Hypertension Control Among African Americans

NB: We do not resell your papers. Upon ordering, we do an original paper exclusively for you.

NB: All your data is kept safe from the public.

Table of Contents

Initial Search Process
PICO Question
Search Process
PRISMA Diagram
Challenge
Conclusion
References

Initial Search Process

High blood pressure contributes to the existing mortality gap between Black and White Americans in a substantial manner (Odedosu, Schoenthaler, Vieira, Agyemang, & Ogedegbe, 2012). The National Health and Nutrition Examination Survey (NHANES) reveals that approximately 40 percent of African Americans suffer from hypertension and hypertension-related outcomes such as cardiovascular complications (as cited in Ferdinand, 2015).

It follows that better control of the chronic condition can substantially improve health outcomes for the population. Telemonitoring of blood pressure has been identified as an effective method for improving hypertension management (Margolis et al., 2013). Unfortunately, the adherence to hypertension self-management behavior among African Americans is much lower than that in other racial groups (Flynn et al., 2013). Therefore, it is necessary to investigate whether telemonitoring of blood pressure can become a viable alternative for controlling hypertension among African Americans. This paper aims to outline an initial search process needed to answer a PICO question.

PICO Question

Among African Americans with hypertension, does telemonitor of blood pressure compared to office visit monitoring improve blood pressure control?

Search Process

To arrive at credible evidence necessary for answering the PICO question, an initial search was performed at the library of the University of Maryland. Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the Medical Literature Analysis and Retrieval System (MEDLINE) were searched to find relevant materials. The scope of the search was limited by the specific variables of the PICO question.

The period of peer-reviewed articles included in the search was set at 2012-2017, to ensure that the evidence, which will help to guide evidence-based practice (EBP) is the most current. Only articles published in the English language were selected for the study.

To discover published studies that investigate the effectiveness of different methods for hypertension management, the following keywords were used: hypertension management, telemonitoring, hypertension control, BP monitoring, home, and telecare. CINAHL and MEDLINE have searched again for relevant studies identified in reference sections of articles discovered during the initial search. The selection of potentially eligible studies was based on the analysis of the information presented in the articles abstracts (Wilson, Guluma, & Hayden, 2015).

A randomized control trial (RCT) and the presence of a control group with traditional blood pressure monitoring were established as the inclusion criteria for the initial search. The first search yielded 74 results. After applying database-specific search limiters to the keywords, only 38 articles were left for the initial analysis. The application of the inclusion criteria furnished a set of 20 articles for the study. Upon carefully reviewing the remaining articles, only 9 articles were left for the final analysis. Eleven articles were excluded due to the presence of additional outcome measures for two groups, lack of control for the adherence to treatment, and incomplete data for blood pressure outcome measures.

PRISMA Diagram

Figure 1 presents a PRISMA diagram for the search process.

Figure 1: A PRISMA diagram for the search process.

Challenge

The research experience was associated with the challenge of assessing a large number of studies, the majority of which were unsuitable. The sheer number of search results made the process of abstract evaluation extremely time-consuming.

Conclusion

The paper has discussed the need to find alternative approaches to controlling hypertension among African Americans. It has also presented steps in the initial search process for answering the PICO question. After applying multiple inclusion and exclusion criteria, nine peer-reviewed articles were included in the study. The paper provided references for two of those studies and made a graphical representation of the search process.

References

Ferdinand, K. (2015). Hypertension in high risk African Americans: Current concepts, evidence-based therapeutics and future considerations. New York, NY: Springer.

Flynn, S., Ameling, J., Hill-Briggs, F., Wolff, J., Bone, L., Levine, D.,&Boulware, L. (2013). Facilitators and barriers to hypertension self-management in urban African Americans: perspectives of patients and family members. Patient Preference and Adherence, 7(1), 741-749.

Margolis, K., Asche, S., Bergdall, A., Dehmer, S., Groen, S., Kadrmas, H.,&Trower, N. (2013). Effects of home blood pressure telemonitoring and pharmacist management on blood pressure control: A cluster randomized clinical trial. JAMA, 310(1), 46-56.

Odedosu, T., Schoenthaler, A., Vieira, D., Agyemang, C., & Ogedegbe, G. (2012). Overcoming barriers to hypertension control in African Americans. Cleveland Clinic Journal of Medicine, 79(1), 46-56.

Wilson, M., Guluma, K., & Hayden. (2015). Doing research in emergency and acute care: Making order out of chaos. New York, NY: John Wilson & Sons.

Logan, A., Irvine, M., McIssac, W., Tisler, A., Rossos, P., Easty, A.,&Cafazzo, J. (2012). Effects of home blood pressure telemonitoring with self-care support on uncontrolled systolic hypertension in diabetics. Hypertension, 60(1), 1-9.

Click Here To Order Now!