homework 2

Response one

A major strength of the study selection process by Verloo et al. is that the search they conducted was methodical and exhaustive.  They worked with a medical librarian to search through 12 different electronic databases, some of which date back over a hundred years.  The researchers manually went through the bibliography of each relevant article they found, and also searched through unpublished works in attempt to find more studies to include in their review.  MeSH terms related to the key phrases “age, medication adherence, nurse, and hospital” were used to search for intersections of the terms, which ultimately produced results that matched the topic of the study.

            Another strength is that the researchers used strict inclusion and exclusion criteria.  They picked only research reports of studies that were randomized or controlled clinical trials that had evaluated the effect of nurse interventions on medication adherence compared to usual care among recently discharged patients over the age of 65 (Verloo, et al., 2017).  They further classified variables such as types of nursing interventions performed and patient outcomes, in order to ensure that only studies that answered their research question were included in their review.

            A possible weakness of their search is that they only used articles in written in English, German or French.  Using research in only these three languages means that they could have missed many other studies that would have otherwise been relevant to their review.  The researchers admit in their discussion that it is possible that they could have missed opportunities to review.

 

Verloo, H., Chiolero, A., Kiszio, B., Kampel, T., & Santschi, V. (2017). Nurse interventions to

        improve medication adherence among discharged older adults: a systematic review. Age

response 2

In this study “Nurse interventions to improve medication adherence among discharged older adults: a systematic review”, by Henk Verloo, Atnaud Chiolero, Blanche Kiszio, Thomas Kampel, and Valerie Santschi,  the authors screened titles,  full texts, and abstracts from the literature available before determining how eligible they were. albeit this type of selection exposes the author to varied studies from which to analyze and establish a niche, they are  flawed with internal validity. it's possible that in selection of studies, the standard is insufficient, the info is insufficient, and there are biases therein selection. Besides, if the articles contain favorable content then the findings might give bias results (Finchkh & Tramer, 2020). However, the search criteria as indicated during this study was supported the language during which they're written; which is English, German, and French. meaning the author had a transparent understanding of data within the study. Similarly, it had been possible for the authors to digest and assimilate tons of data before deciding and therefore the reviews afford an objective appraisal of evidence with minimal bias (Finchkh & Tramer, 2020). Another consideration was studies being controlled or randomized clinical trials then whether or not they had assessed the consequences of collaborative interventions or nurse interventions with the healthcare experts on medical adherence as compared to the usual-care group. The participants were to be recently discharged and older adults of 65 years and more, who lived reception, and took a minimum of one prescribed, medication for any medical situation. The observation was also focused on changes medication adherence within the course of the follow-up measured through the utilization of a questionnaire, electronic monitor, pill counts, adherence tool, prescription refills, patient self-reporting (Clarke, 2011, p. 64).

suggests that systematic review delivers comprehensive summary of each primary research in response to the research question and it seeks predetermined eligibility and relevance of the study criteria, reproductivity and transparency of the methods also as study synthesis. The research purpose was in determining if nursing intervention alone or together with other health experts, were effectual within the improvement of medication adherence among the house dwelling older adults with ages 65 and more, the recently discharged, and inpatient, as compared to the people receiving usual care. Therefore, the above systematics review procedure was quite suitable with this type of purpose because it had been checking something that would allow follow-up and self-reporting. Strengths and weaknesses of how the info was extracted and therefore the risk of bias determined for every study within the review. Consider the procedures employed by the researchers and therefore the tools want to determine risk of bias. In data extraction, the 2 authors worked independently in collecting information by use of a special and standardized process. Discussion among the co-authors helped eliminate disagreements and in data extraction, authors, years of publication, places of publication, study attributes, study participants, intervention features, care group features and outcome measures were considered. Moreover, the authors examined the danger of bias for each study they included through the Cochrane Risk of Bias tool after which they did validate through RCTs using attributes of adequate sequence randomization, selective outcome reporting, concealment of allocation, incomplete data outcome, blinding outcome assessors among other risk bias. The rating of such domains in low, unclear, high risk helped generate top quality assessments. According to Clarke (2011), the meticulous search, methodology selection, synthesis of evidence, enhances low risk in studies involving risks or biases. Therefore, the research targeted was effectively and well done.

 

 

                                                        References

Clarke, J. (2011). What is a systematic review? Evidence-Based Nursing, 14(3), 64. https://doi.org/10.1136/ebn.2011.0049

 

Finckh, A., & Tramèr, M. R. (2020). Primer: strengths and weaknesses of meta-analysis. Nature Clinical Practice Rheumatology, 4(3), 146–152. https://doi.org/10.1038/ncprheum0732

 

Verloo, H., Chiolero, A., Kiszio, B., Kampel, T., & Santschi, V. (2017). Nurse interventions to improve medication adherence among discharged older adults: a systematic review. Age and Ageing, 46(5), 747–754. https://doi.org/10.1093/ageing/afx076