NURS FPX 4025 Assessment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers

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Capella university

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

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Presenting Your PICO(T) Process Findings to Your Professional Peers

Chronic Obstructive Pulmonary Disease (COPD) is a progressive illness that significantly impairs lung function, reduces quality of life, and increases the demand for healthcare services. Cigarette smoking is the leading cause of COPD, and while cessation of smoking is the most effective way to halt disease progression, it remains a challenging goal for patients. The difficulty arises due to nicotine addiction, psychological stress, and inadequate support systems that many individuals face (Choi et al., 2021).

This study investigates whether structured smoking cessation programs, which integrate behavioral and pharmacological strategies, are more effective than conventional counseling in helping COPD patients quit smoking. It further evaluates improvements in pulmonary function over a six-month period.

Diagnosis: Outcomes, Risks, and Complications

COPD is characterized by airflow obstruction, chronic respiratory symptoms, and repeated pulmonary infections. Prolonged exposure to harmful irritants, particularly tobacco smoke, is the primary cause. An estimated 14 million Americans are currently diagnosed with COPD. The clinical manifestations include chronic cough, dyspnea, wheezing, and recurring respiratory tract infections. These symptoms restrict daily activities and lead to progressive decline in overall quality of life (Boers et al., 2023).

The disease trajectory varies depending on severity and treatment adherence. Without adequate intervention, patients often face recurrent hospitalizations due to exacerbations, faster deterioration of lung function, and higher risks of comorbidities such as cardiovascular disease, osteoporosis, skeletal muscle wasting, and depression. Patients with limited healthcare access and continued smoking behaviors are especially vulnerable to worsening disease. Advanced COPD can result in respiratory failure, requiring long-term oxygen therapy or mechanical ventilation (American Lung Association [ALA], 2024).

Patients who continue smoking after diagnosis experience accelerated lung decline, increased hospital admissions, and higher mortality. Evidence demonstrates that structured cessation interventions are critical in slowing disease progression, reducing complications, and improving quality of life.

Research Question Using PICO(T) Criteria

To design an evidence-based approach, the research question was formulated using the PICO(T) framework:

In adult patients with COPD (P), how does a structured smoking cessation program combining behavioral counseling and pharmacotherapy (I), compared to standard smoking cessation counseling (C), influence quit rates and lung function (O) within six months (T)?

The framework is detailed below:

PICO(T) Component	Details
Population (P)	Adults diagnosed with COPD, chosen due to the strong association between COPD and smoking.
Intervention (I)	Structured smoking cessation program that integrates behavioral therapy with pharmacological options (e.g., Nicotine Replacement Therapy, varenicline, bupropion). Evidence suggests multi-component interventions yield higher quit rates (Onwuzo et al., 2024).
Comparison (C)	Standard counseling, which often consists of brief advice or printed educational resources provided by healthcare professionals.
Outcome (O)	Sustained smoking abstinence and measurable improvement in lung function.
Time (T)	Six months. Sustained cessation beyond this period is a reliable predictor of long-term abstinence (Hu et al., 2021).

This structured question ensures targeted evaluation of smoking cessation strategies in COPD management, guiding healthcare professionals in applying evidence-based interventions.

Summary of Evidence from Peer-Reviewed Sources

Several peer-reviewed studies provide compelling evidence in support of structured smoking cessation programs for COPD patients.

• Wang et al. (2024) conducted a meta-analysis of 11 clinical trials involving over 13,000 patients. Results demonstrated a 6.72% improvement in FEV1, an average increase of 64.46 meters in the six-minute walk test (6-MWT), and a 25% reduction in mortality (RR = 0.75).

• Han et al. (2023) carried out a randomized controlled trial (RCT) comparing structured cessation programs to standard counseling. The study showed significantly higher quit rates among those receiving behavioral counseling combined with pharmacotherapy.

• Fu et al. (2022) highlighted the use of the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model to ensure systematic implementation of smoking cessation programs. Their findings underscore the necessity of integrating evidence-based approaches into routine care.

• Hu et al. (2021) reported a 27.6% abstinence rate after six months, reinforcing the relevance of this timeframe for evaluating sustained cessation outcomes.

These studies collectively demonstrate that structured interventions are more effective than conventional counseling in enhancing both smoking cessation rates and pulmonary outcomes.

Answer to the PICO(T) Question Based on Evidence Analysis

The evidence consistently indicates that structured smoking cessation programs are superior to standard counseling in COPD management. The inclusion of behavioral therapy and pharmacological support not only improves cessation rates but also enhances lung function and reduces mortality risk.

Wang et al. (2024) and Han et al. (2023) confirm the effectiveness of structured, multi-component approaches, while Fu et al. (2022) stresses the importance of applying evidence-based models such as JHNEBP for clinical practice. Furthermore, Hu et al. (2021) supports the six-month follow-up as a valid timeframe for assessing long-term success.

Although results are promising, patient outcomes may vary depending on socioeconomic status, healthcare accessibility, and psychological readiness. Tailored interventions are recommended to address these disparities in future research.

Key Steps of Care Based on Evidence-Based Recommendations

To ensure effective implementation of structured smoking cessation programs, the following care steps are recommended:

1. Patient Assessment

   • Document tobacco use history, nicotine dependence, and patient motivation levels.

   • Identify psychological barriers and support needs.

2. Tailored Intervention Plan

   • Combine behavioral counseling strategies with pharmacological agents such as Nicotine Replacement Therapy, varenicline, or bupropion.

   • Incorporate individualized education on COPD management and the health benefits of cessation.

3. Follow-Up and Support

   • Provide scheduled follow-ups at one, three, and six months to reinforce progress, troubleshoot challenges, and maintain motivation.

   • Deliver continuous COPD education, highlighting improvements in lung function and overall health.

4. Interdisciplinary Collaboration

   • Engage healthcare professionals from nursing, respiratory therapy, and primary care to deliver coordinated support.

   • Apply the JHNEBP model to ensure interventions are evidence-based and consistently integrated into practice (Choi et al., 2021).

This structured plan ensures that COPD patients receive comprehensive care, leading to improved smoking cessation outcomes and better disease control.

Conclusion

COPD remains a significant global health concern, particularly among individuals who continue smoking. Evidence strongly supports structured smoking cessation programs that combine behavioral counseling and pharmacotherapy as more effective than standard counseling. These interventions improve quit rates, enhance lung function, and reduce mortality. Healthcare professionals should adopt evidence-based models to ensure systematic and sustainable program implementation, ultimately improving patient outcomes and quality of life.

References

American Lung Association (ALA). (2024). Learn about COPD | American Lung Association. Lung.org; American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/learn-about-copd

Boers, E., Barrett, M., Su, J. G., Benjafield, A. V., Sinha, S., Kaye, L., Zar, H. J., Vuong, V., Tellez, D., Gondalia, R., Rice, M. B., Nunez, C. M., Wedzicha, J. A., & Malhotra, A. (2023). Global burden of chronic obstructive pulmonary disease through 2050. JAMA Network Open, 6(12), e2346598. https://doi.org/10.1001/jamanetworkopen.2023.46598

Choi, H. K., Vargas, J. A., Lin, C., & Singrey, A. (2021). The current state of tobacco cessation treatment. Cleveland Clinic Journal of Medicine, 88(7), 393–404. https://doi.org/10.3949/ccjm.88a.20099

NURS FPX 4025 Assessment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers

Fu, Y., Chapman, E. J., Boland, A. C., & Bennett, M. I. (2022). Evidence-based management approaches for patients with severe chronic obstructive pulmonary disease (COPD): A practice review. Palliative Medicine, 36(5), 770–782. https://doi.org/10.1177/02692163221079697

Han, M. K., Fu, Y., Ji, Q., Duan, X., & Fang, X. (2023). The effectiveness of theory-based smoking cessation interventions in patients with chronic obstructive pulmonary disease: A meta-analysis. BMC Public Health, 23(1). https://doi.org/10.1186/s12889-023-16441-w

Hu, Y., Xie, J., Chang, X., Chen, J., Wang, W., Zhang, L., Zhong, R., Chen, O., Yu, X., & Zou, Y. (2021). Characteristics and predictors of abstinence among smokers of a smoking cessation clinic in Hunan, China. Frontiers in Public Health, 9, 615817. https://doi.org/10.3389/fpubh.2021.615817

Onwuzo, C. N., Olukorode, J., Sange, W., Orimoloye, D. A., Udojike, C., Omoragbon, L., Hassan, A. E., Falade, D. M., Omiko, R., Odunaike, O. S., Momoh, P. A. A., Addeh, E., Onwuzo, S., & Erameh, U. J. (2024). A review of smoking cessation interventions: Efficacy, strategies for implementation, and future directions. Cureus, 16(1). https://doi.org/10.7759/cureus.52102

NURS FPX 4025 Assessment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers

Wang, Z., Qiu, Y., Ji, X., & Dong, L. (2024). Effects of smoking cessation on individuals with COPD: A systematic review and meta-analysis. Frontiers in Public Health, 12, 1433269. https://doi.org/10.3389/fpubh.2024.1433269