User:Chandak93/sandbox

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 * Note: Please use your sandbox to submit assignment # 3 by pasting it below. When uploading your improvements to the article talk page please share your exact proposed edit (not the full assignment 3).


 * Talk Page Template: CARL Medical Editing Initiative/Fall 2019/Talk Page Template

Polypharmacy

Assignment #2
Focus: Pill Burden - ways to improve adherence and avoid medication errors

1.How you searched for a source (search strategy – where you went to find it).

I found secondary sources on Pubmed, with the MeSH search term “Polypharmacy [AND] elderly”, filtering for reviews, guidelines, practice guidelines, within the last 5 yrs.

2.What potential sources were identified and considered (give examples of 1 or 2).

“Profile, cost and pattern of prescriptions for polymedicated patients in Catalonia, Spain”

“Inappropriate Use of Medication by Elderly, Polymedicated, or Multipathological Patients with Chronic Diseases”

3.Why the source was chosen (what made it better than other choices).

I chose the second article since it was published in 2018 and is a review that nicely consolidated the findings from other recent primary sources. The first article though also recent and published in a respectable journal (BMJ impact factor 27.6), it is a primary article, which isn’t the class of sources recommended for wikipedia articles.

4. List at least three reasons why the source that was selected meets Wikipedia’s reliable medical sources (MEDRS) criteria.

Article was a review, that was published in a high quality, peer-reviews open access journal (Impact factor: 2.47, which has been increasing since it was founded in 2004). It was not published in a predatory journal (Impact factor <1) And our source is less than 7 years, specifically this is less than 2 years old. Not part of a university or hospital website resource.

5. How do you plan to use the source for improving the article?

Added a part under the section on “Pill Burden” to highlight a method of addressing

issues with patients adherence:

''“The use of memory tricks has also been seen to improve adherence and reduce pill burden in several countries ( https://www.ncbi.nlm.nih.gov/pubmed/29439425 ). These include associating mealtimes with medications with mealtimes, recording the dosage on the box, storing the medication in a special place, leaving it in plain sight in the living room, or putting the prescription sheet on the refrigerator. The development of applications has also shown some benefit in this regard."''

Assignment #3
1)    Outline your specific planned changes to your section of the article, labelled “Proposed Changes”. Target 1-2 sentences for your improvements. Use the exact language you plan to post to the Wikipedia community, and ensure that it is written in a way that is easily understood by non-medical people.

The use of memory tricks has also been seen to improve adherence and reduce pill burden in several countries. These include associating mealtimes with medications with mealtimes, recording the dosage on the box, storing the medication in a special place, leaving it in plain sight in the living room, or putting the prescription sheet on the refrigerator. The development of applications has also shown some benefit in this regard.

2)    After each proposed change, briefly explain the rationale for the change and the reference(s) you have used to support your content. Label this section “Rationale for proposed change.”

Pill burden is an important issue associated with polypharmacy and it was discussed in the article. The common strategies used to address this issue however were not mentioned. Therefore I felt that it would be interesting to include some recent studies and techniques used by healthcare providers and patients to target this challenge. 3)    Identify any controversy or varied opinion about planned changes in your section, and explain how you decided to move forward with the position you have taken. Add this piece to the rationale section.

It can be argued that the intervention techniques were not the focus of this study, but instead, it was to discuss polypharmacy, and the associated its challenges. We believe, however, that when talking about some of the challenges, it is important and interesting to also mention some of the ways it can be addressed. This way the reader can is better informed of the issue, and if they are interested can do further reading in this direction.

4)    Please identify any issues or concerns with the source (including any possibility of bias) and how (or whether) this has impacted on your plans for the information you are choosing to share. Label this section “Critique of Source.”

The publication is recent and is a meta-analysis, however, it was published in Spain, at Miguel Hernandez University. Also, I was not able to locate the funding used to support this study. Despite this, we believe that the publication holds strong validity since it includes publications from around the world and was published in an international peer-reviewed journal. This ensures the translatability of the findings to different populations.

Feedback:

1.Assignment #2: Since the focus of your assignment was to discuss memory aids in addressing polypharmacy, I would argue that your search could have been more specific to this topic as opposed to searching only "Polypharmacy" and the "Elderly.

2. Your proposed changed is indeed interesting and makes a point that was not raised in the article so far. I would make a small change and remove "mealtime" as it is included twice in the second sentence. In other words:

"These include associating mealtimes with medications with mealtimes, recording the dosage on the box, storing the medication in a special place, leaving it in plain sight in the living room, or putting the prescription sheet on the refrigerator.

You make a valid point when alluding to the controversy to the proposed change. The source you chose is not specifically a review of the the evidence on memory aids. As such, one could argue that the source is not a strong one for this proposed change as the articles selected were not meant to showcase all the relevant evidence for or against the use of memory aids in polypharmacy.

Also, did the chosen review elaborate on how the articles were chosen and the strength of the papers included?

Agata Szlanta