Clinical question- PICO question and answer

1. 1.Clinical question:
A womenwithhighblood pressure,whoisexperiencing sleeplessnesswill non-pharmacological
treatmentsuchas psychotherapy/behavioural therapybe aseffectiveaspharmacological treatment(
drug basedtreatmentasBZD etc. ) for loweringbloodpressure?
 P- The Patientproblem: She sufferedfromhighbloodpressure andsleeplessnessproblem
 I- Intervention:non-pharmacological treatmentsuchaspsychotherapy/behavioural therapy
 C- ComparisonIntervention: pharmacological treatment( drug based treatment as BZD etc)
 O -Outcome of interest: lowering blood pressure
*Non-pharmacological interventions for hypertension include lifestyle modifications like
dietary modifications, exercise, avoiding stress, and minimizing alcohol consumption.
2. No, she does not need prescription of drugs for time being because the blood pressure
medications given can lead to anxiety which will in turn cause insomnia and it will cause
hypertension, so this cycle will continue. Over time, a lack of sleep could hurt your body's
abilitytoregulate stresshormones,leadingtohighbloodpressure.Insomniaisbestmanaged
usingnon-drugstrategiessuchascognitive behaviourtherapy.Soshe doesnotneeddrugsto
control Blood pressure
*Non-pharmacological interventions for hypertension include lifestyle modifications like
dietary modifications, exercise, avoiding stress, and minimizing alcohol consumption.
*Forinsomnia:The mostcommonnonpharmacologicaltreatmentinterventionsare relaxation
therapies,sleephygieneeducation,sleeprestriction therapy, and stimulus control therapy.
3. 1.Focusing the Question
•The most common questions involve
-determining the cause of a condition
-deciding what diagnostic study to order
-choosing which drugs to prescribe
•two general types of clinical questions:
1.Backgroundquestionsare the “who, what, why, and how” questions usually answered in
textbooks and asked by medical students:
WHAT ARE THE RISK FACTORS OF HYPERTENSION?
2.Foreground questions focus on the specifics surrounding care of a patient.
A womenwithhighbloodpressure,whoisexperiencingsleeplessnesswill non-pharmacological
treatmentsuchas psychotherapy/behavioural therapybe aseffectiveaspharmacological treatment(
drug basedtreatmentasBZD etc. ) for loweringbloodpressure?
•The four components of a focused clinical question include:

2. P-the patient’s problem
I-the intervention
C-the comparison intervention
O-the outcome of interest
2. Finding Evidence:
->POEMS
->Meta Analysis
->Original research
->physicians use different websites to find the evidence , some include :-
https://www.pubmed.gov
(http://www.guidlines.gov) clinical guidelines
• reflects some interpretation and synthesis of original research and clinical practice
• physicians must critique the guidelines for validity and relevance in their own setting
3. Incorporating Patient Preferences
•There has been a cultural shift from paternalistic to shared decision making
•The degree of shareddecision makingdependsonrisk, benefit,andapatient’spreferences
4. Conclusion:
Conclusion done by family physician based on following aspects:
1.Medical evidence
2.patients preference
3.Healthcare constrains