Project Development Assignment: Optimization And Development Of The Digital Intervention For Patients

Question

Task: The purpose of this assessment Is to write a clear and objective summary of the original text To write the assignment, you need to select One recent article published In peer reviewed journals relevant to the topic of Project Development and Optimisation. Student need to provide a link to the article summary that will be inserted in their article summary page and a full reference. Guidelines for writing a summary of an article:

• State the main ds of the article.
• Identify the most important details that support the main ideas.
• Write In your own words and avoid copying Phrases aid sentences from the article unless they are direct quotation.
• Express the underlying meaning of the article. not just the superficial details.
• Your summary should be max 5OO words.
• Provide a link to the article summary that well be inserted in their article summary page and a full reference.

Answer

Critical appraisal
The present study on the article by Bowers et at., (2020)supports the Antidepressant Discontinuation (AD) along with the optimization and development of the Digital Intervention(DI) for the patients in the UK’s primary care while using a theory, person and evidenced based approach.

Aim of the article
The article aims to the planning and optimization of the patient confronting DI for supporting the discontinuation that is named as “ADvisor”. It helps in proving the overview of the distinctive stages for the development and the way it collectively abbreviated DI.

Methods
Planning and development of intervention
As advised by Farmer et al., (2016), the methods of PBA helps in providing the guidelines regarding the integrated system of in-depth qualitative research within the development process. The use of PBA within the present study ensures the theory and evidence based techniques that are applied for the full interpretation of the perspective of target users and the psychological context. Thus, the discussed article recapitulates certain components for the comprehensive approach that involves primary qualitative approach, systematic reviewing, behavioral analysis and logic modeling along with the establishment of the guiding principles.

Design
As opined by Greenwood et al. (2019), the studies of Think Aloud are designed for eliciting the in depth perspective regarding the content’s nature rather than just solely concentrating upon the usability as well as the functionability, and are even used in the present article.

Participants and Procedures
The article recruits the participants from the 8 primary care practices within the South of England. There were certain inclusion criteria of eligibility such as, patients taking the antidepressants since 1 year or the period of 2 year regarding the subsequent episode, patients discontinuing the antidepressant or are within the procedure of tapering. The exclusion criteria included,Patient Health Questionnaires 9 that scores equal to or more than 10, patients with suicide attempt history, presently receiving psychiatric treatment or any other social difficulties which has helped in the determination of the future scope of the research with ease. Thus, these eligible participants were given the consent of the Think Aloud interviews, which were conducted by the researcher and these interviews ranged from 38 to 93 minutes that were recorded in audios and transcribed accuratelyas being in consent to the format of the article authored by Bowers et al., (2019).

Results
Thequalitative systematic review displayed the approaches that are psychologically informed like the theory of cognitive behavior that was associated with the higher rates of the discontinuation rather than the elementary advice for reduction. Hence, as stated by Moriarty et al., (2019), through the following of the behavioral diagnosis which is based upon the wheel of behavioral change, the theory of social cognitive aspect provided the theoretical intervention basis. However, these interventions within the present article are optimized upon the basis of interviews of Think Aloud wherein the participants proposed that they had liked the flexibility of the specific system and also found it convincing, going by the findings enlisted in the studies of Yathamet al., (2018). Thus, the changes were built within the tone of the particular material along with the adjustment of the structure.

Conclusion
To conclude, the parent articles highlight the DI within the Primary care sectors of the UK regarding the syndrome of AD and thus, the psychologically acquainted intervention helps in the enhancement of the efficacious discontinuation for the antidepressant medications. Thus, the researchers conducting the interviews of Think Aloud are involved within the development of the DI.

Summary

Article Link: https://bmjopen.bmj.com/content/bmjopen/10/3/e032312.full.pdf
Within medical science, theantidepressant discontinuation refers to the syndromes, which occur through the discontinuation, reduction and interruption of the antidepressant medication. However, the symptoms related to this involve trouble sleeping, flu-like tendencies, sensory changes, poor balance, nausea and anxiety. Thus, to support the patients during such syndromes of antidepressant discontinuation (AD) the primary care sector of the UK has incorporated the Digital Intervention (DI), which involves the enormous potential as the scalable tool for improving the healthcare deliveries through enhancing the effectiveness, accessibility, efficiency, personalization and safety. As argued by Bowers et al., (2019), for achieving these improvements the base of cumulative knowledge is required which helps in the deployment and development of Digital Health Intervention (DHI).

The article aims in developing the DI for supporting the discontinuation of antidepressant medication within the primary care sector of the UK, which is accessible, safe, scalable, feasible and has focused upon the specific work involved within the development of the DI. This article has incorporated the theory, evidence and person-based approaches (PBA) and thus, this comprehensive strategy assimilates the PBA along with more generally used theory as well as evidence-based. A rigorous research has been carried out on the topic, to reach conclusive results, which is one of the significant strengths of the study. Thus, inside the methods of PBA, the qualitative studies of Think Aloud are implemented within the present article for optimizing the original intervention. Thus, the present article involved the two of the primary analytical methods that is rapid coding analysis that tabulated the negative and positive comment provided by the respondents form 8 primary care practices in the Think Aloud interviews as well as intensive thematic analysis with using HMB and preliminary coding frame AWAY which are the significant observation after thoroughly studying the article. However, interviews were continued with the participants until reaching the Data Saturation and certain inclusion and exclusion criteria were maintained for the selection of the participants.

The present article describes the intensive qualitative study and qualitative systematic review highlights the equilibrium of fear of the depression relapse that is the key barriers for the discontinuation of the antidepressant medication. Within the interviews, the Patients are granted the chance of expressing their views in response of the way they are seeing on the page as opposing to solely responding the questions asked by the researchers and thus, the patients within their turns of interviews were encouraged for providing both negative and positive feedback as per their experiences and hence, the same has been incorporated within this article. The Prototype DI named as the ADvisor refers to the theory, evidence and the person-based approach (PBA) will help in the mitigation of the suffering occurred for the discontinuation. However, the feasibility, cost and clinical effectiveness of the ADvisor interventions is needed to be determined in the further research that will be held in future.

References
Aalbers, S., Vink, A., Freeman, R.E., Pattiselanno, K., Spreen, M. and van Hooren, S., 2019. Development of an improvisational music therapy intervention for young adults with depressive symptoms: An intervention mapping study. The Arts in Psychotherapy, 65, p.101584.
Bowers, H.M., Kendrick, T., Glowacka, M., Williams, S., Leydon, G., May, C., Dowrick, C., Moncrieff, J., Laine, R., Nestoriuc, Y. and Andersson, G., 2020. Supporting antidepressant discontinuation: the development and optimisation of a digital intervention for patients in UK primary care using a theory, evidence and person-based approach. BMJ open, 10(3), p.e032312.
Bowers, H.M., Williams, S.J., Geraghty, A.W., Maund, E., O’brien, W., Leydon, G., May, C.R. and Kendrick, T., 2019. Helping people discontinue long-term antidepressants: views of health professionals in UK primary care. BMJ open, 9(7), p.e027837.
Brydges, S., Rennick-Egglestone, S. and Anderson, C., 2019. Men's views of antidepressant treatment for depression, and their implications for community pharmacy practice. Research in Social and Administrative Pharmacy.
Farmer, A.J., McSharry, J., Rowbotham, S., McGowan, L., Ricci?Cabello, I. and French, D.P., 2016. Effects of interventions promoting monitoring of medication use and brief messaging on medication adherence for people with Type 2 diabetes: a systematic review of randomized trials. Diabetic Medicine, 33(5), pp.565-579.

Greenwood, D., Tully, M., Martin, S. and Steinke, D., 2019. Development of a framework to support the evaluation of Emergency Department Pharmacist Practitioners’ impact on quality of care. International Journal of Pharmacy Practice, 27(S2), pp.4-26.
Miller, S., Ainsworth, B., Yardley, L., Milton, A., Weal, M., Smith, P. and Morrison, L., 2019.A framework for Analyzing and Measuring Usage and Engagement Data (AMUsED) in DIs. Journal of medical Internet research, 21(2), p.e10966. Moriarty, A.S., Coventry, P.A., Hudson, J.L., Cook, N., Fenton, O.J., Bower, P., Lovell, K., Archer, J., Clarke, R., Richards, D.A. and Dickens, C., 2019. The role of relapse prevention for depression in collaborative care: a systematic review. Journal of affective disorders.
Yatham, L.N., Kennedy, S.H., Parikh, S.V., Schaffer, A., Bond, D.J., Frey, B.N., Sharma, V., Goldstein, B.I., Rej, S., Beaulieu, S. and Alda, M., 2018. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar disorders, 20(2), pp.97-170.