MAKE CHANGES TO THE PAPER AS DETAILED
Hypothesis-
Reflects as if two treatment options are tested. In reality, antihypertensive and blood pressure-reducing medications are the same. Probably the author wants to compare down-titrating vs aggressive patterns of therapy in elderly patients with systolic hypertension. Suggesting a simplification of the hypothesis.
Why elderly and frail elderly? Is there any significance?
Why not only the elderly? (CHANGE TO ONLY ELDERLY)
In many places in the text, there is mention of elderly and frail subjects (age group is not specified).
Introduction-
Existing studies demonstrate that titration of antihypertensive medications significantly improves BP control. The author has also clearly stated this under the introduction concerning finding from a meta-analysis done by Chen et al. (2019). Again, including Chen and the groups study in the authors RLRA research is inappropriate.
Methods-
The author stated Cochrane Library as an essential website used to select sources for this study. Cochrane is mostly the database for systematic reviews or meta-analysis reports which are not appropriate to include in the RLRA research. However, those could be referred to support the background or discussion in the RLRA paper.
There is no clear information about inclusion and exclusion criteria for screening and/or selecting the studies for the current research.
The selection of only three studies for research is not very impressive. Of these three, one is a systematic review and another one is a paper about secondary analyses of two randomized controlled trials:
Chen et al., 2019. https://doi.org/10.1097/mlr.0000000000001064
Beddhu et al., 2018. https://doi.org/10.1016/s2213-8587(18)30099-8
After excluding these two, only one study remains in the evidence table NOT accepted.
Discussion-
Three different fonts are used to write the Discussion section.
Times New Roman
Cardo
Gungsuh
Describing the definition or process in an integrative literature review approach as stated at the beginning of the limitation is probably unnecessary.
Conclusion-
Instead of discussing the limitations of integrative literature review again, the overall conclusion from the authors research could be stated briefly.
It is unclear how Medication titration can cause benefits such as improved patient education and compliance.
Reviewer #2:
This paper needs to be redone. Abstract needs improvement. Basic and slightly repetitive. Author has not utilized allowed word count. Introduction and method section somewhat appropriate. Introduction can be better with some more references. Author should expand his search for selection of papers, instead of quoting a database for meta-analysis and reviews should use proper sources.
Result and discussion needs to be redone as they only depend on 1 proper study rest are either meta-analysis or reviews / analysis. (Reviews and Meta-analysis are secondary sources. RLRA is a review of primary sources.)
Author have vaguely used the terms antihypertensive, blood pressure-lowering medications, Frail, and elderly throughout the paper.
