Effect Of Pharmacist and Nurse on Improving Blood Pressure

Effect Of Pharmacist and Nurse on Improving gillyf light pressingAfzal HussainProblem and PurposeIn this paper, I will be smallly analyzing the article A Randomized Trial of the EffectOf community of interests of interests Pharmacist and Nurse C be on Improving Blood Pressure Managementin Patients With Diabetes Mellitus- Study of Cardiovascular Risk Intervention by PharmacistsHypertension (SCRIP-HTN) by Donna L. Maclean Finlay A. McAlister Jeffery A. Johnson, Kathryn M. King Mark J. Makowsky Charlotte A. Jones and Ross T. Tsuyuki. This article outlines a valued experimental design involving two sample groups (experimental and Control). According to Sullivan-Bolyai, Bova, Singh (2013), experimental designs ar particularly suitable for testing cause and effect relationships because they help authorise potential alternative explanation ( panics to validity) for the findings (p. 217). The authors articulate their recognition of the concomitant that interventions are key marker s to localise and observe blood nip (BP) determine in diabetic unhurrieds.The authors also recognize the fact that there is a of the essence(p) for a red-hot model of disturbance to improve BP operate, particularly with solid challenges in accessing primary dish out docs attributing to labor shortages in the health fatigue system. In addition, the authors used manipulation by introducing the intervention, then by analyse the standard and usual care among the control group and experimental groups. This resulted in the manipulation variable being the diversion of care among patients with blood pressure and diabetes. mavin intervention delivered to the group based on the manipulated variable of difference of care is evident through the interventions made by the apothecary-nurse teams at various pharmacy sites, which included cardiovascular risk reduction counselling, education cusp on hypertension, lifestyle strategies, effect of diabetes on high BP, and referral to t he patients primary care physician for further BP and cardiovascular assessment (McLean, McAlister, Johnson, King, Makowsky, Jones, and Tsuyuki, 2008, p. 2356).The control group lift upd the standard and usual treatment compared to the experimental intervention group. Furthermore, blood pressure wallet card, educational pamphlet on diabetes and physician care were received by the control group. (McLean et al., 2008, p. 2355).The authors used randomization to categorise the look participants into two groups- experimental intervention and control which is set to receive the standard treatment of care. Mclean et al (2008) states, Randomization was at the level of the patient ( stratified by pharmacy and using a variable binge design), it was performed centrally to preserve allocation concealment using a electronic computer generated sequence over a secure internet service at the Epidemiology Coordinating and Research (EPICORE) centre,(p. 2356). The authors propose a practical nec essity for this enquiry problem to be queryd and be further researched.The purpose of the research was to explore whether pharmacist or nurses thunder mug professionally contribute to improving the BP control of patients with diabetes and implement preventative care measures due to ongoing lack of physicians, pharmacist and nurses, it is clear that the research is also signifi give the bouncet. It is based on changing the office of health care professionals to meet current outcomes, outcomes which seem to be on par with those of the current health care system in Canada. hear Size, Design and Collection MethodsThe sample for this chew over was appropriately assembled for a denary hold. The study sample is easily place when reading the article, included a description of the demographic characteristics and the size of the sample. Also included were any take bias, drop outs or loss of patients to follow up. In doing so, an adjustment of 85 to 110 per group were added. (McLean e t al., 2008, p. 2357). Its purpose was to test the efficacy of community-based interventions through a pharmacist and nurse team approach on reduction of cardiovascular events in diabetes mellitus patients. This was achieved by measuring the BP which has been linked to comorbidities such as cardiovascular disease, and to BP bar changes used as an index finger of health. This sample was appropriate to the study as the sample were to represent diabetic patients. Mclean et al (2013) states, All with child(p) diabetic patients with BP higher than 130/80 mm Hg on 2 screening visits separated by 2 weeks were identified in participating pharmacies. Diabetes was identified by community pharmacists through the use of diabetes indicator medications in each pharmacys prescription database. (p. 2356).In this study, Mclean et al (2008) used a randomized controlled trial (RCT) in 14 community Pharmacies in Edmonton, Alberta as a method of data collection (McLean et al., 2008, p. 2355). Parti cipants were identified and manipulated by pharmacists and nurses who were trained using a combination of an online learning computer program and a case-based learning session both based on the Canadian Hypertension Education Program (CHEP) guidelines. Also the use of a technical BP reminder set at an average of 5 measurements of BP taken 1 minute was used to measure participants BP (McLean et al., 2008, p. 2356). Data analysis procedures were appropriate to the research study because all analyses were conducted using a commercially available packet program (McLean et al., 2008, p. 2357).Threats to Internal and External Validity specifically the authors use of orchestration and selection could possibly have introduced problems of internal validity in the research. This threat was discussed by ensuring that both groups (control and experimental) BP were measured with the same BP device, which has 6 readings, discard the rootage test and further takes an additional 5 measures . Mclean et al (2008) found that, It is assertable that the more frequent contact with the pharmacist nurse team decrease the anxiety of patients and any white coat effect on their BP measurement. (p.2359). Furthermore, the screening modules used by the researchers to collect the data were conducted by pharmacists and nurses swell up versed in their profession. Selection bias was another threat predisposing the sampling design to internal validity.The authors in their findings found that patients eligible for selection presented with lower BP, this can be caused by the researchers utilizing a convenience sample kind of of a random sample. Also, selection bias may have been an essential part of the end results due to the fact that patients who are eager to monitor and control their BP are more likely to agree to participate in the trial, also that more than 80% of trial participants were aware that hypertension is a risk factor for cardiovascular disease (McLean et al., 2008, p. 2 358). The external validity of the study was weakened by the sampling design. The authors failed to take into consideration non English speech people, whose cultural differences and beliefs could influence the study, and who may lack health literacy to read and identify medical abbreviations and symbols. Maclean et al (2008) states, pharmacists and nurses who participated may be different from those who did not participate, an researcher volunteer bias that may limit generalizability of the program (McLean et al., 2008, p. 2359).Limitations of the DesignOne major limitation of the design identified by the authors is regarding the interventions implemented in regards to the in person contact time between patients and the pharmacist-nurse team, which can be further be evaluated by hereafter studies on whether less intensive interventions are The researchers identified a potential limitation regarding that the intervention compound substantial in-person contact time between patient s and study personnel, and that future studies will need to determine whether less intensive interventions are juicy in controlling BP in diabetic patients (McLean et al., 2008, p. 2359Generalization of Findings The research findings can be generally be applied to larger populations, the authors acknowledge the fact that their research intervention was extremely efficacious, resulting in a 24.1 mm Hg greater reduction in systolic BP (McLean et al., 2008, p. 2358) They recommend a new model of care to improve BP control. In addition, by utilizing an experimental research design in which a cause and effect relationship can be analyzed and measured, the researchers were able to provide coherent evidence and correlation that community pharmacists and nurses through a collaborative effort with primary care physicians could have a huge impact on hypertension focal point in patients with diabetes mellitus and BP control within the community (McLean et al., 2008, p. 2360)ReferencesLoBion do-Wood, G., Singh, M.D., (2013). Introduction to quantitative research. In C. Cameron, M. D. Singh (Eds.), Nursing research in Canada Methods and critical appraisal for evidence-based practice (3rd ed.) (pp. 198-215). Toronto Elsevier Canada McLean, D. L., McAlister, F. A., Johnson, J.A., King, K.M., Makowsky, M.J., Jones, C.A., Tsuyuki, R.T. (2008). A randomized trial of the effect of community pharmacist and nurse care on improving blood pressure management in patients with diabetes mellitus. history of Internal Medicine, 168(21), 2355-2361 Retrieved from http//www.ncbi.nlm.nih.gov/pubmed/19029501Sullivan-Bolyai, S., Bova, C., Singh, M.D. (2013). Experimental and quasiexperimental designs. In C. Cameron, M. D. Singh (Eds.), Nursing research in Canada Methods and critical appraisal for evidence-based practice (3rd ed.) (pp. 216-233). Toronto Elsevier Canada