Evidence Based Practice

Table of Contents

Critique of articles

Synthesis of ideas

References

Critique of articles

Article 1: Impact of a Self-Management Support Intervention for Older Adults with Asthma on Use of Controller Medications and Emergency Department Visits

Critique: The current article successfully portrays the issue of older asthmatic patients who are having more stemming issues. The main issue lies in the self-management strategy and use of inhaler and other methods of self-management have been portrayed in the article (Federman et al. 2019). For this reason, the research has been conducted on 405 people above age of 60 years which is known as Supporting Asthma Self-Management Behaviours in aging Adults (SAMBA). The research has been conducted with the help of primary data collection method among which metered dose inhaler (MDI) and Medication Adherence Rating Scale (MARS) have been incorporated. As the research has been done on the mean age of 68 years by lay coached screening method. It has been noticed, about 7.0% patients have shown low hospitalisation rate and lute reduction in risk is about 6.7% (Federman et al. 2019).

In the current article, the methodology of a significant control trail has been conducted on 405 adults more than 60 years old. With the help of SMS (self-management support) intervention, the rate of asthma self-management can be controlled. Along with this, it is also mentioned that hospitalisation rate can be reduced. However, this article has focused on many different issues of asthma patient that has not been addressed yet. Along with this, the use of inhaler and appropriateness of the inhaler dependent self-management strategy has been also identified (Federman et al. 2019). On the contrary, the researcher has much focused on asthma triggers more than other management strategy. Along with this, the researcher has not addressed proper strategic initiatives for supporting evidence based practices.

On the other hand, with the help of statistical data analysis process in which the Medication Adherence Rating Scale (MARS) sampling method has been effectively used. The researcher has thus effectively portrayed the outcomes by calculating adherence, t test and other sampling process. The use of hierarchical linear modelling successfully derives the result which is very close to accurate. The primary issue lies in the self-administration methodology and utilization of inhaler and different techniques for self-administration which have been depicted in the article. On the other hand, a relative study has been conducted in an effective way about behavioural outcome of the clinical intervention (Federman et al. 2019). Sometimes, this is not effective for people of elderly condition and they might have shown some behavioural problems.

There are certain limitations can be noticed in which the researcher has missed to state in-house inhaler intake rate and could have done the control trail on in-house patients rather in hospitalisation case. For this reason, self-management programme is necessary in order to lower the behavioural issues among the elderly people. besides this, inhaler has most low range of side effect. The current article successfully portrays the issue of older asthmatic patients who are having more stemming issues. The main issue lies in the self-management strategy and use of inhaler and other methods of self-management which have been portrayed in the article. Especially in case of people with older age group, they might suffer from high hospitalisation rate which can be significantly lowered with the help of inhaler usage that is portrayed in the current research article.

Article 2: Association Between Asthma Self-Management Knowledge and Asthma Control in The Elderly

Critique: this study is also conducted on controlled trial. The primary research has been done by the researcher in order to understand the hospitalisation rate of the patients and after intake of inhaler, the changed hospitalisation rate. In case of adult people, it is necessary to maintain a self-management strategic intervention for lowering use of medicine and rate of hospitalisation. For this reason, the article has also incorporated primary evidence based practice in order to identify both the aspects of doctors and patients (Ozturk et al. 2015). The researcher has interviewed trained allergist as well as 82 patients for understanding the need of self-management strategy of asthma control practice. The research has also discussed about the use of proper inhaler device in an effective way that the patients can easily access and conduct self-management practice.

It has been noticed, the use of asthma knowledge questionnaire has effectively used in the current study. The research has identified that asthma is the most chronic disease among world and most of the elderly people and numerous adults are suffering from asthma. The article highlights that, this investigation has effectively given need of instructing grown-up patients so as to act the executives program. Consequently, the exploration has recognized various procedures for accomplishing better asthma control, counteraction and treatment system (Ozturk et al. 2015). Along with this, asthma control testing has been done along with spirometry has been conducted. Based on this the statistical analysis has been done in an effective way. This is depicted as transient asthma convention which is vital so as to keep up everyday treatment care of grown-up individuals. if there should arise an occurrence of grown-up individuals, it is important to keep up a self-administration key mediation for bringing down utilization of medication and pace of hospitalization. Consequently, the article has likewise joined essential proof based practice so as to distinguish both the parts of specialists and patients.

It has been clearly identified from the conducted intervention, numerous people do not have least knowledge about use of inhaler and need of inhaler as per the health needs of people. on the contrary, the researcher has also considered the knowledge of people about the self-management of the asthma control and treatment strategy. It has been noticed that, an instant and abrupt treatment can be provided by inhaler to the patients which can increase the patient-centred outcome in an effective way which is a major positive aspect of the journal. It has been also noticed, in case of several adult patients especially in case of elder ones, they have insufficient inhaling equipment and proper training about the use of the inhaler (Ozturk et al. 2015). For this reason, the research has recommended to use patient-centred training care in the post clinical condition in which the allergist or other health care workers can provide training about the inclusion of inhaler dependent treatment. the scientist has likewise considered the information on individuals about the self-administration of the asthma control and treatment methodology. It has been seen that, a moment and unexpected treatment can be given by inhaler to the patients which can expand the patient-focused result in a successful manner.

Synthesis of Ideas

In the article one, the use and necessity of inhaler dependent short-term treatment is portrayed in an effective way. Therefore, it can be recommended that with the help of proper training and monitoring in the post-clinical period, use of inhaler can be understood by adults especially the patient in elderly condition (Perez et al. 2016). On the other hand, in case of the article two, the inclusion of correct action plan for conducting inhaler dependent treatment is mentioned. With the help of this action plan, the self-management programme can be proceeded. Appropriateness of avoidance and triggers of inhaler dependent treatments are also focused. Both the journals have identified the lack of practice of self-monitoring of asthma. Making up to date in the action plan of asthma treatment is necessary in which proper self-management practice can be understood.

It has been unmistakably distinguished from the led intercession, various individuals do not have least information about utilization of inhaler and need of inhaler according to the wellbeing needs of individuals. Unexpectedly, the analyst has likewise considered the information on individuals about the self-administration of the asthma control and treatment procedure. It has been seen that, a moment and unexpected treatment can be given by inhaler to the patients which can expand the patient-focused result in a successful manner (Salo et al. 2019). Both the journal has mentioned about the self-management through inhaler can lower the severe condition and can provide a short-term treatment and the outcomes of the journals have supported the evidence of low hospitalisation rate. Therefore, the examination has prescribed to utilize understanding focused preparing care in the post clinical condition in which the allergist or other health workers can give preparing about the consideration of inhaler subordinate treatment. the researcher has in like manner considered the data on people about the self-organization of the asthma control and treatment procedure. Article one has centred the need of self-administration practice among grown-ups with tedious hospitalization rate. Thus, as to forestall that, preparation to take inhaler has gotten essential and it is prescribed by article one.

Alongside this, the article two has bolstered such procedure and furthermore state need of fitting inhaler according to the clinical need of individual is to be done and individuals are to be prepared to take inhaler at home in a successful manner. It has been seen that, a second and surprising treatment can be given by inhaler to the patients which can extend the patient-centred outcome in an effective way (O'Conor et al. 2015). The procedure is vital that so as to power over polypharmacy and comorbidities, learning of inhaler use methods are essential. Article one has focused the need of self-management practice among adults with repetitive hospitalisation rate. In order to prevent that, training to take inhaler has become necessary and it is recommended by article one. Along with this, the article two has supported such strategy and also state need of appropriate inhaler as per the clinical need of person is to be done and people are to be trained to take inhaler at home in an effective way.

References for Evidence Based Practice

Federman, A., O'Conor, R., Wolf, M., & Wisnivesky, J. (2019). Impact of a self-management support intervention for older adults with asthma on use of controller medications and emergency department visits. Journal of allergy and clinical immunology, 143(2), AB210. Retrieved on: 13 March, 2020, From: https://www.jacionline.org/article/S0091-6749(18)32381-9/pdf

O'Conor, R., Wolf, M. S., Smith, S. G., Martynenko, M., Vicencio, D. P., Sano, M., ... & Federman, A. D. (2015). Health literacy, cognitive function, proper use, and adherence to inhaled asthma controller medications among older adults with asthma. Chest, 147(5), 1307-1315. Retrieved on: 13 March, 2020, From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420182/

Ozturk, A. B., Pur, L. O., Kostek, O., & Keskin, H. (2015). Association between asthma self-management knowledge and asthma control in the elderly. Annals of Allergy, Asthma & Immunology, 114(6), 480-484. Retrieved on: 13 March, 2020, From: https://www.researchgate.net/profile/Ayse_Ozturk4/publication/275772763_Association_between_asthma_self-management_knowledge_and_asthma_control_in_the_elderly/links/5bcd7de4299bf17a1c6622d8/Association-between-asthma-self-management-knowledge-and-asthma-control-in-the-elderly.pdf

Perez, L., Morales, K. H., Klusaritz, H., Han, X., Huang, J., Rogers, M., ... & Apter, A. J. (2016). A health care navigation tool assesses asthma self-management and health literacy. Journal of Allergy and Clinical Immunology, 138(6), 1593-1599. Retrieved on: 13 March, 2020, From: https://www.jacionline.org/article/S0091-6749(16)31128-9/fulltext

Salo, P. M., Akinbami, L. J., Cloutier, M. M., Wilkerson, J. C., Feinstein, L., Elward, K. S., ... & Zeldin, D. C. (2019). Environmental management of asthma in clinical practice: results from the national ambulatory medical care survey. Journal of Allergy and Clinical Immunology, 143(2), AB210. Retrieved on: 13 March, 2020, From: https://www.jacionline.org/article/S0091-6749(18)32383-2/pdf

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