Evidence Based Practice (EBP) Guideline Paper - Schizophrenia

Evidence Based Practice (EBP) Guideline Paper- Schizophrenia Name Course Date 1. Introduction To make the diagnosis of Schizophrenia, criteria must be met that are the following according to the diagnostic manual (DSM-V), and researchers have looked into the effectiveness of different approaches to manage schizophrenia. Schizophrenia is a serious mental disorder is often grouped together with psychotic disorders (Velthorst et al., 2015). The quantitative research approach has been used in to minimize subjectivity in studies and research and to justify the validity of its conclusions. Quantitative research can be experimental research or nonexperimental research and in experimental research, the researchers actively introduce an intervention or treatment. On the contrary, in nonexperimental research the researchers do not intervene when collecting the data (Polit & Beck, 2016). This is a quantitative appraise of articles on the effectiveness of interventions to improve outcomes for people with schizophrenia spectrum disorders2. Quantitative Literature The first step when using quantitative research for the Advanced Practice Nurse’s (APN’s) practice is formulating and delimiting the problem, which is necessary to conceptualize the problem before determining the research design and collecting data (Polit & Beck, 2016). Studies and research on the effectiveness of interventions in people with schizophrenia compare outcome before and after using different treatments to determine, which are the most effective . The use of medication is the most common, but there is also patient non adherence and there is a need to explore how different approaches help improve adherence and their usefulness when medication does not lead to the expected outcomes (Chien et al., 2014). Quantitative research is a positivist approach where structured and elderly procedures are used to collect data that is then analyzed based using statistics and based on the empirical evidence (Polit& Beck, 2016). “Adherents of positivism assume that nature is basically ordered and regular and that an objective reality exists independent of human observation” (Polit& Beck, 2016, p.14). Using a questionnaire and survey to determine the effectiveness of schizophrenia treatment when psychosocial treatments is used together medication, changes from baseline and improved patient outcomes for the treated subjects would be considered to determine whether the treatment option is viable. 3. Appraisal Tools 1) Gray, R., Bressington, D., Ivanecka, A., Hardy, S., Jones, M., Schulz, M., ... & Chien, W. T. (2016). Is adherence therapy an effective adjunct treatment for patients with schizophrenia spectrum disorders? A systematic review and meta-analysis. BMC psychiatry, 16(1), 90. JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses Name of the article “Is adherence therapy an effective adjunct treatment for patients with schizophrenia spectrum disorders? A systematic review and meta-analysis”. AuthorGray, R., Bressington, D., Ivanecka, A., Hardy, S., Jones, M., Schulz, M., ... & Chien, W. T Year 2016 Yes No Unclear Not applicable 1 Is the review question clearly and explicitly stated? YYes □ □ □ 2 Were the inclusion criteria appropriate for the review question? YYes □ □ □ 3 Was the search strategy appropriate? Yes □ □ □ 4 Were the sources and resources used to search for studies adequate? Yes □ □ □ 5 Were the criteria for appraising studies appropriate? Yes □ □ □ 6 Was critical appraisal conducted by two or more reviewers independently? □ □ Unclear □ 7 Were there methods to minimize errors in data extraction? Yes □ □ □ 8 Were the methods used to combine studies appropriate? Yes □ □ □ 9 Was the likelihood of publication bias assessed? Yes □ □ □ 10 Were recommendations for policy and/or practice supported by the reported data? Yes □ □ □ Were the specific directives for new research appropriate? □ □ □ Not applicable Overall appraisal: Include□Exclude□Seek further info □ Source Aromataris E, Fernandez R, Godfrey C, Holly C, Kahlil H, Tungpunkom P. Summarizing systematic reviews: methodological development, conduct and reporting of an Umbrella review approach. Int J Evid Based Healthc. 2015;13(3):132-40. The reviewers focused on improving adherence, but did not report on whether the review was undertaken independently. The articles included focused on the effectiveness of effective adjunct treatment and they searched the articles in the MEDLINE, Cumulative Index to Nursing and Allied Health (CINAHL with Full Text), Cochrane Library, EMBASE PubMed and Scopus (Gray et al., 2016). The review highlighted that adherence therapy is potentially beneficial to improve adherence and patient outcomes. The researchers also pointed out those studies with missing data are not to be included in reviews because they are incomplete, while there is need for more research to conform the study findings in different settings. There was focus on determining that there were no biases in the choice of RCTs in systematic review and meta analysis. 2) Chien, W. T., Mui, J., Gray, R., & Cheung, E. (2016). Adherence therapy versus routine psychiatric care for people with schizophrenia spectrum disorders: a randomised controlled trial. BMC psychiatry, 16(1), 42. JBI Critical Appraisal Checklist for Randomized Controlled Trials TitleAdherence therapy versus routine psychiatric care for people with schizophrenia spectrum disorders: a randomised controlled trial AuthorChien, W. T., Mui, J., Gray, R., & Cheung, E. Year2016 Yes No Unclear NA Was true randomization used for assignment of participants to treatment groups? Yes □ □ □ Was allocation to treatment groups concealed? □ □ Unclear □ Were treatment groups similar at the baseline? Yes □ □ □ Were participants blind to treatment assignment? Yes □ □ □ Were those delivering treatment blind to treatment assignment? Yes □ □ □ Were outcomes assessors blind to treatment assignment? Yes □ □ □ Were treatment groups treated identically other than the intervention of interest? Yes □ □ □ Was follow up complete and if not, were differences between groups in terms of their follow up adequately described and analyzed? Yes □ □ □ Were participants analyzed in the groups to which they were randomized? Yes □ □ □ Were outcomes measured in the same way for treatment groups? Yes □ □ □ Were outcomes measured in a reliable way? Yes □ □ □ Was appropriate statistical analysis used? Yes □ □ □ Was the trial design appropriate, and any deviations from the standard RCT design (individual randomization, parallel groups) accounted for in the conduct and analysis of the trial? Yes □ □ □ Overall appraisal: IncludeExclude□Seek further info □ treatment groups Sources Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Chapter 3: Systematic reviews of effectiveness. In: Aromataris E, Munn Z (Editors). Joanna Briggs Institute Reviewer's Manual. The Joanna Briggs Institute, 2017. Available from https://reviewersmanual.joannabriggs.org/  In the RCT study there was focus on credibility of the research and the findings were confirmed to show that the data reflected in the findings, but the researchers did not mention whether allocation to a treatment group was concealed. In both articles, the authors discussed interpretations of the findings and looked at similar studies where adherence therapy improves outcomes in schizophrenia spectrum disorders. Similarly, validity and reliability, which are standards of scientific rigor, are quality criteria that were prioritized and the research designs were appropriate. 4. Quantitative Meta-analysis or Systematic Review Study Article Discussion Gray, R., Bressington, D., Ivanecka, A., Hardy, S., Jones, M., Schulz, M., ... & Chien, W. T. (2016). Is adherence therapy an effective adjunct treatment for patients with schizophrenia spectrum disorders? A systematic review and meta-analysis. BMC psychiatry, 16(1), 90. * brief overview of study’s purpose and findings The research reviews the effectiveness of adjunct treatment for patients with schizophrenia and such treatments focuses on improving symptoms by enhancing treatment adherence. The researchers included studies where the adjunct treatment was used treatment against the usual or a comparator intervention (Gray, et al., 2016). Adjunct treatment is an effective adjunctive treatment for people with schiz...