Background
The issue of chronic pain and the effects of different drugs on its management in various populations, including adolescents, has been explored in multiple papers. In this assessment, the qualitative articles by Andersson et al. (2017) and Skarstein et al. (2016) have been scrutinized as sources of knowledge on the problem of using analgesics. Similarly, the quantitative papers by Lee et al. (2016) and Voicu et al. (2019) delve into the effects of using psychoactive drugs on the well-being of patients. The studies under analysis have provided grounds for the exploration of the effects of caffeine on the treatment efficacy for adolescents and young adults with chronic pain such as migraine, proving their significance to nursing.
Each of the articles mentioned above has a unique set of objectives, yet their purpose is mostly the same, namely, seeking to alleviate chronic pain in patients. As for the objectives, Andersson et al. (2017) examine the problems of psychoactive drugs and self-treatment, whereas Skarstein et al. (2016) study the causes and effects of using over-the-counter drugs for patients with chronic pain. In turn, Lee et al. (2016) seek to prove that the refusal to consume caffeine affects patients with migraine positively, while Voicu et al. (2019) scrutinize the effects of a combination of different medications on chronic pain development.
Therefore, the research question that each of the studies poses is unique and centered on the problem of pain management. Andersson et al. (2017) ask whether self-treatment should be prioritized in pain management. In turn, Skarstein et al. (2016) question the changes in the quality of patients’ lives after using over-the-counter drugs for pain management. Lee et al. (2016) ponder over the effects of caffeine discontinuation. Finally, Voicu et al. (2019) ask if a combination of “acetylsalicylic acid, caffeine, acetaminophen, and chlorpheniramine” affects the efficacy of treating back pain (para. 1).
Support of the Nurse Practice Issue
Although the themes that the articles listed above do not necessarily align with the ones explored in this paper all the time, there are multiple overlapping issues to be considered when writing the paper. For instance, the article by Andersson et al. (2017) will be used to question the efficacy of the existing standards for treating pain. In turn, the outcomes of the study by Skarstein et al. (2016) will shed light on the challenges of overusing medication for treating pain, which may be linked to the reduced effect of painkillers due to the overuse of caffeine, especially in young people.
The study by Lee et al. (2016) will have a particularly resounding effect on the direction of this research since it tackles the issue of increased caffeine intake and the resulting pain management issues directly. To conclude the discussion of the problem, the paper by Voicu et al. (2019) will be utilized to examine the interactions between different components of pain management medication. Therefore, each of the articles under analysis will expand the issue and add a unique perspective to it since each will allow identifying and recognizing an array of nuances to the management of pain.
Notably, the interventions in each of the studies align with the research question fully. Specifically, every article of the four under analysis points to the issue of managing pain with the help of analgesics. At the same time, none of the studies focuses specifically on the effects of caffeine on the extent of pain medication’s efficacy in adolescents and young adults, which provides extra room for hypothesizing.
Method of Study
For this review, four studies have been selected to represent the qualitative and quantitative methods evenly and objectively. Thus, two qualitative and two quantitative studies have been provided to examine the issue of pain management. However, there are slight differences even within the articles that are supposed to utilize the same research methods. For instance, the paper by Andersson et al. (2017) uses a thematic analysis as the means of locating the key themes and ideas concerning the use of psychoactive medication as the last resort. The specified approach toward arranging and analyzing data helps to categorize the existing information neatly and locate the key themes accurately, though it is quite prone to subjective interpretations. Compared to Andersson et al.’s (2016) methodological framework, the study by Skarstein et al. (2016) uses a similar approach of a thematic analysis, yet its data comes from interviews as opposed to forum discussions.
The quantitative approaches toward the analysis of the issue are equally as profound and effective as the qualitative ones described above. Specifically, the paper by Lee et al. (2016) has used the Migraine-ACT questionnaire to collect and quantify the data, which has allowed obtaining rather precise results. In turn, Voicu et al.’s (2019) research were based on the clinical trial conducted in a local facility using the Visual Analog Pain Intensity Scale. The described approach has also helped to obtain rather accurate results, despite the possibility of subjective pain assessment by patients.
Results of Study
Overall, the results of the studies above indicate that the present approach toward pain management leaves much to be desired in terms of its efficiency, as well as the long-term effects such as the development of chemical dependency. Therefore, the articles scrutinized for this research have proven that there is a substantial knowledge gap concerning the effects of pain management drugs on patients when introducing extra factors, such as the increased intake of caffeine.
The described issue with the existing literature provides substantial grounds for the present research. Namely, they justify the idea of exploring the impact of caffeine intake on the performance of pain medications, particularly, in regard to migraine and general pain issues in adolescents and young adults. Overall, the implications of these studies for the nursing practice include a better assessment of the unique circumstances under which pain medications are consumed, particularly, by adolescents and young adults.
Ethical Considerations
Performing an academic study typically implies assuming an ethical stance and certain responsibility for the well-being of the stakeholders of the study, primarily, patients and other vulnerable groups. In the case under analysis, the issue of patient consent demands attention since adolescents mentioned in the PICOT question and representing one of the two main groups for the analysis cannot legally consent to participate in the study. Therefore, obtaining consent from their parents or legal guardians is an essential ethical issue to be kept in mind when constructing the study. Another essential ethical concern is the requirement for anonymity as the means of maintaining participants’ safety.
The studies mentioned above tackle the issues in question quite well. Every article mentioned above involves the participation of adults, which is why obtaining consent was very easy in all four cases. Similarly, the problem of identity was resolved effectively by avoiding mentioning any of the participants directly and, instead, focusing on the pain-related information that they provided. Overall, key ethical requirements have been met in all four papers.
Outcomes Comparison
Returning to the initial PICOT question, it is anticipated that this research will show the connection between the intake of caffeine and the efficacy of medications consumed by patients. Namely, the inverse correlation between the specified variables in adolescents and young adults who experience chronic pain, including migraine, is believed to be located after the research is completed. In other words, the existing studies, particularly, the ones reviewed above, allow suggesting that the PICOT question will receive a positive answer.
The statement above is based on the overview of the research outcomes of the four articles in question to a substantial extent. Specifically, each of the papers under analysis indicates that the introduction of side factors to the treatment of pain, especially for the cases involving analgesic-related medications, reduces the efficacy of the intervention. Thus, it is reasonable to suggest that the intake of caffeine is in inverse relation to the extent to which analgesics affect patients and their perception of pain.
Proposed Evidence-Based Practice Change
Based on the evaluation of the four key articles mentioned above, the transition to a more elaborate development of a treatment method for adolescents and young adult patients with chronic pain is suggested. Namely, given the assumption that the increase in caffeine intake reduces the extent to which pain management medications affect a patient’s negative experiences with pain management, a transition to an all-embracive treatment method is needed (Wham et al., 2017). Specifically, the dietary specifics of a patient’s daily menu will have to be taken into consideration when shaping the treatment strategy.
The described change to be informed by the future outcomes of the study is likely to produce a notable effect on the current treatment framework. Given the fact that there is an evident problem with the development of chemical dependency on painkillers in patients due to the strong effects that the specified medication has, side factors such as caffeine intake must be considered. The importance of the issue is enhanced by the observed rise in the instances of over-the-counter selling and purchasing of strong analgesics as pain management substances. Although the specified medications have a doubtless effect on pain, their uncontrolled usage will inevitably cause the need to increase the dose due to its loss of impact (Voicu et al., 2017). Therefore, including the factors that will reinforce the further addiction to medication and the need for the dosage increase is highly irresponsible, which calls for a change in the treatment paradigm.
The articles analyzed above factor into the specified change directly since they provide evidence concerning the addiction development and the over-the-counter selling problem. Likewise, the articles point to the problem of caffeine and other substances reducing the efficacy of painkillers’ effects. Therefore, the studies listed above have created the grounds for advancing the current perception of side factors in the prescription of analgesics to adolescents and young adults experiencing chronic pain.
References
Andersson, M., Persson, M., & Kjellgren, A. (2017). Psychoactive substances as a last resort – A qualitative study of self-treatment of migraine and cluster headaches. Harm Reduction Journal, 14(1), 1-10.
Lee, M. J., Choi, H. A., Choi, H., & Chung, C. (2016). Caffeine discontinuation improves acute migraine treatment: A prospective clinic-based study. The Journal of Headache and Pain, 17(1), 1-6.
Skarstein, S., Lagerløv, P., Kvarme, L. G., & Helseth, S. (2016). High use of over-the-counter analgesic; possible warnings of reduced quality of life in adolescents – A qualitative study. BMC Nursing, 15(1), 1-11.
Voicu, V. A., Mircioiu, C., Plesa, C., Jinga, M., Balaban, V., Sandulovici, R.,… Mircioiu, I. (2019). Effect of a new synergistic combination of low doses of acetylsalicylic acid, caffeine, acetaminophen, and chlorpheniramine in acute low back pain. Frontiers in Pharmacology, 10.
Voicu, V. A., Mircioiu, I., Sandulovici, R., Mircioiu, C., Plesa, C., Velescu, B. S., & Anuta, V. (2017). Chlorpheniramine potentiates the analgesic effect in migraine of usual caffeine, acetaminophen, and acetylsalicylic acid combination. Frontiers in Pharmacology, 8(758), 1-11.
Wham, C., Rowe, K., Ali, A., & Rutherford-Markwick, K. (2017). Influences of caffeine consumption among adult New Zealanders: A qualitative study. Journal of Caffeine Research, 7(4), 142-150.