Introduction.
With the increased emergency of complex healthcare challenges along with world epidemics, it has become necessary for healthcare professionals and other healthcare stakeholders to engage in extensive research to help devise a long-term evidence-based solution to the said challenges. One of the best approaches that have been established to deal with various healthcare conditions is the use of PICOT questions to provide answers to a burning medical or clinical question. The term PICOT is described as a mnemonic obtained from components of a clinical research question where the letters; P- stands for patient or population, I-intervention, C-comparison, O-outcome, and T- time or duration the intervention will take to realize desired results. Obesity and hypertension are among the health conditions that immensely contribute to untimely deaths that could otherwise be avoided if appropriate measures such as patent education and nursing interventions are implemented to help patients with the said conditions (Jurik & Stastny, 2019).
Problem statement.
With reference to the question, this report will be considered discussing evidence-based findings on how a change of diet along with regular exercise will help reduce weight and hypertension among the patients with the said condition as opposed to the use of medical interventions such as Orlistat drugs in managing obesity and hypertension for two months.
A practice issue to be explored and addressed via a PICO(T) approach.
As mentioned early, the healthcare sector is one of the most sensitive sectors whose primary concern is to guarantee safety, effective, reliable, and quality care services to the public. The PICOT question to address in this discussion is: In adults with obesity and hypertension (p), does a change in their diet and regular exercise(I) result in accelerated weight loss and reduced hypertension (O) compared to the use of medications such as Orlistat within two months(T). Obesity and overweight are described as abnormal accumulation of fats in the body caused by a poor diet rich in more calories than the body can utilize. The underutilized fats are then stored as fats within the adipose tissues (The Editors of Encyclopaedia Britannica, 2022).
The predisposing factors for obesity included but were not limited to factors such as too little or no physical activity, poor sleep, poor diet, family history of obesity and overweight, stress, environment, health conditions, and medication and emotional factors. People with a body mass index (BMI) of 30.0 or higher are considered obese (SingleCare Team, 2022). On the other hand, hypertension is defined as a condition in which one’s blood pressure is higher than normal. The condition may be caused by factors such as stress, eating food with more calories, lack of physical exercise, diabetes, and indiscriminate smoking.
Obesity and hypertension have been identified as the primary conditions that raise the risk for diabetes and as well as other morbidities that may, in turn, contribute to the development of kidney diseases due to increased reabsorption. Perhaps, increased tubular reabsorption hampers pressure natriuresis, an aspect that leads to volume expansion through the activation of the sympathetic nervous system (SNS) and renin-angiotensin system (RAS). According to the study conducted by CDC in 2019, it was found that one person out of three U.S adults is obese. Among the affected people, it was evident that Hispanic, and non-Hispanic black people, Mexican the highest rate of obesity. CDC further provided that over 40% of all U.S adults are obese, an aspect that has made the U.S government spend over $150 billion per year in treating and managing obese cases (SingleCare Team, 2022).
How the exploration of the practice issue will benefit from a PICO(T) approach.
Evidence-based research conducted by Jurik & Stastny has indicated a great combined effect of change in diet and regular exercise as one of the non-pharmacological approaches in managing obesity and hypertension compared to medications (Jurik & Stastny, 2019). The study further found that effective ways of reducing or managing hypertension and obesity are through combined efforts on lifestyle changes. The exploration of the PICOT approach to overweight and high blood pressure management will provide more insights into the pros of using non-pharmacological interventions instead of medical approaches, which might pose more health complications to patients with obesity and hypertension. For example, through the PICOT approach, healthcare professionals can understand that medications such as Orlistat in obese management will cause short-term and long-term effects on obese patients. Some of the side effects of the use of Orlistat in the treatment and management of obesity include steatorrhea, fatty stools, clay-colored stools, diarrhea, flatulence with discharge, abdominal pains, fecal incontinence, and anal fissures (Jurik & Stastny, 2019).
Sources of evidence effectively answering a PICO(T) question.
During the study, I employed different approaches in searching for reliable evidence-based sources that provided answers to my PICOT question on obesity and hypertension management. Using the Nursing care delivery model as one of the key components of Staffing and Nursing Care Delivery Models, I collected adequate data on obesity and high blood pressure management strategies that are more effective and reliable with minimal or no side effects (Edwards, 2022). Care providers and patients are the key stakeholders in the healthcare sector. Information provided by nurses and other healthcare professionals acts as the basis for formulating nursing interventions for treating and managing obesity. Also, the Capella university summons library made it easy to locate evidence-based articles related to obesity and hypertension management. Searches on google scholar articles were narrowed to keywords on the PICOT question and with the selection of only peer-reviewed articles not older than five years of publication.
Findings from articles or other sources of evidence relevant to the health care issue.
Studies.
In their study, Jain et al. found that obesity and hypertension cases are rapidly increasing at an alarming rate. This has necessitated healthcare professionals to come up with non-pharmacological and pharmacological approaches to mitigate the issues before they get out of control. Findings indicate that even though medications such as Orlistat can be effective, safety issues, more so those related to side effects, can be detrimental to patients. This, therefore, provides that, as opposed to the use of Orlistat and other medications for the treatment of obesity and hypertension, it is highly recommended for patients to make use of the DASH diet plan to help manage the said conditions. The DASH diet plan comprises foods such as plenty of fruits, vegetables, whole grains, fish, nuts, and low-fat dairy products (Edwards, 2022). A combination of the DASH diet along with regular exercise reduction will reduce obesity and hypertension in as little as two weeks. Lifestyle changes using the DASH meal plan and exercise strategies have been found to be effective in reducing systolic and diastolic blood pressure.
The relevance of the findings from chosen sources of evidence to making decisions related to a PICO(T) question.
As per the statistics provided by the centers for disease control and prevention (CDC), in 2020, over 670, 000 across various parts of the united states were attributed to hypertension as the main contributing factor (CDC, 2022). In her study, Jennifer M. Edwards argues that obesity and overweight are the main risk factors for developing other cardiovascular conditions, such as high blood pressure. Therefore, she suggests that if appropriate evidence-based interventions are implemented in healthcare facilities, it becomes much easier for the overweight patient to manage their weight and hypertension in a cheaper and cost-effective way. As per the data provided by the National Heart, Lung, and Blood Institute, approximately 75% of all united states population aged 20 years and above fall into the obesity and overweight group (Edwards, 2022). The cost of treatment of hypertension and obesity has been increasing daily. Therefore, the information provided from the evidence-based studies on various articles will offer insightful knowledge to patients and healthcare professionals on better ways of managing obesity without incurring extract costs.
Conclusion.
Given that diet play a vital role in the pathogenesis of obesity and high blood pressure, exploration of the PICOT question put forth for this discussion will form the basis for the understanding of the essence of better dieting together with regular exercises as the most effective approaches in reducing the risk of worsening of obesity and hypertension symptoms (The Editors of Encyclopaedia Britannica, 2022). Through the knowledge and insights provided in this report, patients, as well as healthcare providers, have been enlightened on the best foods recommended to facilitate the progressive and efficient treatment of hypertension and obesity. In a nutshell, the PCOT approach will ensure objective treatment and management of obesity and hypertension are achieved with no medical errors and in a more cost-effective way that can benefit a large population, including those from low-income families.
References
CDC. (2022, July 12). Facts about hypertension. Centers for Disease Control and Prevention. https://www.cdc.gov/bloodpressure/facts.htm
The Editors of Encyclopaedia Britannica. (2022, August 31). Causes of obesity. Encyclopedia Britannica. https://www.britannica.com/science/obesity/Causes-of-obesit y
Edwards, J. M. (2022, April 28). Obesity-induced hypertension: Causes, risks, and treatment. Healthline. https://www.healthline.com/health/high-blood-pressure- hypertension/obesity-and-hypertension
Jain, et al., S. S. (2011, April). Evaluation of efficacy and safety of Orlistat in obese patients. PubMed Central (PMC).https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3125014/
Jurik, R., & Stastny, P. (2019). Role of nutrition and exercise programs in reducing blood pressure: A systematic review. PubMed Central (PMC).https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780911/
SingleCare Team. (2022, February 15). Obesity in America: Here are the latest statistics. The Checkup. https://www.singlecare.com/blog/news/obesity-statistics/
Yasmine, A. S. (2022, May 27). Causes and risk factors of obesity. Verywell Health. https://www.verywellhealth.com/obesity-causes-4014562
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