Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

This is my PICOT question.

The assignment is below.

I have chosen mental health as my clinical issue of interest.

Working at a psychiatric hospital, I have noticed doctors prescribing two or more antipsychotics at once to patients with psychotic disorders. There has been great concern about prescribing two or more antipsychotics due to drug interaction, noncompliance, or medication errors.

Many of our patients are homeless or low-income and have difficulty affording medication and being medication compliant. Prescribing more than one antipsychotic can put patients at risk for drug interactions and can be very dangerous. I want to go more in-depth into this subject because patient safety is essential to nurses.

My PICO(T) question is, In patients with psychotic disorders, does the use of two or more antipsychotics than one antipsychotic have better and more effective medication therapy outcomes?

As I was forming my PICOT question, I decide to use MEDLINE and CINAHL Plus as my two databases. With MEDLINE, I search the terms antipsychotic medications and combination therapy it gave me a total of 225 search results. I then researched Two antipsychotic drugs concurrently it gave me four articles in my search result that were relevant to my PICO question. For CINAHL Plus, I researched Antipsychotic schizophrenia and combination therapy, and it gave me 270 articles.

I then researched antipsychotics and combination therapy and effectiveness and gave me 62 articles. Using different word combinations and different word placement, I narrowed my search on both databases. Using Boolean operators also narrowed my search, and I intend to use them often.


References Lenardon, A., Ahmed, M., Harfield, K.-L., & Das, M. (2017).

The successful concurrent use of two long-acting depot antipsychotics in a patient with treatment-resistant schizophrenia and history of serious violence: a case report. Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists, 25(2), 181–184. https://doi-org.ezp.waldenulibrary.org/10.1177/1039856216679547. Miller, B. (2020). Combination Therapy for Treatment-Resistant Schizophrenia? Psychiatric Times, 37(11), 32. Dong, M., Zeng, L., Zhang, Q., Ungvari, G. S., Ng, C. H., Chiu, H. F. K., Si, T., Sim, K., Avasthi, A., Grover, S., Chong, M., Chee, K., Kanba, S., Lee, M., Yang, S., Udomratn, P., Kallivayalil, R. A., Tanra, A. J., Maramis, M. M., & Shen, W. W. (2019). Concurrent antipsychotic use in older adults treated with antidepressants in Asia. Psychogeriatrics, 19(4), 333–339. https://doi-org.ezp.waldenulibrary.org/10.1111/psyg.12416. Constantine, R. J., Andel, R., McPherson, M., & Tandon, R. (2015). The risks and benefits of switching patients with schizophrenia or schizoaffective disorder from two to one antipsychotic medication: a randomized controlled trial. Schizophrenia Research, 166(1–3), 194–200. https://doi- org.ezp.waldenulibrary.org/10.1016/j.schres.2015.05.038.


Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of an automobile has high mileage is encouraging.

But who produced that report?

How valid is it?

How was the data collected, and what was the sample size?

In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.

To Prepare:

Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.

Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course. Use the keywords from the PICO(T) question you developed and search at least four different databases in the Walden Library.

Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses).

The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.

Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.


The Assignment (Evidence-Based Project) Part 2:  Advanced Levels of Clinical Inquiry and Systematic Reviews.

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

Identify and briefly describe your chosen clinical issue of interest. Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.

Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected. Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question.

If there are no systematic review level articles or meta-analyses on your topic, then use the highest level of evidence peer-reviewed article.

Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

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