Expanding the Evidence Base – Insights from Mixed Methods Research

Expanding the Evidence Base – Insights from Mixed Methods Research

Purpose of the Study

The study aimed to assess the effectiveness of additional risk minimization measures implemented for the fentanyl buccal tablet. The focus was on the prescriber’s knowledge, understanding, and behavior regarding safety as well as evaluation of illicit use of the fentanyl buccal tablet in Canada (Kaplan et al., 2020).

How the Study Was Conducted

This study was conducted in three components, primarily based on the objectives of the study. To begin with, the first component, the knowledge and understanding (KAU) survey, was aimed to assess the knowledge of fentanyl prescribers regarding safety concerns. This phase was conducted in two waves. This component targeted prescribers and general practitioners. The second component was the retrospective prescription study done to evaluate the practices of fentanyl buccal tablets, which was done by reviewing 22 patient records. The third component was the web surveillance done to observe and evaluate the illicit use of fentanyl buccal tablets in Canada (Kaplan et al., 2020).

Findings of the Study

The three components revealed the results which formed the findings of the study. First, the KAU survey revealed high levels of understanding regarding the use in breakthrough pain on cancer patients (97.8%)| use in opioid-tolerant patients (97.8%)| dose titration (89.1%)| abuse/addiction risk (100). A lower understanding was only found for drug interactions (58.7%). Secondly, in the retrospective prescription study, it was found that only 13.6% of patients were prescribed fentanyl buccal tablets in line with the approved indication. Also, 45.5% of patients had cancer, where 50% recorded a breakthrough pain indication, and 36.4 were opioid tolerant. Lastly, web surveillance mentioned 4.3% of illicit use. In summary, the findings of the study revealed that physicians had good knowledge of fentanyl buccal tablet indication and safety measures (Kaplan et al., 2020). However, some gaps need improvement, such as compliance with the prescribing practice and knowledge of drug interaction.

Benefits of Mixed Methods to the Findings of the Study

The use of the mixed-methods approach benefited the study in various ways, such as providing comprehensive insights combining quantitative and qualitative data, hence facilitating the exploration of complex research questions from diverse perspectives and consequently bringing richer and more nuanced insights (Wasti et al., 2022). Secondly, the mixed-methods approach enhances data integrity through the integration of different types of data, providing a full view of the research landscape, which helps uncover relationships and connections that might not be hard to uncover when using a single method. Lastly, the mixed methods ensured a balance between strengths and weaknesses through the use of both qualitative and quantitative methods, thereby ensuring reliable and full-bodied findings (Wasti et al., 2022).

Differences between Meta-Analysis, Meta-Synthesis, and Systemic Review

These three methods are distinct and differ based on the type of data they address. For instance, meta-analysis is a quantitative technique that combines the results of several studies and tailors them to derive a collective estimate of effect size. It uses statistical methods to integrate findings and provide a high statistical power and precise estimate of the effect. On the other hand, meta-synthesis is a qualitative technique that integrates findings from different qualitative studies to generate new insights and theories instead of combining numerical results. Lastly, the systemic review is a comprehensive review of existing literature on a specific research question. A researcher should use a structured and clear method to search for, appraise, and synthesize studies on a topic, whether quantitative, qualitative, or mixed methods (Ahn & Kang, 2018).

The Advantages of Using These Three Different Techniques in Nursing Research

In line with their differences, each technique contributes uniquely to the body of knowledge and evidence-based practice. Their advantages to nursing are also different, as discussed. Firstly, the meta-analysis has increased statistical power, offers precise estimates, resolves inconsistencies, provides integrated data that promotes the generalizability of findings, and has evidence synthesis that supports the development of clinical guidelines and policy decisions by synthesizing (Wasti et al., 2022).

Secondly, meta-synthesis has advantages, such as rich insights emanating from a deep exploration of qualitative data. Also, it contributes to theory development, equips researchers with a holistic understanding, contextualizes findings, and fosters patient-centered care through the integration of qualitative research. Lastly, the systemic review benefits nursing research in several ways, such as providing a comprehensive overview of all relevant studies on a particular research question, reducing bias, integrating qualitative and quantitative research evidence, and identifying gaps in the current literature. Wasti et al. (2022) also note that it highlights areas where further research is needed, informs decision-making in policy and practice development by summarizing the best available evidence, and that standardized methodology ensures the reliability of the review process, enhancing the credibility of the conclusions.

References

Ahn, E., & Kang, H. (2018). Introduction to systematic review and meta-analysis. Korean Journal of Anesthesiology, 71(2), 103–112. NCBI.

Kaplan, S., Bergamasco, A., Sergerie, M., Castilloux, A.-M., & Moride, Y. (2020). Effectiveness of risk minimization measures for fentanyl buccal tablet (FENTORA) in Canada: A mixed-methods evaluation using surveys, medical chart records and web surveillance. Drug Safety, 43(2), 163–177. https://doi.org/10.1007/s40264-019-00882-7

Wasti, S. P., Simkhada, P., Teijlingen, E. van, Sathian, B., & Banerjee, I. (2022). The growing importance of mixed-methods research in health. Nepal Journal of Epidemiology, 12(1), 1175–1178. NCBI. https://doi.org/10.3126/

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Review the rubric to make sure you understand the criteria for earning your grade.
2. Read Chapter 11 (pp. 164-165), Chapter 16 (p. 267), and Chapter 2 (p. 22) in the textbook.
3. Read the article, Mixed methods research: Expanding the evidence base
4. View the Chapter 11 (11.3) PowerPoint file.

Expanding the Evidence Base – Insights from Mixed Methods Research

5. View the video, Systematic reviews, meta-analyses, and real-world evidence: An introduction
6. Review the video, How to search for an article in OCLS
7. Review the video, How to save an article as a PDF document.
8. Conduct a search in OCLS for a mixed methods research article related to your patient-centered problem. If you cannot find a mixed-methods article related specifically to your patient-centered problem, you could choose an article similar to your problem. (Do not use articles from previous discussions).
a. Use the following search options:
i. Add the word mixed-method to Search Term(s)
ii. Full text (left column)
iii. Research article (left column)
iv. Published date: From – 5 years ago; To- next year (right column)
v. Peer-reviewed (right column)
vi. PDF Full text (right column)
9. Prepare to discuss the following Discussion Prompts:
a. Based on the mixed-methods research article that you located answer the following questions:
i. What was the purpose of the study?
ii. How was the study conducted?
iii. What were the findings from the study?
iv. How did a mixed-methods approach benefit the study findings?
v. Describe the differences between meta-analysis, meta-synthesis, and systematic review.
vi. What are the advantages of using these three different techniques in nursing research?
10. Attach a PDF copy of the research article to your initial discussion post.
11. Find at least two current scholarly sources to support your explanations and insights. OCLS resources are preferred sources and can be accessed through IWU Resources. Wikipedia is not permitted, as it is not a peer-reviewed, scholarly source. 12. Whether written or spoken, interactions are expected to: