University Assignment: PICO Question on Fish Oil and Osteoarthritis

This assignment presents a PICO (Patient, Intervention, Comparison, Outcome) question focusing on the effectiveness of fish oil in treating osteoarthritis in older women. The student investigates this clinical question, examining the available evidence and research findings to determine if fish oil is a viable treatment option. The assignment includes a discussion of relevant databases like CINAHL and EBSCO, search strategies, and key search terms used to identify pertinent articles. Two articles are reviewed, highlighting the role of omega-3 fatty acids (EPA and DHA) in reducing inflammation and pain associated with osteoarthritis. The student concludes that there is strong evidence supporting the usefulness of fish oil in treating osteoarthritis, suggesting its potential benefits for patients. References to supporting research are also included.

Running head: PICO QUESTION
PICO QUESTION
Name of the Student
Name of the university
Author’s note

1PICO QUESTION
Introduction
PICO QUESTION – In older women (P) with osteoarthritis is fish oil (I) an effective
treatment option (O)?
The PICO question is to address whether there is any valid evidence that fish oil is
effective in treating osteoarthritis. The above case compares between those who take fish oil as a
remedy to osteoarthritis and those who do not rely on the fish oil as in Peggy. The question
actually aims to focus on the clinical evidence that supports the use of the fish oil for arthritis. It
has been found that a huge number of Australian populations have been using fish oil for the
curing of Arthritis.
It has been found that in fish oil there are two types of omega -3 fatty acids, which are
DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid). Researches have found that
these omega 3 fatty acids can lessen the inflammation in the joints, which normally causes
swelling and pain. Although some evidences show that the acids can suppress the body’s
immune system.
Discussion
In this study two main databases that have been used is CINAHL and EBSCO.
Nurses and the health care professionals use the CINAHL database to find out a wide
variety of journals. It makes the best use of the research informations. Science literatures have
evolved from time to time in terms of their specialization and this website provides us with a vast
array of scientific literatures. It is the best database while conducting a review of qualitative

2PICO QUESTION
evidence. It is a reliable database which has more than 27 millions of articles. This search engine
helps to conduct researches on nursing, science journals. It gives a quick access to the newly
published articles.
The EBSCO database is a global leader in providing all kind of researches. It serves the
research and the content needs of the top academic journals and the top academic literatures. The
most amazing part of this database is that the limiters and the expanders can be generated. This
provides with a collection of databases that helps in the health care decision making process.
Key words terms/phrases Alternative words
P Osteoarthritis in women,
osteoarthritis in older females,
Osteoarthritis patients OR
inflammation in knee joints.
Osteoarthritis pain, sore and stiff
joints, rheumatoid arthritis.
I Fish oil osteoarthritis, Omega 3
fatty acids in fish oil, effect of
EPA and DHA in knee
osteoarthritis.
Osteoarthritis patients OR
omega 3 fatty acids.
Benefits of fish oil in
osteoarthritis
C High dose COD liver oil, low
dose COD liver oil, Dietary fatty
acids, omega 3 fatty acids, EPA
and DHA.
COD liver oil in slow arthritis.
Fish oil OR cod liver oil.
O Fish oil treatment in
osteoarthritis,
Fish oil arthritis and pain relief,
Fish oil efficacy in arthritis.
Osteoarthritis pain relief, OR
mechanism of osteoarthritis
relief.
Usefulness of fish oil Or relief

3PICO QUESTION
from pain.
Action Search mode Results Limiters/Expanders
S1 Boolean/Phrase-
Osteoarthritis female
patients AND fish oil,
Fish oil OR
osteoarthritis, knee
arthritis, inflammation
of joints, COD liver oil
AND osteoarthritis.
70 Full text, 2010-2017
S2 Auto OR all search
terms- Osteoarthritis in
females OR knee
osteoarthritis in older
females
34 Full text Pdf.
S3 Auto AND all search
terms- Fish oil AND
osteoarthritis
23 Publication type-
Clinical
nutrition
S4 SmartText searching-
Omega-3 Fatty Acid in
12 Full text, 2012-2017,
peer review

4PICO QUESTION
osteoarthritis OR EPA
and DHA in reducing
inflammation in joints.
S5 SmartText searching-
mechanisms of omega 3
fatty acids in
osteoarthritis treatment
6 Publication type- The
journal of nutrition,
health & aging
S6 SmartText searching-
Efficiency of fish oil in
treating osteoarthritis
2
Application of related
words, Full text, pdf
2012-2017
(Source: Richardson-Tench et al., 2016)
My final search has generated two results, which appropriately addresses the PICO
question.
Review
Two articles that are appropriate in addressing the research question are as follows:-
Senftleber, N. K., Nielsen, S. M., Andersen, J. R., Bliddal, H., Tarp, S., Lauritzen, L., ... &
Christense, R. (2016). PT09. 4: Fish Oil Supplements for Arthritis Pain: A
Systematic Review and Meta-Analysis of Randomized Trials. Clinical Nutrition, 35,
S40.

5PICO QUESTION
A systematic review has been conducted as per this article and by randomized trials has
been conducted for determining the efficacy of omega 3 fatty acids present in the fish oil. %
databases have been searched and about 30 trials have been found that are meeting the criteria.
The randomized trials have provided evidences regarding the importances of the omega 3- fatty
acids in the treatment of the pain in Osteoarthritis.
Byelashov, O. A., Sinclair, A. J., & Kaur, G. (2015). Dietary sources, current intakes, and
nutritional role of omega‐3 docosapentaenoic acid. Lipid technology, 27(4), 79-82.
The above journal gives idea about the dietary usefulness of the omega 3 fatty acids. It has
emphasized on the role of the omega 3 fatty acids in relieving the pain in osteoarthritis.
Epidemiological studies show that the EPA and the DHA levels are present in substantial amount
in the fish oil. It has been mentioned further, that degradation of the collagen in cartilage is also
managed by the omega 3 acids. The article indicates that EPA and DHA inhibit the expression of
various proteins that contributes to osteoarthritis. It has been found that if they are administered
in a dose dependant manner into the cartilage cell membranes, they decrease the enzymes that
are responsible for the degradation of the cartilage and the inflammatory cytokines.
Conclusion
Strong evidences have been found regarding the usefulness of the fish oil in the treatment
of the osteoarthritis. Therefore intake of fish oil along with the normal diet for Mrs Peggy is
advisable. Researchers have shown the mechanism how the DHA and EPA can lessen the
inflammation in joints and extensive research is required to understand the effectiveness of fish
oil in treating osteoarthritis.

6PICO QUESTION