Critique and Picot
Literature Evaluation Table
Student Name:
Summary of Clinical Issue (200-250 words):
One of the clinical issues that are faced in the US is opioid overdose. The opioid crisis has been in the U.S. for over two decades. The crisis has grown at an alarming rate in the previous years. That has increased the average number of people who die from opioid overdose daily. The number of people with opioid disorder has also increased. The problem has increased with more reported cases of people dying from opioid overdose daily. It is estimated that more than 130 people die daily from opioid misuse. Opioid abuse increased by 71% from 2012 to 2018. Therefore, it is a serious issue facing society. When teens and adults result in drug use, they are not productive. That leads to a huge loss in society. They may also result in other social injustices such as crime to get the money for the drugs. Therefore, the opioid crisis can be used to formulate a good PICOT question. Over time, self-administered drugs such as naloxone, also known as Narcan, have been developed to curb opioid misuse (Narcan, n.d). Due to the rising numbers of opioid misuse, the legislature and executive of the U.S. have spotted the problem. That led Trump to make the opioid crisis a public health disaster in the U.S. Trump’s administration has taken several strategies to help fight opioid misuse.
PICOT Question: Can opioid users who have access to naloxene be compared to those without access to naloxene at the risk of having a fatal opioid overdose?
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Criteria |
Article 1 |
Article 2 |
Article 3 |
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APA-Formatted Article Citation with Permalink |
Tobin, K., Clyde, C., Davey-Rothwell, M., & Latkin, C. (2018). Awareness and access to naloxone necessary but not sufficient: examining gaps in the naloxone cascade. International Journal of Drug Policy, 59, 94-97.
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Murphy, S. M., McCollister, K. E., Leff, J. A., Yang, X., Jeng, P. J., Lee, J. D., ... & Schackman, B. R. (2019). Cost-effectiveness of buprenorphine–naloxone versus extended-release naltrexone to prevent opioid relapse. Annals of internal medicine, 170(2), 90-98.
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Katzman, J. G., Takeda, M. Y., Bhatt, S. R., Balasch, M. M., Greenberg, N., & Yonas, H. (2018). An innovative model for naloxone use within an OTP setting: a prospective cohort study. Journal of addiction medicine, 12(2), 113.
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How Does the Article Relate to the PICOT Question? |
The article relates to the use of naloxene to in prevention of opioid use |
It investigates the cost effectiveness of naloxene |
The study investigates how naloxene should be used to avoid opioid overdose |
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Quantitative, Qualitative (How do you know?) |
Quantitative - method of data collection |
Quantitative -Method of data collection |
Quantitative - Method of data collection |
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Purpose Statement |
Investigating the accessibility of naloxene |
To evaluate the cost-effectiveness of buprenorphine–naloxone versus extended-release naltrexone. |
The goal of this study is to measure the opioid overdose reversal rate with take-home naloxone among participants with a diagnosis of opioid use disorder (OUD) in an opioid treatment program (OTP) setting. |
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Research Question |
Are there gaps in the naloxene cascade? |
What is the cost-effectiveness of using naloxene? |
What is the effectiveness of naloxene in prevention of deaths related to opioid overdose? |
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Outcome |
There is a gap in the possession of naloxene |
Incremental costs combined with incremental quality-adjusted life-years (QALYs) and incremental time abstinent from opioids. |
Thirty-one study participants reported overdose reversals using naloxone auto-injector kits on 38 community members. |
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Setting |
Healthcare facility |
Healthcare facility |
The participants stayed at home but they were monitored |
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Sample |
353 people |
570 adults with opioid disorder |
Two hundred forty-four study participants received overdose education, instruction on how to use naloxone, and were provided with 2 doses of a take-home naloxone auto-injector kit. They were subsequently followed for 3 months. |
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Method |
Cross-sectional survey was used |
Clinical trial |
Cohort study |
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Key Findings of the Study |
This study identifies that consistent possession is a gap in the naloxone cascade. |
Buprenorphine–naloxone is preferred to extended-release naltrexone as first-line treatment when both options are clinically appropriate and patients require detoxification before initiating extended-release naltrexone. |
The large number of overdose reversals reported in this prospective study suggests that this novel model for naloxone use may be replicated at other OTP settings to reduce opioid overdose deaths. |
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Recommendations of the Researcher |
Future research is needed to understand reasons for not always carrying naloxone. |
Conduct a study that includes the follow up data |
Future research papers should study the effectiveness of self-administered naloxene |
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Criteria |
Article 4 |
Article 5 |
Article 6 |
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APA-Formatted Article Citation with Permalink |
Oliva, E. M., Christopher, M. L., Wells, D., Bounthavong, M., Harvey, M., Himstreet, J., ... & Workgroup, D. (2017). Opioid overdose education and naloxone distribution: Development of the Veterans Health Administration’s national program. Journal of the American Pharmacists Association, 57(2), S168-S179.
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Neale, J., & Strang, J. (2015). Naloxone-does over-antagonism matter? Evidence of iatrogenic harm after emergency treatment of heroin/opioid overdose. Addiction (Abingdon, England), 110(10), 1644–1652. https://doi.org/10.1111/add.13027 |
Bessen, S., Metcalf, S. A., Saunders, E. C., Moore, S. K., Meier, A., McLeman, B., ... & Marsch, L. A. (2019). Barriers to naloxone use and acceptance among opioid users, first responders, and emergency department providers in New Hampshire, USA. International Journal of Drug Policy, 74, 144-151.
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How Does the Article Relate to the PICOT Question? |
The study related to preventing opioid-related deaths by using naloxene |
The study investigates the effects of using naloxene in prevention of opioid addiction |
The study investigates the effectiveness of naloxene in preventing opioid addiction. |
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Quantitative, Qualitative (How do you know?) |
Qualitative - Method of data collection |
Qualitative - Method of data collection |
Qualitative - Method of data collection |
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Purpose Statement |
To prevent opioid-related mortality, the Veterans Health Administration (VHA) developed a national Opioid Overdose Education and Naloxone Distribution (OEND) program. |
To analyse drug users' views and experiences of naloxone during emergency resuscitation after illicit opiate overdose |
This study was conducted to understand emergency responders’ and opioid users’ experiences with, and opinions about, naloxone use and distribution in New Hampshire. |
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Research Question |
How can opioid related deaths be prevented? |
What are the effects of using naloxene in preventing opioid addiction? |
Is naloxene available in New Hampshire and is it effective? |
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Outcome |
The number of naloxene-related reversal increased. |
Participants had limited knowledge of naloxone and its pharmacology, yet described it routinely in negative terms and were critical of its medical administration. |
Users and responders largely agreed that naloxone had become increasingly available in NH at the time of the study. |
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Setting (Where did the study take place?) |
Medical facilities |
Emergency departments, drug services and pharmacies in two Scottish cities. |
New Hampshire counties |
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Sample |
172 participants |
131 males and 69 females. |
76 opioid users and 36 emergency responders |
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Method |
Clinical outcomes observations |
face-to-face interviews |
Semi-structured interviews |
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Key Findings of the Study |
VHA has successfully translated community-based OEND into health care system–based OEND targeting 2 patient populations. |
Opiate users in urban Scotland repeatedly report harm caused by naloxone over-antagonism, although this is not evident in observational data. |
Opioid users’ and emergency responders’ perceptions about naloxone may limit the optimal use of naloxone within the community. |
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Recommendations of the Researcher |
Future studies should investigate the accessibility of naloxene. |
Future research should be conducted to help to explain why naloxone has such a feared reputation among opiate users.
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Future studies should be conducted to identify opportunities to address misconceptions about naloxone and challenges in accessing naloxone, which may improve opioid overdose prevention strategies.
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Hello Eliety,
You presented good efforts overall on your Module 1 assignment! Please narrow your focus towards a nursing practice issue. Review how you can address this problem in your area of practice. You are presenting the medical problem and not the nursing problem.
It would be helpful to further describe the problem as it relates to nursing practice. Review the nursing practice problem versus medical practice problem. This will assist in strengthening your PICOT question formulation. It will be helpful to look at the reading materials. I also included a sample posted to the Class announcement page for assistance. You also did a good job selecting articles to help in your proposed research. However, the articles appear to address the medical problem.
Please see my additional balloon comments noted throughout the paper above for feedback. Also, please remember to review the assignment guidelines and rubric completely to make certain all points are included. As you review the research method, please remember to include the specific method and detail used to conduct the research. Once the method used is identified, such as qualitative, then you can state interviews, or observational.
Continue to review APA 6th edition guidelines to assist in your formatting; you are doing a good job overall. I hope the corrections will be of help to you for next writing assignment. Once again, good efforts! - Cherryl Llanos MSN, RN
�Good efforts here; however please review how you can direct this more towards a nursing practice problem?
Where does the nurse fit into this issue? How can the nurse assist in this issue? Please review to address the issue in your area of nursing practice.
�Good efforts here; however please review how you can direct this more towards a nursing practice problem?
�Good efforts here as you review the articles. However, it will be helpful to review an issue in nursing practice. Please review nursing journals for further assistance.
�Good start. It also would have been helpful to include your permalinks per guidelines.
�Overall good efforts noted here. Further details on how the articles relate to the PICOT would be helpful.
�
�
�What is the method of data collection?
How did you determine if qualitative or quantitative?
�Good
�Good job identifying questions.
�Outcomes also presented well
�Remember to be more specific. Provide research setting in regards to center, unit, clinic, etc.
�Good start here, what was the specific method used to conduct the study?
�Findings have been discussed and key points noted
�Good
�remember permalinks
�How do you know? Please be specific.
�watch for change in font style
�Remember to be more specific. Provide research setting in regards to center, unit, clinic, etc.
�Good start here, what was the specific method used to conduct the study?
�Overall, good efforts selecting your articles for the article search!
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