Read and respond to Josephine Akarue and Mamadou Bhoye Diallo and provide further suggestions on how their database searches might be improved.
For my clinical research, I’m examining the treatment of hypertension, a prevalent and costly condition affecting millions globally. If uncontrolled, hypertension can lead to severe outcomes such as heart disease, stroke, kidney failure, and death. While it can be managed effectively through lifestyle changes, medication, and monitoring, identifying the best and most effective treatments is essential due to its chronic nature. My specific focus is on whether home blood pressure monitoring and patient education are effective in controlling hypertension.
To address this issue, I developed the following PICO(T) question: For adults with hypertension (P), does home blood pressure monitoring and patient education (I), compared with regular clinic visits (C), lower blood pressure (O) over six months (T)? This question compares the effectiveness of home monitoring and education with the traditional approach of clinic visits, with better blood pressure control being the primary outcome of interest.
I began my search at the Walden University Library, utilizing resources like PubMed and CINAHL. In PubMed, I started with keywords such as “hypertension,” “home blood pressure monitor,” and “patient education,” which initially returned 120 papers. By combining these phrases with Boolean operators like “AND,” I narrowed the results to 65. I then applied filters to focus on studies from the last five years, reducing the count to 30. A similar search in CINAHL yielded 45 articles, which I further narrowed to 18 using the same Boolean operators and date filters. These studies included both cohort studies and randomized controlled trials (RCTs) that directly addressed my PICO(T) question and supported the use of home monitoring for hypertension management.
To improve my search strategy, I plan to incorporate synonyms for keywords (e.g., “blood pressure monitoring” or “hypertension management”) to capture a broader range of studies. I will also use more specific filters, such as restricting results to RCTs or observational studies, as these provide stronger evidence for intervention studies. Expanding the search to additional databases will help ensure comprehensive coverage of the topic. Additionally, I will review reference lists of relevant articles to identify any studies I may have missed in my initial search.
According to Hashmi et al. (2024), telehealth represents a promising approach to enhancing access to healthcare through remote technology. However, its implementation can be intimidating for some individuals due to a lack of familiarity. My clinical focus is on the implementation of telemedicine and its effectiveness, particularly in psychiatric care. This discussion will refine my focus by developing a PICO(T) question and improving my search strategy using Boolean operators.
The resulting question is: In psychiatric patients, how does implementing telemedicine for follow-up appointments and primary visits, compared to in-person appointments only, affect patient outcomes and timely prescription filling over a 3-month period?
Using the Walden Library database, I started my search in EBSCO with “telemedicine,” which returned 41,000 articles—far too broad. Narrowing it to “telemedicine and psychiatry” reduced the results to 2,993. Further refining the search to “telemedicine in psychiatry and outcomes” yielded 4 articles. In ProQuest, a similar strategy produced 21,272 results for “telemedicine effectiveness,” which I narrowed to 209 using the phrase “telemedicine in psychiatry and outcomes.” Using Boolean operators like AND, OR, and NOT significantly improved the search precision. For instance, grouping terms with parentheses (e.g., (telemedicine AND psychiatric patients) AND outcomes) or using quotations for exact phrases (e.g., “psychiatric telemedicine outcomes”) proved highly effective.
To further refine the search, consider:
