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Create a PICOT question In your initial discussion, identify a phenomenon (clinical problem) of interest. Clearly define the problem and its significance (what will happen if we don’t address the problem), and create a PICOT question related to it. Use peer-reviewed evidence based data to support. We will continue to refine the PICOT in discussions, as it is the basis for the research proposal. The PICOT question is what you will be building on for Parts 1, 2, and 3. It is essential the question is worked out this week for this reason. If the PICOT question is not clear and solid, Parts 1,2, and 3 will be severely affected. Note: the discussion board requirements have not changed (at least 250 word, references). etc.) Here are templates that may help you with developing your question: templates https://www.aaacn.org/sites/default/files/documents/misc-docs/1e_PICOT_Questions_template.pdf So make sure that the question you develop is about something you can immerse yourself in for the 12 week semester. You may even want to continue with this topic throughout the entire program. These are two examples of how the question should be presented in the Discussion Board. Use this format. Example 1: P: adolescent mothers I: breastfeed their infants C: over the age of 19 O: return to pre-pregnancy weight T: N/A PICOT question: Do adolescent mothers (P) who breastfeed their infants (I) return to pre-pregnancy weight (O) faster than mothers over the age of 19 (C)? Example 2 : P: patients experiencing chronic back pain I: inversion table therapy C: conventional pain medications and muscle relaxants O: better pain relief T: six weeks PICOT question: Will patients experiencing chronic back pain (P) have better pain relief (O) using inversion table therapy (I) than patients who use conventional pain medications and muscle relaxants (C) over a period of six weeks (T)? If you do not have P, I, C, O, T listed and described as above and then the question with (P) (I) (C) (O) (T) placed in the correct place within the question, you will be asked to correct this in the discussion board before the question is approved. Phenomenon of Interest: Medication Adherence in Patients with Chronic Heart Failure Definition of the Problem: Medication adherence refers to how well patients follow their prescribed treatment regimens. For patients with chronic heart failure (CHF), adherence to medication is crucial because it directly impacts disease management, hospitalizations, and overall health outcomes. Despite the availability of effective medications, many patients with CHF struggle with adherence, leading to frequent hospital readmissions, reduced quality of life, and increased healthcare costs. Significance of the Problem: If medication adherence in CHF patients is not adequately addressed, several negative outcomes can occur: 1. Increased Hospitalizations: Poor adherence often results in worsening symptoms, leading to more frequent and costly hospital admissions. 2. Deterioration in Quality of Life: Non-adherence can cause exacerbations of CHF symptoms, significantly impacting patients’ quality of life. 3. Higher Healthcare Costs: Frequent hospitalizations and additional treatments due to non-adherence contribute to increased healthcare costs for patients and the healthcare system. 4. Increased Mortality: Adherence to medications has been linked to improved survival rates; thus, non-adherence can increase mortality risk. PICOT Question: Population: Adult patients with chronic heart failure Intervention: Implementation of a tailored medication adherence intervention (e.g., educational programs, medication management tools) Comparison: Standard care without tailored adherence interventions Outcome: Improved medication adherence rates, reduced hospital readmissions, and improved quality of life Time: Over a 6-month period PICOT Question: In adult patients with chronic heart failure, how does the implementation of a tailored medication adherence intervention compared to standard care affect medication adherence rates, hospital readmissions, and quality of life over a 6-month period? Supporting Evidence: 1. Medication Adherence and CHF Outcomes: · According to a study by McMurray et al. (2014), non-adherence to heart failure medications is a significant predictor of poor outcomes, including increased hospitalizations and mortality rates (McMurray, J. J. V., et al. [2014]. The Lancet, 384(9943), 776-789). The study emphasizes the need for interventions that address adherence to improve patient outcomes. 2. Effectiveness of Adherence Interventions: · A systematic review by Nieuwlaat et al. (2014) found that interventions targeting medication adherence, such as educational programs and adherence tools, have a positive effect on improving adherence rates and reducing hospital readmissions in chronic disease management (Nieuwlaat, R., et al. [2014]. The Cochrane Database of Systematic Reviews, 2014(11), CD000011). This review supports the potential benefit of tailored adherence interventions for CHF patients. 3. Impact on Quality of Life: · Research by Khatib et al. (2016) highlights that better medication adherence in CHF patients is associated with improved quality of life and reduced symptom burden (Khatib, R., et al. [2016]. Journal of the American College of Cardiology, 68(12), 1324-1335). This evidence underscores the importance of addressing adherence to enhance overall patient well-being. Addressing this clinical problem with a well-designed PICOT question and supporting evidence will guide the development of a research proposal aimed at improving medication adherence and thereby enhancing patient outcomes in chronic heart failure.

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