Hypertension Treatment in Evidence-Based Practice

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Picot Question

For African Americans ages 18-35 with uncontrolled hypertension receiving care from a community health center (P), does ongoing education on lifestyle modifications (healthy eating habits and increased physical activity) (I), compared to medication therapy alone (C), contribute to a better control of blood pressure; therefore, reducing the incidence of cardiovascular disease (CVD) and stroke (O) over a 1-year period?

Search Strategy Conducted

The search was divided into three phases. In the first phase, an online search was conducted using the PubMed database using the combination of search terms hypertension, cardiovascular disease, stroke, exercise, and diet. Once a number of articles were located that matched the purposes of the project, their titles, abstracts, and keywords were examined for search words that could be added to the list. After the list was expanded, the second search on PubMed was conducted in order to minimize the number of omitted articles. Finally, once the list of search results was exhausted, the reference lists of the located sources were examined in order to detect additional studies. The search was limited to the articles published in or translated into English. Both published and unpublished studies were included in the results as long as they complied with the designated quality criteria.

Critical Appraisal of the Evidence Performed

For the sake of quality, the highest priority was given to randomized controlled trials and qualitative studies that demonstrated a reasonable degree of scientific integrity. The located sources were evaluated for methodological validity using standardized appraisal instruments provided by Joanna Briggs Institute. The quality criteria for the former included the blinding of the participants, treatment delivery, and researchers, the presence of follow-up and responsible reporting of identified differences, the reliability of measurement process, and the use of appropriate statistical tools, among others (Joanna Briggs Institute, 2017b). The latter were checked for consistency between the research methodology, formulated objectives, and philosophical perspective, validity of the interpretation of results, compliance with the ethical criteria, adequate representation of participants voices, and the logical connection between the results of the analysis and the conclusions, among others (Joanna Briggs Institute, 2017a). The results were corroborated through comparison of independent conclusions.

References

Joanna Briggs Institute. (2017a). Checklist for qualitative research. Web.

Joanna Briggs Institute. (2017b). Checklist for randomized controlled trials. Web.

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