pain management approach as compared to adopting standard pharmacological treatment?’
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databases
Database 1: PubMed
Focus: Biomedical literature.
Database 2: Cochrane Library
Focus: in identified systematic reviews and meta-analyses.
Database 3: CINAHL
Focus: Nursing and allied health literature are used as sources to get perspective on the knowledge deficit.
Database 4: Evidence appraisal and synthesizing will be done using the Joanna Briggs Institute (JBI)
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Peer-reviewed articles
Article 1
Kechichian, A., Lafrance, S., Matifat, E., Dube, F., Lussier, D., Benhaim, P., ... & Desmeules, F. (2022). Multimodal interventions including rehabilitation exercise for older adults with chronic musculoskeletal pain: a systematic review and meta-analyses of randomized controlled trials. Journal of Geriatric Physical Therapy, 45(1), 34-49.
Article 2
Cohen, S. P., Vase, L., & Hooten, W. M. (2021). Chronic pain: an update on burden, best practices, and new advances. The Lancet, 397(10289), 2082-2097.
Article 3
Yong, R. J., Mullins, P. M., & Bhattacharyya, N. (2022). Prevalence of chronic pain among adults in the United States. Pain, 163(2), e328-e332.
Article 4
Bao, Z., & Landers, M. (2022). Non‐pharmacological interventions for pain management in patients with dementia: A mixed‐methods systematic review. Journal of Clinical Nursing, 31(7-8), 1030-1040.
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Levels of evidence in selected articles
Article 1: Level I
•Strengths: Publication level assessment aims at examining the body of evidence and its relevance to the clinical question of interest, hence the focus was done on the randomized controlled trials.
Article 2: Level I
•Strengths: Basically, using more than one therapy comparison with high number of sample subjects, enhanced research method.
Article 3: Level II
•Strengths: Cohort studies with plentiful data of high quality, duration of the follow-up data.
Article 4: Level I
•Strengths: Option of unpredictable approach, versatility in applying the intervention strategies.
Advantages of Systematic Reviews: High relevance, methodological rigor, integration of other research reports.
Examples: Having continued education clinical practice guidelines lead to better decisions.
Strengths of using systematic reviews for clinical research
Comprehensive Evidence: Then sum up available information from a number of studies.
Reduces Bias: This approach limits bias that might be associated with carrying out research on specific studies.
Generalizability: Key Research Strength: Extends the generalizability of the results to other groups of people.
Informs Practice: Fully substantiates standards being utilized in the clinical field.
Efficiency: Reduces time spent in attempting to analyze large data sets through giving a summary of the research done.
Decision-Making: Affords well-based clinical decisions to light the professionals.
references
Bao, Z., & Landers, M. (2022). Non‐pharmacological interventions for pain management in patients with dementia: A mixed‐methods systematic review. Journal of Clinical Nursing, 31(7-8), 1030-1040.
Cohen, S. P., Vase, L., & Hooten, W. M. (2021). Chronic pain: an update on burden, best practices, and new advances. The Lancet, 397(10289), 2082-2097.
Kechichian, A., Lafrance, S., Matifat, E., Dube, F., Lussier, D., Benhaim, P., ... & Desmeules, F. (2022). Multimodal interventions including rehabilitation exercise for older adults with chronic musculoskeletal pain: a systematic review and meta-analyses of randomized controlled trials. Journal of Geriatric Physical Therapy, 45(1), 34-49.
Yong, R. J., Mullins, P. M., & Bhattacharyya, N. (2022). Prevalence of chronic pain among adults in the United States. Pain, 163(2), e328-e332.