Implementation of Multifaceted Interventions Questioned

Implementation of Multifaceted Interventions Questioned

Implementation of Multifaceted Interventions Questioned

 

Change Topic (2-3 sentences): Does implementing a multifaceted intervention versus standard care increase medication adherence and improve health outcomes in older adults receiving home healthcare .

 

Criteria	Article 1	Article 2	Article 3	Article 4
Author, Journal (Peer-Reviewed), and  Permalink or Working Link to Access Article	Christopher, C., Kc, B., Shrestha, S., Blebil, A. Q., Alex, D., Mohamed Ibrahim, M. I., & Ismail, N.   Aging Medicine. https://doi.org/10.1002/agm2.12203	Omboni, S., McManus, R. J., Bosworth, H. B., Chappell, L. C., Green, B. B., Kario, K., … & Wakefield, B. J Hypertension https://doi.org/10.1161/HYPERTENSIONAHA.120.15873	Manias, E., Bucknall, T., Hughes, C., Jorm, C., & Woodward-Kron, R. BMC geriatric. https://doi.org/10.1186/s12877-019-1102-6	Correia, J. C., Lachat, S., Lagger, G., Chappuis, F., Golay, A., & Beran, D BMC Public Health. https://doi.org/10.1186/s12889-019-7842-6
Article Title and Year Published	Medication use problems among older adults at primary care: A narrative of literature review. 2022	Evidence and Recommendations on the Use of Telemedicine for the Management of Arterial Hypertension. 2020	Family involvement in managing medications of older patients across transitions of care: a systematic review.. 2019	Interventions targeting hypertension and diabetes mellitus at community and primary healthcare level in low-and middle-income countries: a scoping review. 2019
Research Questions (Qualitative)/Hypothesis (Quantitative)	What are the medication use issues amongst older patients in primary care?	What are clinical usefulness and application and the present barriers and challenges for medicine in hypertension management?	Family play important role in the management of older patients’ medications in transition care.	What are the interventions for hypertension and diabetes mellitus at the primary and community healthcare level in low and middle-income nations?
Purposes/Aim of Study	To find out some of the major issues amongst older adults within primary care.	To conduct a critical review of the available evidence on the clinical usefulness and application of telemedicine in hypertension management, as well as the current barriers and challenges.	What is the impact of family involvement in the management of older patients’ medications across transitions of care.	To synthesize the evidence about the primary care interventions on hypertension and diabetes mellitus.
Design (Type of Quantitative, or Type of Qualitative)	Narrative Review of literature on medication use problems.	Literature review	Systematic review study approach.	scope or literature review
Setting/Sample	No setting or sample since it was a narrative review of past studies.	None	None	None
Methods: Intervention/Instruments	No intervention	The use of telemedicine in the management of patients.	Family intervention in the management of older patients’ medications.	The interventions for both hypertension and diabetes Mellitus
Analysis	A narrative review of past studies.	None	None	None
Key Findings	This review demonstrates that medication use remains a significant issue among older adults in OECD countries. Several studies have identified medication use issues in older adults, such as a high incidence of adverse drug events and nonadherence to medication, inappropriate medication, polypharmacy, a lack of deprescribing, medication beliefs, and a lack of knowledge and awareness about medication use. Despite these issues, there appears to be a lack of interventions for older adults’ medication use problems, particularly at the primary care level.	Telemedicine is a viable option for assisting doctors and other care managers in providing effective care to hypertensive patients and optimizing their management. The available evidence supports its use in patients with difficult-to-treat hypertension or who are noncompliance with medication management.	While families actively engaged in strategies to ensure safe medication management with older patients, communication about medication plans of care across transitions tended to be haphazard and disorganized, and there was a lack of shared decision-making between families and health professionals.	This review demonstrates the variety and complexity of approaches tested to address HTN and DM in LMICs, as well as the elements of interventions that must be addressed in order to strengthen care delivery. Most studies provided little information about implementation processes, making replication difficult.
Recommendations	There is a need to have effective interventions in the primary care to address the issue of medication use problems.	More scientific evidence is required to demonstrate the efficacy of telemedicine in other specific subgroups, in addition to effective blood pressure control.	More research is needed to assess the efficacy of these strategies in terms of medication outcomes, to facilitate shared decision making between families and health professionals, and to clarify medication plans of care across transitions.	Study designs and evaluation techniques must be modified to include process evaluations rather than just effectiveness or outcome evaluations.
Explanation of How the Article Supports EBP/Capstone Project	The study is important for the capstone project since it reveals that medication usage issues in older adults require a comprehensive approach and a collaborative effort from healthcare providers and healthcare institutions hence a successful effort in promoting medication adherence.	The study is important for the capstone project as it reveals about the importance of telemedicine as it allows patients and healthcare professionals to exchange medical data over the Internet. It is used to improve patients’ access to care and to provide effective remote healthcare services. This helps in the promotion of medication adherence at home.	The study is important for the capstone study as it reveals the role played by family members in the management of older patients’ medications.	The study is important for the capstone project as it recommends some of the interventions to be in place to help in strengthening the delivery of healthcare.

 

 

 

 

 

Criteria	Article 5	Article 6	Article 7	Article 8
Author, Journal (Peer-Reviewed), and  Permalink or Working Link to Access Article	Manyazewal, T., Woldeamanuel, Y., Blumberg, H. M., Fekadu, A., & Marconi, V. C. NPJ digital medicine. https://doi.org/10.1038/s41746-021-00487-4	Wong, A. K. C., Wong, F. K. Y., Chow, K. K. S., & Wong, S. M. Gerontology. https://doi.org/10.1159/000516967	Edward, A., Campbell, B., Manase, F., & Appel, L. J. BMC health services research. https://doi.org/10.1186/s12913-021-06858-7	Wilkinson, R., Garden, E., Nanyonga, R. C., Squires, A., Nakaggwa, F., Schwartz, J. I., & Heller, D. J.  International Journal of Nursing Studies. https://doi.org/10.1016/j.ijnurstu.2021.104143
Article Title and Year Published	The potential use of digital health technologies in the African context: a systematic review of evidence from Ethiopia. 2021	Effects of a Video-Based mHealth Program for Homebound Older Adults: Study Protocol for a Pilot Randomized Controlled Trial. 2022.	Patient and healthcare provider perspectives on adherence with antihypertensive medications: an exploratory qualitative study in Tanzania. 2021.	Causes of medication non-adherence and the acceptability of support strategies for people with hypertension in Uganda: a qualitative study. 2022
Research Questions (Qualitative)/Hypothesis (Quantitative)	What is the level of digital acceptance by the population?	What is the impact of video-based mHealth program for homebound older adults?	What are the perceived barriers to the HT medication adherence.	What are the causes of medication non-adherence and the acceptability of support strategies for individuals with hypertension in Uganda?
Purposes/Aim of Study	To understand whether and how digital healthcare technologies are absorbed in Africa.	The goal of this study is to move away from the current reactive, cure-oriented approach and toward a preventive and health-promoting model, empowering homebound older adults to take an active role in their health, be responsive to their care needs, and thus improve their overall health.	To identify perceived barriers to adherence to HT medication in Dar es Salaam	This research had two objectives. First, the researchers wanted to know what factors help or hinder patients’ efforts to stick to their hypertension medications at the start. Second, the purpose of this study was to investigate the acceptability and feasibility of adherence interventions for both providers and patients.
Design (Type of Quantitative, or Type of Qualitative)	Systematic review	Pilot Randomized control trial	Qualitative study grounded theory principles.	Qualitative study performed to explore the beliefs of the participants concerning the medication non-adherence as the researcher examined the acceptability of support approaches validated in same context.
Setting/Sample	None	5 community centers.	Catchment areas of the two semi-urban clinic in Dar es Salam.	Study performed in a large, urban private hospital in Kampala, Uganda. Fifteen healthcare providers and forty-two patients were interviewed
Methods: Intervention/Instruments	Acceptance of the digital health technologies	Video-based mHealth program for homebound older adults	Perspectives on adherence with hypertensive medications.	Looking into the causes of non-adherence and the acceptability of support approaches for individuals with hypertension.
Analysis	None	None	The KIIs were written down, coded, and analyzed. For both KIIs and FGDs, coding was completed in a systematic manner with iterative review by a research team member, with consultation of a second member on any arbitrary statements.	The transcripts of the interviews were analyzed using the NVIVO software.
Key Findings	Digital health technologies hold great promise for addressing major clinical and public health backlogs and strengthening Ethiopia’s health systems. Although they are a relatively new phenomenon in Ethiopia, their potential to improve clinical and public health practices is clear.	The current study will contribute to the body of knowledge about using mHealth in conjunction with a health-social team to improve quality of life and self-care and meet the needs of these especially vulnerable older adults.	Several context-specific measures will be required for effective management of hypertensive patients for medication adherence. These include policy measures addressing financial access, such as medication subsidies for the poor and easily accessible distribution systems for medication refills; physician measures to improve health provider counseling for patient-centered care; and patient-level strategies with medication adherence reminders in low-resource settings.	Participants made connections between these interventions and previously unknown non-adherence drivers, such as the absence of symptoms from untreated hypertension, fear of medication side effects, interest in traditional herbal medicine, and the importance of family and community support.
Recommendations	More RCTs on emerging DHTs such as AI, big data, cloud, cybersecurity, telemedicine, and wearable devices are required to provide robust evidence of their potential use in such settings and to materialize the Global Digital Health Strategy.	None	Policy changes, ideally guided by rigorous intervention studies, are required to improve medication adherence in HT patients.	None
Explanation of How the Article Supports EBP/Capstone	The study is important as it reveals about the important of adopting the digital health technology in the healthcare of a patient. The use of digital health technology supports the effective communication process and exchange of patient information between the provider and the family members/patient.	The study is important for the capstone project as it reveals about the important of mHealth in connecting the patients and family with providers.	The study is important for the capstone since it shows some of the factors impeding on patient medication adherence and the potential strategies to help in the effective process of addressing the present gap in continuous patient care.	The study is important for the capstone project as it reveals about the role of providers and patients at the facility in recognizing the medication non-adherence as a key barrier in hypertension control.

Implementation of Multifaceted Interventions Questioned