evidenced base

My study interest is psychiatric mental health. Psychiatric patients are often given various medications to treat psychotic disorders. My PICOT question is what are the risks and benefits of anti-psychotic medications? My clinical inquiry is focused safe and effective treatment for psychotic disorders. The continuum performance of multitude interventions such as administering medication, arouse questions about the evidence supporting their use and effectiveness (Stillwell, Fineout-Overholt, Melnyk, & Williamson, 2010). While delivering care, I am intrigued to learn how medications will affect my patients.

I initiated my search using the key term “psychotic disorders” at the Walden University Library as filtered and unfiltered. I chose a database with strong levels of evidence for intervention questions because they have the best study designs and are generally the most rigorous” (Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M., 2010b). I retrieved unfiltered information from the Cochrane Database of Systematic Reviews from 2014-2018. This resulted in nine articles. These articles pertained to medications and there affects. I retrieved 31,509 unfiltered results by adding two additional databases, PsychINFO, and CINAHL Plus with Full Text. To narrow my search, I added key terms psychotic disorders, mono anti-psychotic medication, and combination therapy in my additional search terms and identifiers.

I then used Boolean phrases with full text peer-reviewed scholarly articles, ranging from 2014-2019, and Cochrane reviews from 2014-2019. I used special limiters for PsychINFO, which were Peer-Review Journals from 2014-2019. My Boolean search with key term “medications” resulted in 783 articles, key term “Safety,” resulted in 35 articles. These articles pertained to specific medications for psychotic disorders.

I found two articles to further study. I will focus on one to answer my PICOT question “The risks and benefits of switching patients with schizophrenia or schizoaffective disorder from two to one antipsychotic medication: A randomized controlled trial”. The article imply changing medications risks exceed benefits for patients on long-term psychiatric therapeutic medications. The article further states, changing medications should be approached with great caution (Constantine et al., 2015). Effective medication management is essential in safe treatment for psychosis. In schizophrenia spectrum disorders antipsychotic medications are routine maintenance treatment (Birur at el., 2020)

References

Birur, B., Kraguljac, N. V., VerHoef, L., Morgan, C. J., Jindal, R. D., Reid, M. A., Luker, A., & Lahti, A. C. (2020). Neurometabolic correlates of 6 and 16 weeks of treatment with risperidone in medication-naive first-episode psychosis patients. Translational Psychiatry, 10(1), 15. https://doi-org.ezp.waldenulibrary.org/10.1038/s41398-020-0700-6

Constantine, R. J., Andel, R., McPherson, M., & Tandon, R. (2015). The risks and benefits of switching patients with schizophrenia or schizoaffective disorder from two to one antipsychotic medication: A randomized controlled trial. Schizophrenia Research, 166(1–3), 194–200. https://doi-org.ezp.waldenulibrary.org/10.1016/j.schres.2015.05.038

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Searching for the evidence. American Journal of Nursing, 110(5), 41–47. doi:10.1097/01.NAJ.0000372071.24134.7e. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2010/05000/Evidence_Based_Practice,_Step_by_Step__Searching.24.aspx

Walden University Library. (n.d.-a). Databases A-Z: Find the best library databases for your research. Retrieved from https://academicguides.waldenu.edu/az.php