Evidence Based Practice

Evidence Based Practice Assignment

Abstract

Objective

Objective is to evaluate the adherence of tablet (oral) medication to depot injection in reducing noncompliance. This is done by finding the evidence from a research study and critically appraises the evidence in order to implement change, improve or maintain standards in a clinical practice.

Method

After formulating a clinical question, a search plan was designed and data bases were searched using free text search

Setting

Three data bases, Psycho Info, Embase and Medline were searched.

Subjects

Only one article was found and that was a cross sectional study and it was chosen for critical appraisal using CASP. 2002

Results

The article was critically appraised and it appeared the evidence is not sufficient enough for it to be applied into clinical areas.

Abbreviations used:

EBP - evidence based practice,

PICO - Population, Intervention, Counter intervention, Outcome.

ROMI - Rating of Medication Influences.

CT - Control trials.

RCT - Randomised control trial.

DAI - Drug Attitude Inventory

Background

The reason for carrying out the evidence based practice is to identify and to apply the most effective intervention in order for patients to have a better quality and quantity of life. I work in forensic in-patients mental health unit that care for male aged between 18 to 65 years of age. The method began by evaluating the practice area and developing that information into a clear question.

In treating medical illness such as schizophrenia, oral atypical antipsychotics is a relatively recent introduction which has caused a shift away from depot medication which is a relatively old practice. Medical experts are of the view that main driving force behind this shift is reduced side effects which oral medication offers as compared to depot medication and the supposed lesser risk of Tardive Dyskinesia with oral atypical.

Definition of evidence-based practice and the organisational infrastructure required for achieving desired outcomes (Adams & Cook 1998). However, (Sackett et al, 1997:71) defined evidence based practice (nursing social care/medicine): “is the conscientious, explicit and judicious use of current best in making decisions about the care of the individual patients… (It) means integrating individual clinical expertise with the best available external clinical evidence from systematic research (acknowledging patients preferences and values).” When carrying out the evidence based practice, it improve patient care and will give confidence to the nurses reassurance and facts that they are providing care that is current and is supported by evidence and not their experience.

(Sackett et al 2000), stated that in the area of mental treatment, depot antipsychotics has been developed specifically for promoting treatment compliance (adherence) as they are long acting which makes them more useful and consistent in successful treatment of patients with mental illness. Depot injection in treating mentally ill patients, especially schizophrenia patients who are in need of maintenance medication, has proved to be valuable option. But use of depot injection has dropped in recent years and several medical practitioners have attributed it to the introduction of oral (tablets) atypical antipsychotics. Patient and psychiatrist acceptance of depot injection or medication is ...