NUR 545 PNUR 545 Population Health: Analysis and Evaluation week 5 Assignment

 Week 5: Applying Evidence at the Population Level

Applying Evidence at the Population Level

At the end of the week, the student will be able to:

• Identify search engines utilized in literature review.
• Develop a PICO question and create a literature review table.

As we have learned, there can be many factors that affect research and how it is reported. As a DNP you will need to interpret the research to select the best evidenced based practice.

Using the PICO format to develop your clinical question can help provide direction in your research. This week I would like you to start research for your final paper.

• Develop your PICO question for your paper and use Table 5.1 as an example.
• Organize your research using the format in Chapter 5, Table 5.3.
• Include 5 articles in your table.

Anxiety-related disorders affect over 40 million adults in the United States. Although there are numerous medications to treat anxiety disorders, studies have shown not all patients respond favorably. Furthermore, many people experience unmanageable side effects (Cherney, 2019). Cannabidiol (CBD) is the most prominent non-intoxicating component in cannabis, and has many powerful anti-anxiety properties. As noted by Kossen (2016), CBD is a natural chemical found in both marijuana and hemp plants, and unlike tetrahydrocannabinol (THC), it is non-psychoactive. Additionally, it is thought that CBD alters 5-HT1A, GPR55, CB1/CB2, and mu/delta opioid receptor sites, while simultaneously enhancing hippocampal neurogenesis (Kossen, 2016).

          Many adults with anxiety are prescribed multiple medications. Interventions today have been moderately helpful in reducing these effects, however alternative methods are now available. New interventions, such as the use of CBD oil, may improve symptoms and decrease polypharmacy. Recent studies are evaluating the effects of CBD oil as an alternative anti-anxiety treatment.

PICO:

Population - Adult patients with anxiety

Intervention - Use of CBD oil

Comparison - FDA approved anti-anxiety medications

Outcome - Anxiety and/or polypharmacy reduction

PICO question: Can the use of CBD oil in the adult improve the symptoms of anxiety management resulting in the decrease of pharmaceutical use, as compared to those who don’t incorporate this alternative medicine?

          Below are five articles listed to support my PICO question. I used table 5.3 as recommended, while reviewing each article. Finding relevant, reputable, and recent sources was challenging, as CBD in research is currently evolving. The first article listed is low level on the pyramid at level 5, as it is a systematic review of descriptive and qualitative studies. The second article was actually conducted on rats, so I'm not sure if this is okay to reference going forward. I wanted to include it for this discussion, as it was a very in depth and interesting study. I am asking to gain clarification on research studies that were not done on the human population. What are the standards around this? The third article was strong at level 2 as it was a randomized, placebo-controlled, comparative study. The fourth article also came in strong at level 1, as it was a  clinically-focused systematic review. The last article was level 4 on the evidence pyramid, as it was a large case series. I will continue to find research and my goal is to gather more RCT’s and systematic reviews.

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Articles

Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics: the journal of the American society for experimental neurotherapeutics, 12(4), 825–836. https://doi.org/10.1007/s13311-015-0387-1

Gregorio, D., McLaughlin, R. J., Posa, L., Ochoa-Sanchez, R., Enns, J., Lopez-Canul, M. (2019). Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain. Pain 160, 136–150. doi: 10.1097/j.pain.0000000000001386

Masataka, N. (2019). Anxiolytic effects of repeated cannabidiol treatment in teenagers with social anxiety disorders. Frontiers in psychology. 10: 2466. https://doi.org/10.3389/fpsyg.2019.02466 (Links to an external site.)

Sarris, J., Sinclair, J., Karamacoska, D. , Davidson, M., and Firth, J. (2020). Medicinal cannabis for psychiatric disorders: A clinically-focused systematic review. BMC Psychiatry 20, 24 (2020). https://doi.org/10.1186/s12888-019-2409-8

Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in anxiety and sleep: A large case series. The permanente journal, 23, 18–041. https://doi.org/10.7812/TPP/18-041 (Links to an external site.)

References

Cherney, K. (2019). CBD oil for pain: Does it work? Retrieved from

https://www.healthline.com/health/cbd-oil-for-pain

Kossen, J. (2019). How cannabidiol (CBD) works for treating anxiety. Retrieved from

https://www.leafly.com/news/health/cbd-for-treating-anxiety