Databases searched by Loiselle et al. (2016) included PubMed; CINAHL, ERIC, Ovid, PsychINFO, EBSCOhost, EBMAR, and Scopus. Search dates included were all dates for PubMED and 1982 through February 2015 for the other databases. Eight key terms used for search were: medication compliance, sickle cell disease, adolescent, infant, child, treatment compliance, sickle cell anemia, and medication adherence. No information on the person performing the literature search was given. An informative and easy to read PRISMA four-phase flow diagram was used to show study selection details. This visualized the initial article search through screening and to inclusion. Exclusion criteria was discussed in the text portion of the review and shown visually in the flow diagram.
Article search for Walsh et al. (2014) included systematic review of Cochrane, Scopus, Embase, Web of Science, PubMed, the World Health Organization Global Health Library from the year 1940 to February 2012. Key words used for search were not specifically mentioned in text but according to the authors included specific medication names used for treatment, disease names specific to this study, and various terms for adherence. The search was conducted by a professional librarian without search restriction. The flow diagram was present and visualized the process of initial abstract identification to inclusion into the final literature review. Exclusion criteria were shown on the flow diagram and were discussed in text.
While an extensive search was performed, key words were used, and a flow diagram was provided by both authors, Loiselle et al. (2016) provided more detailed information in text and for quick reference via the flow diagram. Additionally, Walsh et al (2014) excluded abstracts for being “not English” and according to Khan, Kunz, Kleijnen, and Antes (2003), searches should not be language restricted.
Critique of Study Quality Evaluation
While both authors did adequate study evaluation, Loiselle et al. (2016) was superior to Walsh et al. (2014) Three authors used to collect and standardize data versus two authors. The Theory of Pediatric Self-Management Model was used to guide how correlates were selected and structured as opposed to the absence of theory discussion. All abstracts were reviewed by the first author and any discrepancies were resolved by consensus in comparison to rereview. Inclusion and exclusion criteria was discussed in both studies and shown in the flow diagrams. Result reliability, however, was assessed in Walsh et al. (2014) using the Newcastle-Ottowa Quality Assessment Scale. According to Polit and Beck (2017) the use of this tool increases study validity and reliability.
Critique of Synthesis of Evidence
According to Khan et al (2003), data analysis is a study of quality and effects, characteristics, and statistical methods for comparing studies and combining their effects through meta-analysis. Of the forty-nine studies that reported medications as a primary or secondary aim, twenty-two studies were included in the systematic review by in Loiselle et al. (2016). Meta-analysis was performed by using a 22-item quality rating rubric and two independent coders rated the studies. Rating agreement was determined using Cohen’s kappa. Any coding disagreement was resolved by the first author. Inclusion criteria for meta-analysis was any study with association between medication adherence and a demographic from the Pediatric-Management Model.
As compared to Walsh et al. (2014) ninety-one articles were screened for inclusion and twenty-four studies were included in the review. There was no meta-analysis was performed. Polit & Beck (2017) state that “for systematic integration of quantitative evidence, meta-analysis offers a simple advantage: objectivity” (p. 648).
Critique of Conclusion of Evidence
Both authors did an excellent job in interpreting and summarizing their findings. Limitations and potential biases were discussed in each study. Impacts of the studies were discussed with regards to possible interventions for increasing medication adherence and improved patient health outcomes. Each author reiterated their research problem and reinforced how their data could impact medication adherence.
Study findings by Loiselle et al (2016) showed that adherence is likely to be higher when methods other than self-reporting are used. Provider attention is particularly important when they are prescribing penicillin and iron chelators because adherence is lower than other prescribed medications. Adolescents are of greater risk of adherence problems. Barriers to medication regimens should be assessed and given interventions to increase adherence.
Walsh et al. (2014) stated that route of administration influenced adherence. Injected antibiotics had better adherence than oral. It was also identified that moderate adherence might have some benefit than poor adherence, more objective measures for monitoring adherence should be used and multicomponent interventions are more effective educational intervention alone.
Critique of Literature Review Table
Both authors included literature review tables that were informative, complete, and present. Any abbreviations or variables used where defined. Literature table comparison found Walsh et al (2014) to be formatted to ease data facilitation, it was less clustered, and was visually more appealing.
However, Loiselle et al. (2016) used numerical and statistical data displayed throughout three separate tables. Meta-analysis tables displayed clear results including confidence interval (CI) and effect size. A Forest plot of correlations and CIs was included to graphically display results. Walsh et al. (2014) did not perform a meta-analysis so there is no comparison with regards to meta-analysis by Loiselle et al. (2016).
References
- Khan, K. S., Kunz, R., Kleijnen, J., & Antes, G. (2003, March). Five steps to conducting a systematic review. Journal Of The Royal Society Of Medicine, 96, 118-121.
- Loiselle, K., Lee, J. L., Szulczewski, L., Drake, S., Crosby, L. E., & Pai, A. L. (2016). Systematic and meta-analytic review: Mediation adherence among pediatric patients with sickle cell disease. Journal of Pediatric Psychology, 41(4), 406-418. https://doi.org/10.1093/jpepsy/jsv084
- Polit, D. F., & Beck, C. (2017). Nursing research: Generating and assessing evidence for nursing practice (10 ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.
- Walsh, K. E., Cutrona, S. L., Kavanagh, P. L., Crosby, L. E., Malone, C., Lobner, K., & Bundy, D. G. (2014, December). Medication adherence among pediatric patients with sickle cell disease: A systematic review. Pediatrics, 134(6), 1175-1183. https://doi.org/10.1542/peds.2014-0177
