NRS 465 Literature Evaluation Table
University:
Grand Canyon University
NRS 465 Literature Evaluation Table
Paper Instructions
Assessment Description
In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. The ability to articulate research data and summarize relevant content supports the student’s ability to further develop and synthesize the assignments that constitute the components of the capstone project.
This assignment will be used to develop a written implementation plan.
For this assignment, provide a synopsis of the review of the research literature. Using the “Literature Evaluation Table,” determine the level and strength of the evidence for each of the eight research articles you have selected.
The articles should be current (published within the past 5 years) and closely relate to the PICOT question developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project.
While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
Attachments
- NRS-465-T4-RS-Literature Evaluation Table
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Sample Answer
Finalized PICOT Question
In elderly patients suffering from chronic diseases (population), how do medication reminder apps (intervention), compared to traditional reminder methods like alarms or written schedules (Comparison), affect medication adherence (Outcome) within three months (Time, Optional)?
Literature Search Strategy Employed
A literature strategy is important to attain the right research articles using scholarly journals and databases on a selected topic or area of interest in evidence-based practice capstone project proposals. In this case, the strategy entailed using library databases to search for research articles on the proposed intervention to enhance medication adherence among elderly patients with chronic diseases.
These databases included PubMed, CINAHL, Medline, Sage Journals, and Google Scholar. Most of the journals in these databases offered free access articles meaning that they were full-text articles while others offered comprehensive abstracts of the articles.
The key search words included prevalence of non-adherence to medications, chronic diseases, and medication adherence, reminder apps to increase medication adherence, and efficacy of alarm or written schedule on medication adherence.
| Criteria | Article 1 | Article 2 | Article 3 | Article 4 |
| APA Reference
All peer-reviewed journal articles should be current (published within the last 5 years) and closely related to the PICOT question developed earlier in this course. Include the GCU permalink or working link used to access the article. |
Li, A., Del Olmo, M. G., Fong, M., Sim, K., Lymer, S. J., Cunich, M., & Caterson, I. (2021). Effect of a smartphone application (Perx) on medication adherence and clinical outcomes a 12-month randomized controlled trial. BMJ open, 11(8), e047041. https //doi.org/10.1136/bmjopen-2020-047041 | Cao, W., Wang, J., Wang, Y., Hassan, I. I., & Kadir, A. A. (2024). mHealth App to improve medication adherence among older adult Stroke survivors Development and usability study. Digital health, 10, 20552076241236291. https //doi.org/10.1177/20552076241236291 | Liu, J., Yu, Y., Yan, S., Zeng, Y., Su, S., He, T., … & Yue, X. (2023). Risk factors for self-reported medication adherence in Community-dwelling older patients with multi-morbidity and poly-pharmacy a multicenter cross-sectional study. BMC geriatrics, 23(1) 75. DOI https //doi.org/10.1186/s12877-023-03768-7 | Poorcheraghi, H., Negarandeh, R., Pashaeypoor, S., & Jorian, J. (2023). Effect of using a mobile drug management application on medication adherence and hospital readmission among elderly patients with polypharmacy a randomized controlled trial. BMC health services research, 23(1), 1192. DOI https //doi.org/10.1186/s12913-023-10177-4 |
| Purpose/Aim of Study | The purpose of the study was to determine the efficacy of the Perx app in enhancing medication adherence and clinical outcomes over 12 months compared to standard among patients requiring poly-pharmacy. | The purpose of this study was to design and develop a smartphone app, OASapp, to improve medication adherence among older adults with stroke and evaluate the efficacy of its usability. | The purpose of this article was to explore risk factors leading to medication non-adherence among older patients with multi-morbidity and poly-pharmacy. The article also examines the link between medication non-adherence and potentially inappropriate medication use. | The purpose of the study was to examine the effects of using mobile drug management applications on medication adherence and hospital readmission among older adults with poly-pharmacy. |
| Research question(s) (Qualitative)/Hypothesis (Quantitative) | The hypothesis was that having a mobile app enhances medication adherence among patients with chronic conditions and poly-pharmacy. | The authors hypothesized that having a mobile health (mHealth app could be a novel tool to improve medication adherence among stroke survivors as it can potentially empower patients. | The hypothesis in the study was that older patients with multi-morbidity and poly-pharmacy have low medication adherence rates. Further, the study hypothesized that these patients also experience a higher rate of prevalence of potentially inappropriate medication (PIM) use. | The authors hypothesized that mobile drug management applications can improve medication adherence and reduce readmissions among older adults with poly-pharmacy. |
| Design
Type of quantitative or type of qualitative study design |
The study used a randomized controlled trials design with a 12-month follow-up. | The researchers used a mixed method approach where they reviewed literature before using participants to test the app’s efficacy. | Cross-sectional study design | The researchers used a randomized controlled design |
| Setting
Where did the study take place? What type of setting – inpatient, outpatient, etc.? |
The setting for the study was an outpatient clinic in three tertiary hospitals in Australia’s Sidney. | The setting was varied but within China where patients from various areas were included and also experts in a discussion group. | The study was set in 16 tertiary hospitals in 12 provinces and cities in China. | The setting was hospitals with inpatient and outpatient populations in Tehran. |
| Sample
Number and characteristics of participants |
The sample comprised individuals aged 18-75 years with at least one chronic condition and taking over three different medications or injections. The participants required access to a smartphone. The participants were 124 with 45 using the app and 40 in the control group. | The sample comprised nine experts and three representatives from Indeed users, all older adult stroke survivors above 60 years. The sample also includes two moderators who carried out the NGT session with the nine participants. | The sample comprised outpatients who were 65 years and above with multi-morbidity and poly-pharmacy. The study has 800 participants who met the inclusion criteria from 16 16 hospitals in the 12 provinces and cities of China. | The sample comprised 192 older adults who volunteered to participate and were assigned case and control groups through block randomization. The sample featured both out and inpatients in the selected hospitals in Tehran, Iran. The inclusion criteria entailed 60 years and above, daily intake of over 5 types of medications, being able to read and write, and having a smartphone. The participants also had a history of at least two comorbidity chronic conditions like diabetes, COPD, and hypertension among others. |
| Methods
Interventions/Instruments |
The interventions included a group that used Perx apps with customized reminders and gamified interactions to ensure medication adherence. | The authors used a three-phase development process to develop the app on stroke medication adherence reminders. Phase 1 was exploration, phase 2 was developing a prototype, and phase 3 was testing through Alpha and Beta to validate the app. | The intervention and instruments included interviews, collection of data, and use of PIM utilizing accepted tools like Beers Criteria. | The intervention included an in-depth review of the medication reminder application and the development of a drug management app compatible with the Android operating system. The app had features like easy use, changeable font and text size, colors, and saying the names of drugs among other features. |
| Analysis
How were the collected data analyzed? |
The authors used statistics to analyze data through means, frequencies, and variances. The authors estimated the medication adherence rate using a pooled linear regression model. | The authors analyzed the results through themes based on voting cards. The most prevalent feature in the review was medication reminders as part of the developed app. | The authors analyzed the collected data using a visual analog scale (VAS). They also collected data using face-to-face interviews based on a standardized questionnaire. They use descriptive analysis to analyze the collected data. | The authors analyzed data collected using various tools like the SPSS software version 22 descriptive analysis for frequency of chronic medications, and inferential tool. |
| Outcomes/key findings of the study and implications for nursing practice
Summary of study results |
The findings or outcomes demonstrate that smartphone reminders enhanced adherence to medications for many participants, especially those taking diabetes medications and also taking more than four different medications. The primary outcome was the rise in the overall medication adherence rates among the participants. The study implies that nursing practice should be aware of the new technologies to improve medication adherence among older adults with chronic conditions. | The findings show that the app was effective in enhancing medication adherence among patients based on its quality features that allowed users to access more information on their conditions alongside reminders to take their medicines. The study of nursing practice implies that nurses should embrace new ways to provide patient care like using mobile apps for medication adherence. | The findings show that various factors impact medication adherence. The findings show that non-adherence to medication is a global health issue with only 50% of older patients suffering from chronic conditions adhering to medications. The study notes several factors leading to the non-adherence to medications. The implication is that nurses should explore risk factors for medication non-adherence and develop EBP interventions to mitigate the issue. | The results show a significant rise in medication adherence among patients with poly-pharmacy which aligns with existing literature evidence. Drug management apps improve medication adherence levels and enable individuals to control their blood pressure and cholesterol levels. The results show that nurses can enhance the use of mobile apps to improve adherence to medication among patients with chronic conditions. The results are categorical that nurses as core care providers should embrace these apps to improve medication adherence. |
| Recommendations of the researcher | The authors recommend more trials to build the evidence base and prove the efficacy of mobile apps in enhancing medication adherence. | The authors recommend future research studies to establish the clinical efficacy of the app so that it can be employed to enhance clinically relevant outcomes. | The authors suggest targeted interventions to enhance medication adherence like encouraging self-administration of medications and reducing medication expenses. | The researchers recommend more trials to improve evidence and demonstrate beyond doubt that medication adherence apps can have positive effects on chronic disease management. |
| Explain how this article supports your proposed PICO(T) question. | The article supports the proposed PICOT question as it shows the effectiveness of using mobile apps to enhance adherence among patients with chronic conditions and comorbidities. | The article is essential to the proposed PICOT question and Capstone Change Project as it illustrates the importance of app-based reminders to improve medication adherence among older adults. | The article supports the PICOT question and Capstone Change project as it illustrates the importance of understanding various factors that hinder medication adherence among the target population. It shows that older individuals have increased rates of non-adherence to medication which necessitates measures to improve adherence. | The article is essential as it shows the suggested intervention works and leads to better outcomes for the Capstone Change Project proposal. |
| Criteria | Article 5 | Article 6 | Article 7 | Article 8 |
| APA Reference
All peer-reviewed journal articles should be current (published within the last 5 years) and closely related to the PICOT question developed earlier in this course. Include the GCU permalink or working link used to access the article. |
Hartch, C. E., Dietrich, M. S., Lancaster, B. J., Stolldorf, D. P., & Mulvaney, S. A. (2024). Effects of a medication adherence app among medically underserved adults with chronic illness a randomized controlled trial. Journal of Behavioral Medicine, 47(3), 389-404. DOI https //doi.org/10.1007/s10865-023-00446-2 Volpi, | S. S., Biduski, D., Bellei, E. A., Tefili, D., McCleary, L., Alves, A. L. S. A., & De Marchi, A. C. B. (2021). Using a mobile health app to improve patients’ adherence to hypertension treatment a non-randomized clinical trial. Peer J, 9, e11491. DOI 10.7717/peerj.11491 | Park, L. G., Ng, F., K Shim, J., Elnaggar, A., & Villero, O. (2020). Perceptions and experiences of using mobile technology for medication adherence among older adults with coronary heart disease A qualitative study. Digital health, 6, 2055207620926844. s https //doi.org/10.1177/2055207620926844 | Nguyen, A., Uppal, S., Pereira, M. M., Pluti, A., & Gualtieri, L. (2024). MedHerent Improving Medication Adherence in Older Adults With Contextually Sensitive Alerts Through an Application That Adheres to You. Mayo Clinic Proceedings Digital Health, 2(1), 1-7. https //doi.org/10.1016/j.mcpdig.2023.11.001 |
| Purpose/Aim of Study | The purpose of the study was to investigate the effects of a smartphone app on adherence, self-efficacy, knowledge, and medication social support among medically underserved adult populations having various chronic illnesses. | This study aimed to verify the effect of using a mHealth app on patients’ adherence to hypertension treatment. The authors also aimed at examining user experience and its influence on outcomes. | The study aimed to explore perceptions, attitudes, and beliefs of patients with coronary heart disease concerning the use of text messaging and mobile phone apps to enhance medication adherence. | The purpose of this study was to evaluate the effects of shifting perspective from medication adherence being a patient issue to a needs and context of patient aspect. Therefore, the authors focused on creating a contextually sensitive digital health mobile application to enhance medication adherence among older adults. |
| Research question(s) (Qualitative)/Hypothesis (Quantitative) | The authors hypothesized that participants using the mobile phone app condition would have increased medication adherence and medication self-efficacy than those without the intervention for a month. | The authors hypothesized that poor adherence to hypertension treatment increases complications of the condition. Mobile health apps can optimize processes and increase access to health information. | The authors hypothesized that because of its adoption and growing popularity among older adults, mobile technology can be an effective strategy to enhance medication adherence. | What if medications could adjust to the needs and context of patients, instead of the other way around? |
| Design
Type of quantitative or type of qualitative study design |
The researchers used a randomized control trial design. | The authors conducted a quasi-experimental study through non-randomized, controlled, and open-label and collected data at enrollment and 12 weeks after the intervention. | The authors used a mixed-method approach to inform the development of a 12-month randomized clinical trial to examine the effectiveness of mHealth technologies in improving medication adherence. | The authors used the design thinking process to create many interventions to answer their research question and hypothesis. |
| Setting
Where did the study take place? What type of setting – inpatient, outpatient, etc.? |
The researchers set the study in a federally qualified health center (FQHC). | The setting entailed patients in different areas of their treatment as inpatients and outpatients in various healthcare facilities and homes. | The setting was a community hospital system and three Veteran Affairs medical centers in the San Francisco Bay Area and Sacramento. | The setting entailed different healthcare centers with patients having chronic diseases; including the development of personas and scenarios. |
| Sample
Number and characteristics of participants |
The study does not mention the number of participants. However, inclusion criteria entailed adults over 18 years, able to speak and understand English, having a personal smartphone, and taking at least one medication for chronic illness. | The sample comprised 49 participants; both men and women, and diagnosed with hypertension. The participants were also to be on medical treatment during the study. | The sample comprised 28 participants including veterans and non-veterans with a history of coronary heart disease and antiplatelet medication use. | The authors did not use any sample except the personas and scenarios they developed and the prototypes. |
| Methods
Interventions/Instruments |
The authors had several interventions; the key among them was the MedSafe app that focused on enhancing medication adherence and self-efficacy. | The core intervention was developing and deploying a mobile health app to enhance adherence to medication by setting reminders for patients.The authors also conducted a follow-up to increase adherence to medications. | The interventions were varied; including focus groups and randomized controlled trials. | The interventions included semi-structured interviews, personas and scenarios, developed prototypes, evaluation of existing solutions, and consulting subject matter experts (SMEs). |
| Analysis
How were the collected data analyzed? |
The study analyzed collected data using an intent-to-treat model through the IBM SPSS statistics version 28. The authors also used a frequency distribution to summarize nominal and ordinal data | The authors used the statistical package SPSS 22.0 to analyze quantitative data. A descriptive analysis of nominal and ordinal level variables was conducted to determine the efficacy of the proposed interventions. | The authors analyzed data using grounded theory to attain findings and outcomes. | The authors analyzed the collected data using themes and perceptions of personas and scenarios they developed. |
| Outcomes/key findings of the study and implications for nursing practice
Summary of study results |
The results show that a higher percentage of participants who used the app demonstrated a rise in medication adherence above and beyond the expected measurement errors. The findings of nursing practice imply that having medication adherence apps improves medication adherence among older patients with chronic conditions and they should integrate this knowledge to improve outcomes. | The findings show that health apps can assist patients in self-managing their conditions and improve medication adherence and overall treatment process. Based on user experience, the authors found that mobile apps could improve adherence to medications. These findings suggest that nurses can improve medication adherence when they implore patients to leverage apps and mobile health technologies like app reminders. | The findings show that many participants perceived text message reminders as easy, convenient, and flexible to have a routine for medication adherence. The study also found that many participants wanted to leverage these apps to improve medication adherence. The study of nursing practice implies that mobile health technologies are an effective way to enhance patient outcomes, especially for those with chronic diseases and on routine medications. | The authors found that the design thinking process effectively crafted digital health apps to improve medication adherence among older patients. The authors developed an app feature tailored to the unique patient needs; especially simple medication adherence apps. The study asserts that medication adherence apps with reminders improve adherence to medications among older adults with chronic conditions. |
| Recommendations of the researcher | The researchers recommend more future studies to underscore these findings and integrate them into clinical settings, especially for underserved populations. | The authors suggest that using mHealth apps empowers patients to manage their health and increase adherence to hypertension treatment. | The researcher recommends increased clinical trials to test the efficacy of mobile health technology in promoting medication adherence in populations that need strict medication adherence. | In their conclusion, the authors recommend the use of digital health solutions for older adults to enhance their medication adherence. The app has five core functions, key among them reminders alerts, and educational resources as well as social sharing. |
| Explain how this article supports your proposed PICO(T) question. | The article is vital as it demonstrates the efficacy of the suggested intervention in the PICOT question as a core part of the proposed change project. | The study helps the proposed PICOT question and Capstone Change Project by showing that the suggested intervention is effective and will lead to better outcomes. The evidence supports its implementation in the proposed change project. | The article proves that using mobile app reminders is an easy and flexible way to enhance medication adherence among patients with routine medications due to chronic conditions like coronary artery disease. | The article is categorical that mobile apps can enhance medication adherence among older adults with chronic conditions, implying that the intervention is effective as captured in the PICOT question, and will be implemented in the proposed Capstone project. |
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