Evidence-Based Project Proposal
Part 3: Literature Review and Critical Appraisal
Literature Review
Key terms used to guide the search for evidence
1. In the homeless population, hypertension is a significant health issue.
2. Clinical practice protocols - For practitioners, this guideline offers clear and comprehensive evidence-based recommendations based on current knowledge and practices for the Diagnosis and Management of Hypertension in the homeless population.
3. Hypertension management - High blood pressure may be prevented or delayed via healthy lifestyle choices, reducing heart disease risk. Treatments for hypertension may be more effective by altering homeless people's daily routines (Bernstein et al., 2018).
Five (5) research studies to support the evidence
The author relies on the findings of five studies to support his claims. A set of practice recommendations for the management of hypertension in the homeless population has been developed by the 2020 International Society of Hypertension practice guidelines. This group of people necessitates the use of effective therapeutic regimens. A clinical practice guideline is also critical to the treatment of hypertension because of the increasing number of homeless people and the link between their condition and their living situations. Bernstein et al. (2018), Johnson (2019), Association (2020), and Bagget, Liauw, and Hwang (2018) were among the papers that the author examined. First-line therapies for hypertension include weight reduction and pharmaceutical interventions with fewer cardiovascular risks than equivalent studies.
Critical Appraisal of Literature
Strength of evidence
Clinical practice guidelines may be utilized to help homeless persons with hypertension be diagnosed with a more thorough diagnostic that considers the obstacles they face daily in society, according to the author's findings (Association, 2020). Undiagnosed or poorly managed, hypertension may have severe consequences on other organ systems, such as the kidneys. Advanced practice nurses may reduce the risk of renal disease by identifying and treating hypertension and reducing morbidity and mortality in a primary care context. Health care practitioners may play an essential role in interacting with, treating, and teaching patients and achieving better health outcomes in this community by adopting clinical practice protocols (Johnson, 2019)
Weakness of the evidence
The author uses no specific clinical strategy to effectively diagnose and treat hypertension in the homeless population, which remains an open question. This author has some issues with evidence since homeless individuals have a lot of difficulties due to their living situations, which necessitates implementing a strict clinical procedure to assure accurate diagnosis and successful treatment (Bagget, Liauw, and Hwang, 2018).
What do we know?
In the homeless population, less than half of all hypertensive patients have successfully managed their blood pressure, despite well-established procedures for diagnosis and treatment. Chronic diseases such as heart disease and stroke are less likely when high blood pressure is under control. That is to say, although the therapy decreases blood pressure, the underlying reason is not often addressed, or other variables maintain the risk high even after the treatment is completed. The remaining risk may be reduced by starting treatment early, achieving therapeutic objectives quickly, and treating concurrent concerns.
What are the gaps?
Patients who experience homelessness have various specific problems that may make it difficult for them to get essential resources or adhere to a treatment plan. The homeless population often lacks primary health care, such as regular physicals and vaccines. These patients should be treated in the same way as the rest of the population. If the patient was last immunized for tetanus more than ten years ago, they should be vaccinated again. Pneumococcal immunization should be given to all people who are at risk of developing pneumonia.
References
Association, A. D. (2020). 1. Improving care and promoting health in populations: standards of medical care in diabetes2020. Diabetes Care, 43(Supplement_1), S7-S13.
Baggett, T. P., Liauw, S. S., & Hwang, S. W. (2018). Cardiovascular disease and homelessness. Journal of the American College of Cardiology, 71(22), 2585-2597.
Bernstein, R. S., Meurer, L. N., Plumb, E. J., & Jackson, J. L. (2018). Diabetes and hypertension prevalence in homeless adults in the United States: a systematic review and meta-analysis. American Journal of Public Health, 105(2), e46-e60, https://doi.org/10.2105/AJPH.2014.302330.
Johnson, H. (2019). Anxiety and Hypertension: Is There a Link? A Literature Review of the Comorbidity Relationship Between Anxiety and Hypertension. Current Hypertension Reports, 21(9). https://doi.org/10.1007/s11906-019-0972-5.
Unger, T., Borghi, C., Charchar, F., Khan, N. A., Poulter, N. R., Prabhakaran, D.,Ramirez, A., Schlaich, M., Sterglou, G. S., Tomaszewski, M., Wainford, R. D.,Williams, B., & Schutte, A.E. (2020). 2020 International society of hypertensionglobal hypertension practice guidelines.Journal of Hypertension,38(6), 982-1004.