Introduction
It is challenging to overestimate the significance of medical research because this sphere provides the healthcare industry with crucial knowledge on how to improve the population’s health. However, not all scientists do their best to create valuable writing pieces, and low-quality studies appear. This statement denotes that people should be able to assess research articles to understand whether an article is worth reading. The study “Specific Hypertension Smartphone Application to Improve Medication Adherence in Hypertension: A Cluster-Randomized Trial” by Contreras and others is an example of high-quality research with slight inefficiencies, and the following discussion will justify this statement.
Research Problem and Purpose
The study under critique focuses on a fundamental problem in the healthcare industry. Contreras et al. (2019) focus on high blood pressure, one of the most widespread health problems worldwide, and its medications. Even though appropriate drugs have shown their effectiveness in controlling blood pressure, the current issue is that numerous patients fail to adhere to medication guidelines. This problem refers to the fact that it is challenging to achieve positive treatment outcomes because patients fail to follow the required recommendations. That is why the authors explicitly mention that their study’s purpose is to evaluate the effectiveness of an intervention using a mobile application, ALERHTA, that is designed to improve hypertensive patients’ medication adherence. It is worth admitting that the problem is not new, and the investigators mention that this research area has some gaps, meaning that a high-quality study is required. The focus on this problem is beneficial for nursing because the study promises to demonstrate how medical professionals can improve patients’ behavior and health outcomes.
Review of the Literature
The study does not have a separate section that is devoted to the literature review. However, the authors present the existing knowledge on the topic and explore a few concepts in the introduction. They include the existing medication adherence inefficiencies and the use of different mobile applications to address the issue. The study has 30 references, and almost half of them are current regarding the study’s publication date. However, the other half comprises outdated sources, with two of them being published in the late 20th century. It seems that the use of older references can indicate the authors’ failure to find more recent articles. Since the topic is widespread, they could easily find more current scientific information.
Theoretical Framework
The authors do not identify their overall assumptions or a theoretical framework for their study. This fact makes it challenging for readers to guess what findings the investigators intend to achieve. Simultaneously, the failure to mention a theoretical framework denies the audience an opportunity to understand how the authors plan to impact patients. Research demonstrates that Dorothea Orem’s self-care deficit theory can be applied to the study under critique. This theoretical framework implies that people typically have health problems because they fail to draw sufficient attention to themselves. Consequently, it is necessary to make people take care of themselves, and mobile applications can remind individuals to do it.
Variables, Hypotheses, and Questions
The authors do not state what hypothesis they try to test. However, it is possible to restore this information by reading the study. Thus, a probable theory is that the use of a mobile application can improve medication adherence and lead to better health outcomes. Consequently, making patients use the mobile application is an independent variable, but Contreras et al. (2019) fail to state it explicitly. However, the investigators followed a different and more professional approach to the dependent variables that are concrete and measurable. They include medication adherence as well as systolic and diastolic blood pressure. The authors provide the definitions of these dependent variables and explain how they are measured. An obvious explanation of the variables is significant because it eliminates the possibility that the authors and readers can interpret them differently.
Methodology
The study under critique follows a quantitative methodology, and it is a prospective randomized controlled trial. Hypertensive patients are the study’s population, and the researchers intended to select 154 individuals from four primary care centers and divide them into control and intervention groups with 77 members in each. The probability cluster technique was used, and an independent person was asked to select tables with random numbers to define the composition of intervention and control groups. The investigators do not provide any details as to how they measure the independent variable. It seems that they take it for granted that all the members of the intervention group use the application. As for the dependent variables, the Medication Event Monitoring System (MEMS) was used to measure medication adherence, while a semi-automatic sphygmomanometer was used to measure blood pressure. Even though the authors only comment on the validity of the MEMS, it is possible to state that the two measurement approaches are reliable and valid in the given case.
The investigators stipulate that their study follows specific ethical standards, but they fail to mention what ethical considerations should be concerned. It is necessary to ensure that all individuals voluntarily participate in the study, members’ data is adequately secured, and no harm is applied. In conclusion, the study relies on inductive reasoning because the authors rely on little data to generate conclusions for a larger population.
Data Analysis
The investigators utilized a comprehensive approach to deal with quantitative information. In particular, they used Student’s t, Chi-square, and McNemar tests for paired and unpaired data. Confidence intervals of 95% were used to ensure that the findings were reliable. The authors did a great job because they presented the findings in the narrative and included tables as appendices to the study. This fact denotes that readers can choose the most suitable way to become familiar with the results. For example, the study indicates that the app improved medication adherence, which led to a statistically significant reduction of systolic and diastolic blood pressure in the intervention group. This information reveals that the authors managed to identify improvement for a dependent variable.
Summary, Implications, and Recommendations
The authors fail to mention the strengths and limitations of their study in their conclusion. Thus, possible weaknesses include the absence of a theoretical framework, insufficient attention to measuring an independent variable, and the failure to state the research hypothesis explicitly. However, the article implies a few essential advantages that refer to proper statistical analyses and finding an effective way to promote medication adherence and improve population health. Furthermore, the methodology is also a crucial strength because the study dealt with a diverse population, while a randomized controlled trial allowed for assessing the impact of the intervention on different people. Even though further research is necessary to identify how the mobile application affects specific population groups, it is still possible to generalize the findings to the overall population.
It is possible to suppose that the findings are essential for individual nurses and the whole profession. For example, I can rely on the study to understand that medication non-adherence is a significant issue that requires attention. The findings demonstrate that a mobile application can be an effective intervention to address the problem. It seems that many other nursing professionals can also rely on the study’s results to improve population health.
Reference
Contreras, E. M., Rivero, S. M., Garcia, E. R., López-García-Ramos, L., Vilas, J. C. P., Suárez, A. B., Diez, C. G., Guillén, V. G., Claros, N. M., & Compliance Group of Spanish Society of Hypertension (SHE-LELHA). (2019). Specific hypertension smartphone application to improve medication adherence in hypertension: A cluster-randomized trial. Current Medical Research and Opinion, 35(1), 167-173. Web.