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PICO (T) Questions and an Evidence-Based Approach

Stroke is a leading cause of disability and mortality worldwide, making it a critical focus for healthcare interventions. To improve patient outcomes through evidence-based practice, it is essential to gather credible, relevant, and trustworthy evidence for integration into clinical practices. Thus, a structured approach to clinical inquiry, such as the PICOT framework, will be beneficial. PICOT stands for Patient/Population, Intervention, Comparison, Outcome, and Time, and it helps formulate research questions that guide evidence-based practice (Hosseini et al., 2023). In this assessment, we apply this framework to inquire about the benefits of telehealth services in improving medication adherence among stroke patients, eventually enhancing patient outcomes. 

Practice Issue to be Explored and PICO(T) Inquiry

Patients encountering stroke are at high risk of developing medication non-adherence, leading to exacerbations, relapses, and poor disease control (Zeng et al., 2021). Thus, it has become a significant medical practice issue where providers strive to ensure that patients maintain medication adherence and engage in self-management practices to control further attacks. In the growing healthcare landscape and increasing disease burden, traditional in-person follow-up visits are insufficient for continuous monitoring, especially in elderly patients who face mobility challenges or other barriers to accessing care. Therefore, this paper explores the use of telehealth services to improve outcomes in this vulnerable population.

In patients who have suffered a cerebrovascular attack (stroke) (Population), does the use of telehealth for monitoring and follow-up (Intervention), compared to in-person follow-up visits (Comparison), improve medication adherence and disease control (Outcome)? 

Benefit of Using the PICO(T) Framework 

Exploring this practice issue through the PICOT approach allows for a structured and focused investigation that can lead to evidence-based interventions. The PICOT framework breaks down the research question into specific components, making it easier to identify relevant evidence and compare the effectiveness of different interventions (Hosseini et al., 2023). By applying this approach, healthcare providers can systematically evaluate the importance of evidence-based interventions in managing post-stroke patients. Ultimately, this can inform clinical guidelines and improve patient outcomes by promoting strategies that are proven to be effective in controlling the disease and reducing the risk of recurrence.

Sources of Evidence and Rationale/Criteria

Several online sources, including databases, journals, and websites, are capable of answering the PICOT question regarding the effectiveness of telehealth services versus in-person follow-up for medication adherence and disease control in stroke patients. 

1. Databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed. 
2. Journals: Journal of Telemedicine and Telecare and the Journal of Stroke and Cerebrovascular Diseases. 
3. Authoritative Website: The American Stroke Association (ASA). 

The Rationale for Selecting These Sources 

The selected sources are capable of answering the PICOT question due to their focus on high-quality, peer-reviewed research and evidence-based guidelines. Additionally, these sources provide information that abides by the CRAAP criteria (currency, relevance, authority, accuracy, and purpose). According to Oermann et al. (2021), among other databases, CINAHL and PubMed are acknowledged for their comprehensive coverage of healthcare-related topics. Therefore, these databases are crucial to accessing literature studies that directly examine the impact of telehealth on chronic disease management, including stroke.

Simultaneously, the Journal of Telemedicine and Telecare explicitly focuses on telehealth, making it an invaluable resource for understanding the nuances of remote patient monitoring and follow-up care. Similarly, the Journal of Stroke and Cerebrovascular Diseases provides insights into the latest research on stroke management, ensuring that the information is both current and relevant. Finally, the authoritative website of ASA offers reliable guidelines, which are essential for supporting clinical decisions based on the latest evidence (American Stroke Association, n.d.). These sources collectively provide a robust foundation for exploring the efficacy of telehealth in improving post-stroke outcomes, directly addressing the PICOT question.

Findings from the Literatu