LINK TO PRESENTATION

https://myacu-my.sharepoint.com/:p:/g/personal/s00339116_myacu_e
du_au/ERntPuIA0_RPk6JZO2-I5h4BZtV4yBlf_0XxRzC3UdTAgw?e=lINrr8
CRITICAL APPRAISAL
The association between social
support and medication adherence in
patients with hypertension: A
systematic review
(Shahin et al., 2021)
WHY ARE CRITICAL APPRAISALS
DONE?
• Verification and replication,

• Advancing Knowledge,

• Methodological rigor,

• Debunking flawed studies or misleading information, and

• Peer review process.

WHY HAVE I CHOSEN THIS STUDY?
• Focuses on hypertensive patients,

• Medication adherence: a determinant of treatment

outcome,

• Highlights the importance of social support, and

• Aimed to provided updated findings.

CHECKLIST FOR SYSTEMATIC
REVIEW
• Was the research question appropriate?

• Was the search strategy appropriate?

• How was quality of included studies assessed?

• Were all important exposure(s) considered?

CHECKLIST FOR SYSTEMATIC
REVIEW
• Were all important outcome(s)considered?

• What were the results?

• Can the results be applied to the population?

• Any potential conflicts of interest?

WAS THE RESEARCH QUESTION
APPROPRIATE?
• Specific and focused,

• Aligns with objective of the study,

• Clearly defines scope of the study,

• Relevant and important in the context,

• Yes, it was.
WAS THE SEARCH STRATEGY
APPROPRIATE?
• Comprehensive and systematic search,

• Relevant search terms,

• Application of time limitations,

• Yes, it was.
HOW WAS QUALITY OF INCLUDED
STUDIES ASSESSED?
• Type of study designs,

• Absence of formal quality appraisal,

• Assessed for a risk of bias

WERE ALL IMPORTANT
EXPOSURE(S) CONSIDERED?
• Reviewing the research question and objectives,

• Design of inclusion and exclusion criteria,

• Included studies cover exposure of interest,

• Measurement of exposure,

• Discussion adequately address the exposure,

• Yes, it was.
WERE ALL IMPORTANT OUTCOME(S)
CONSIDERED?
• Review the research question,

• Examining the inclusion and exclusion criteria,

• Evaluating the search strategy,

• Checking the study selection process,

• Measurement of outcomes,

• Yes, all important outcomes were considered.

WHAT WERE THE RESULTS?
• 1,155 articles located,

• 321 duplicates removed,

• 225 articles further removed,

• 14 articles selected.
WHAT WERE THE RESULTS?
• 9 studies found positive association for family,

• 2 studies found no association for family,

• 3 studies found no association for healthcare support.

CAN THE RESULTS BE APPLIED TO
THE POPULATION?
• 2 studies conducted in Nigeria,

• 2 in Middle-Eastern countries,

• 1 in China,

• 2 in turkey,

• 1 in Spain,
CAN THE RESULTS BE APPLIED TO
THE POPULATION?
• 1 in Poland,

• 2 in United States,

• 1 in Ethiopia,

• 1 in Malaysia, and

• 1 in Indonesia.
CAN THE RESULTS BE APPLIED TO
THE POPULATION?
• Focused on older patients.

• No adjustment for confounders.

ANY POTENTIAL CONFLICTS?
• None.

• No Funding.
CONCLUSION
• First to evaluate chosen question,

• Valid and reliable.

REFERENCE
• Shahin, W., Kennedy, G. A., & Stupans, I. (2021). The association between social support and
medication adherence in patients with hypertension: A systematic review. Pharm Pract
(Granada), 19(2), 2300. https://doi.org/10.18549/PharmPract.2021.2.2300

•  Adisa, R., Olajide, O. O., & Fakeye, T. O. (2017). Social Support, Treatment Adherence and
Outcome among Hypertensive and Type 2 Diabetes Patients in Ambulatory Care Settings in
southwestern Nigeria. Ghana Med J, 51(2), 64-77.

• Criswell, T. J., Weber, C. A., Xu, Y., & Carter, B. L. (2010). Effect of self-efficacy and social support
on adherence to antihypertensive drugs. Pharmacotherapy, 30(5), 432-441.
https://doi.org/10.1592/phco.30.5.432
REFERENCE
• Hacihasanoglu Asilar, R., Yildirim, A., Saglam, R., Demirturk Selcuk, E., Erduran, Y., & Sarihan, O.
(2020). The effect of loneliness and perceived social support on medication adherence self-
efficacy in hypertensive patients: An example of Turkey. J Vasc Nurs, 38(4), 183-190.
https://doi.org/10.1016/j.jvn.2020.07.003

• Haidari, A., Moeini, M., & Khosravi, A. (2017). The Impact of Peer Support Program on
Adherence to the Treatment Regimen in Patients with Hypertension: A Randomized Clinical
Trial Study. Iran J Nurs Midwifery Res, 22(6), 427-430.
https://doi.org/10.4103/ijnmr.IJNMR_16_16

• Hatah, E., Lim, K. P., Ali, A. M., Mohamed Shah, N., & Islahudin, F. (2015). The influence of
cultural and religious orientations on social support and its potential impact on medication
adherence. Patient Prefer Adherence, 9, 589-596. https://doi.org/10.2147/ppa.S79477
REFERENCE
• Khadoura, K., Shakibazadeh, E., Mansournia, M. A., Aljeesh, Y., & Fotouhi, A. (2021). Determining the
Prevalence of and the Factors Associated with Antihypertensive Medication Non-Adherence in the Gaza
Strip. Korean J Fam Med, 42(2), 150-158. https://doi.org/10.4082/kjfm.19.0081

• Kurniawati, N. D., Wahyuni, E. D., & Toulasik, Y. A. (2019). Family Support Improves Hypertensive
Patient Drug Compliance. Indian Journal of Public Health Research & Development, 10(8).
• Hansen, C., Lundh, A., Rasmussen, K., & Hróbjartsson, A. (2019). Financial conflicts of interest in systematic reviews:
associations with results, conclusions, and methodological quality. Cochrane Database Syst Rev, 8(8), Mr000047.
https://doi.org/10.1002/14651858.MR000047.pub2

• Olowookere, A. J., Olowookere, S. A., Talabi, A. O., Etonyeaku, A. C., Adeleke, O. E., & Akinboboye, O. O.
(2015). Perceived family support and factors influencing medication adherence among hypertensive
patients attending a Nigerian tertiary hospital. Annals of Tropical Medicine & Public Health, 8(6).
REFERENCE
• Pladevall, M., Brotons, C., Gabriel, R., Arnau, A., Suarez, C., de la Figuera, M., Marquez, E., Coca, A.,
Sobrino, J., Divine, G., Heisler, M., & Williams, L. K. (2010). Multicenter cluster-randomized trial of
a multifactorial intervention to improve antihypertensive medication adherence and blood
pressure control among patients at high cardiovascular risk (the COM99 study). Circulation,
122(12), 1183-1191. https://doi.org/10.1161/circulationaha.109.892778

• Shen, Y., Peng, X., Wang, M., Zheng, X., Xu, G., Lü, L., Xu, K., Burstrom, B., Burstrom, K., & Wang, J.
(2017). Family member-based supervision of patients with hypertension: a cluster randomized trial
in rural China. J Hum Hypertens, 31(1), 29-36. https://doi.org/10.1038/jhh.2016.8

• Spikes, T., Higgins, M., Quyyumi, A., Reilly, C., Pemu, P., & Dunbar, S. (2019). The Relationship
Among Health Beliefs, Depressive Symptoms, Medication Adherence, and Social Support in African
Americans With Hypertension. J Cardiovasc Nurs, 34(1), 44-51.
https://doi.org/10.1097/jcn.0000000000000519
REFERENCE
• Tsadik, G. D., Berhane, Y., & Worku, A. (2020). Adherence to Antihypertensive Treatment and
Associated Factors in Central Ethiopia. Int J Hypertens, 2020, 9540810.
https://doi.org/10.1155/2020/9540810

• Turan, G. B., Aksoy, M., & Çiftçi, B. (2019). Effect of social support on the treatment adherence
of hypertension patients. J Vasc Nurs, 37(1), 46-51. https://doi.org/10.1016/j.jvn.2018.10.005

• Uchmanowicz, B., Chudiak, A., Uchmanowicz, I., Rosińczuk, J., & Froelicher, E. S. (2018). Factors
influencing adherence to treatment in older adults with hypertension. Clin Interv Aging, 13,
2425-2441. https://doi.org/10.2147/cia.S182881
REFERENCE
• Jimmy, B., & Jose, J. (2011). Patient medication adherence: measures in daily practice. Oman Med J, 26(3), 155-
159. https://doi.org/10.5001/omj.2011.38

• Mhaskar, R., Emmanuel, P., Mishra, S., Patel, S., Naik, E., & Kumar, A. (2009). Critical appraisal skills are essential
to informed decision-making. Indian J Sex Transm Dis AIDS, 30(2), 112-119.
https://doi.org/10.4103/0253-7184.62770

• Fisher, N. D. L., & Curfman, G. (2018). Hypertension—A Public Health Challenge of Global Proportions. JAMA,
320(17), 1757-1759. https://doi.org/10.1001/jama.2018.16760

• Aromataris E, Fernandez R, Godfrey C, Holly C, Kahlil H, Tungpunkom P. Summarizing systematic

reviews: methodological development, conduct and reporting of an Umbrella review approach. Int J
Evid Based Healthc. 2015;13(3):132-40. https://jbi.global/critical-appraisal-tools