Research Critique: Opioid Use in Hospice - Essay Example

 Research Critique: Opioid Use In Hospice Problem Statement Underpinning the study is that use of opioids in patients with renal impairment has the potential of increasing the adverse effects (King, Fores, Hanks, Ferro, & Chambers, 2011). The implication is that opioids differ in the effects on renal impairment in terms of efficacy and tolerability. Also underpinning the study is that there is little knowledge and understanding on safe as well as effective use of opioids in managing pain with the renal impairment patients and also recommend guidelines for safer use. The significance Of the particular study is evident from the fact that over recent years, there has been an increased recognition of impact that opioids use have on renal function since few cases have been reported that the parent drug use can lead to accumulation and raising toxicity levels which is not the case as the study seeks to prove so. Purpose and research question The primary focus of the study is therefore, to identify and also assess the existing quality of evidence on how health caregivers can ensure safe and efficient use of the opioids to relief cancer pains especially for patients suffering from renal impairment. Some of the research questions that lay the foundation of the research include: Does the knowledge on which opioids and also the dose to use effectively as well as safe pain control in patients with cancer who exhibit renal impairment? Does opioid use affect the renal function of cancer patients? The above research questions are undoubtedly related to the research question because they also focus on bringing new insights on the safe application of opioids in cancer patients with renal impairment. There is ultimately little knowledge on safe use and application of opioids in cancer patients suffering from renal impairment and the study can shade some light on how health caregivers can manage pain and still ensure that toxicity levels of the patient does not increase the severity of the renal impairment (King, Fores, Hanks, Ferro, & Chambers, 2011). To answer the question, the researchers have relied on secondary data collection of qualitative studies to arrive at the conclusions and inferences (Burns & Grove, 2011). In effect, the study refers to previous medical and clinical studies to determine the safe prescriptions of the opioids in patients with renal impairment and how the pain can be managed effectively to reduce the toxicity levels of the Kidney. Literature Review Being a secondary qualitative study, the author has referred to previous studies on the research topic to identify trends in opioid use on patients with renal impairment. In this regard, there has been an appropriate reference to both quantitative and qualitative literature on the research topic (Burns & Grove, 2011). To engage in a comprehensive literature search, the authors arranged the pieces of literature in their orders of importance and sought more information from empirical studies of older journals, books and papers. On the other hand, the research included duplicate publications to lay the foundation for reviewing the extent to which the existing studies may be accurate in addressing the study topic. Also an important part of the literature search is that the study assessed them for quality. In effect, the researchers used a form to record publication details of the literature, their duration of the study, interventions and also the outcomes of the measured variables. Therefore, the literature review was provided in the form of a narrative analysis as opposed to the common meta-analysis since it would have been impossible to complete the multiple analyses because of the nature of the published data. The study is balanced in using the existing literature as there is the use of both literatures from the previous studies, dating back to 20 years ago and the recent studies, dating back to 5 years. Therefore, the research relies on both older and recent studies in substantiating that opioid use in cancer patients with renal impairment requires proper monitoring and prescription to avoid raising toxicity levels of the patient’s body. The literature review identified the weakness of the current literature especially on the health care professional's awareness of the relation between renal function and drug prescription. On the other hand, the literature search identifies gaps in the awareness of a patient's renal function especially inadequate knowledge of how it is important for opioid prescription (King, Fores, Hanks, Ferro, & Chambers, 2011). Nonetheless, the literature search identifies weaknesses with the recommended doses of opioid in patients with renal impairment and also the available prescription of the opioids for cancer patients. The literature search provides the rationale for logical arguments that the researchers used to make inferences and conclusions from the research findings (Burns & Grove, 2011). For instance, the literature logically argues that the effectiveness of managing pain in cancer patients with renal impairment is prior understanding of the correct dose to administer to such patients. On the other hand, literature review describes some of the commonly used opioids in managing cancer pain. In this regard, the information about the pain management drugs identifies the opioids that are associated with higher levels of toxicity thus crucial information for managing pain in cancer patients with renal impairment (King, Fores, Hanks, Ferro, & Chambers, 2011). Conceptual / Theoretical Framework The study was rather developed from a literature search perspective where the rationale for the study was formulated from the fact that there is limited clinical evidence for opioid use with patients exhibiting renal failure. The implication is that the research found out that no single study indicates the risk associated with the rising levels of toxicity of the opioids when used on cancer patients with renal impairment. On the other hand, the research was conducted from the perception that even patients with normal renal function do not show any signs of increased toxicity with the application of different types of opioids. The study is generally a qualitative search of the existing literature on the use of opioids on cancer patients with renal impairment thus the research developed a conceptual framework of the searched literature. In this case, the study used the PRISMA chart to organize the information retrieved from the secondary literature search (Burns & Grove, 2011). In effect, the information contained in the literature was organized according to relevance, year of publication and topical coverage so that the trends that appear in the search would be used to underpin analysis, discussion and the final recommendation. References King, S., Fores, K., Hanks, G.W., Ferro, C. J., & Chambers, E. J. (2011). A systematic review of the use of opioid medication for those with moderate severe cancer pain and renal impairment: collaborative opioid guideline project. Palliative medicine 25(5), 525-552 Burns, N., & Grove, S. (2011). Understanding Nursing Research (5th ed.). Elsevier. 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