scholarly journals Shared Decision-Making and Patient Satisfaction in Japanese Rheumatoid Arthritis Patients: A New “Preference Fit” Framework for Treatment Assessment

2019 ◽  
Vol 6 (2) ◽  
pp. 269-283 ◽  
Author(s):  
Jörg Mahlich ◽  
Ulrike Schaede ◽  
Rosarin Sruamsiri
2021 ◽  
pp. jrheum.201615
Author(s):  
Julie Kahler ◽  
Ginnifer Mastarone ◽  
Rachel Matsumoto ◽  
Danielle ZuZero ◽  
Jacob Dougherty ◽  
...  

Objective Treatment guidelines for rheumatoid arthritis (RA) include a patient-centered approach and shared decision making which includes a discussion of patient goals. We describe the iterative early development of a structured goal elicitation tool to facilitate goal communication for persons with RA and their clinicians. Methods Tool development occurred in three phases: 1) clinician feedback on the initial prototype during a communication training session; 2) semi-structured interviews with RA patients; and 3) community stakeholder feedback on elements of the goal elicitation tool in a group setting and electronically. Feedback was dynamically incorporated into the tool. Results Clinicians (n=15) and patients (n=10) provided feedback on the tool prototypes. Clinicians preferred a shorter tool de-emphasizing goals outside of their perceived treatment domain or available resources, highlighted the benefits of the tool to facilitate conversation but raised concern regarding current constraints of the clinic visit. Patients endorsed the utility of such a tool to support agenda setting and prepare for a visit. Clinicians, patients, and community stakeholders reported the tool was useful but identified barriers to implementation that the tool could itself resolve. Conclusion A goal elicitation tool for persons with RA and their clinicians was iteratively developed with feedback from multiple stakeholders. The tool can provide a structured way to communicate patient goals within a clinic visit and help overcome reported barriers, such as time constraints. Incorporating a structured communication tool to enhance goal communication and foster shared decision making may lead to improved outcomes and higher quality care in RA.


2020 ◽  
Vol 16 (2) ◽  
pp. e148-e154 ◽  
Author(s):  
Melissa K. Frey ◽  
Annie Ellis ◽  
Savannah Shyne ◽  
Ryan Kahn ◽  
Eloise Chapman-Davis ◽  
...  

PURPOSE: Women with ovarian cancer identify patient-physician communication as an essential element in determining treatment course and believe a discussion about goals and values should precede treatment decisions. We sought to develop a patient-centered priorities assessment tool for women with ovarian cancer that could streamline communication, enhance treatment discussions, and increase patient satisfaction. MATERIALS AND METHODS: We designed a priorities assessment tool using a validated ovarian cancer symptom index (National Comprehensive Cancer Center–Functional Assessment of Cancer Therapy Ovarian Symptom Index-18) combined with an index to assess daily quality-of-life priorities. The tool was distributed to women with ovarian cancer in small focus group settings and online, followed by a postactivity feedback form. RESULTS: In this pilot study, 36 women completed the priorities assessment tool and 35 completed the postactivity feedback form between September 2015 and May 2016. All participants reported that the tool was easy to understand and comprehensive in scope. Twenty-nine participants (82.9%) completed the tool in 10 minutes or less. Most participants (n = 31, 86.1%) were able to stratify their priorities and identify 5 top treatment-related priorities. Participants who indicated that their goals and priorities had changed since diagnosis (n = 25, 69.4%) reported that the tool helped to identify current goals and priorities (22 [88%] of 25 participants) and would help them feel more comfortable participating in shared decision making with their medical team (21 [84%] of 25 participants). CONCLUSION: A patient-centered priorities assessment tool was easy to complete and viewed as comprehensive and useful in a pilot cohort of women with ovarian cancer. Use of a priorities assessment tool has the potential to enhance communication, promote shared decision making, and improve patient satisfaction.


2014 ◽  
Vol 55 (6) ◽  
pp. 586-594 ◽  
Author(s):  
Arjan G.J. Bot ◽  
Jeroen K.J. Bossen ◽  
James H. Herndon ◽  
David E. Ruchelsman ◽  
David Ring ◽  
...  

2014 ◽  
Vol 41 (7) ◽  
pp. 1290-1297 ◽  
Author(s):  
Jennifer L. Barton ◽  
Laura Trupin ◽  
Chris Tonner ◽  
John Imboden ◽  
Patricia Katz ◽  
...  

Objective.Treat-to-target guidelines promote shared decision making (SDM) in rheumatoid arthritis (RA). Also, because of high cost and potential toxicity of therapies, SDM is central to patient safety. Our objective was to examine patterns of perceived communication around decision making in 2 cohorts of adults with RA.Methods.Data were derived from patients enrolled in 1 of 2 longitudinal, observational cohorts [University of California, San Francisco (UCSF) RA Cohort and RA Panel Cohort]. Subjects completed a telephone interview in their preferred language that included a measure of patient-provider communication, including items about decision making. Measures of trust in physician, education, and language proficiency were also asked. Logistic regression was performed to identify correlates of suboptimal SDM communication. Analyses were performed on each sample separately.Results.Of 509 patients across 2 cohorts, 30% and 32% reported suboptimal SDM communication. Low trust in physician was independently associated with suboptimal SDM communication in both cohorts. Older age and limited English proficiency were independently associated with suboptimal SDM in the UCSF RA Cohort, as was limited health literacy in the RA Panel Cohort.Conclusion.This study of over 500 adults with RA from 2 demographically distinct cohorts found that nearly one-third of subjects report suboptimal SDM communication with their clinicians, regardless of cohort. Lower trust in physician was independently associated with suboptimal SDM communication in both cohorts, as was limited English language proficiency and older age in the UCSF RA Cohort and limited health literacy in the RA Panel Cohort. These findings underscore the need to examine the influence of SDM on health outcomes in RA.


Author(s):  
Paul Szotek

As the digital age of healthcare is evolving, patients are more aware, educated, and concerned about their surgical options due to access to information. Patients undergoing hernia repair are being exposed to the growing litigious environment surrounding mesh via targeted social media marketing and inorganic search engine optimization (paid SEO). As a result, we elected to implement a shared decision making (SDM) process to give our patients an active role in choosing the reinforcement material used in their repair. A cohort of 142 patients underwent the SDM process with 133 (93.7%) choosing the reinforced biologic repair (ReBAR), 8 patients (5.6%) chose permanent synthetic mesh and 1 patient (0.7%) chose a completely resorbable bio-synthetic mesh. Clinical outcomes have been similar before and after implementation of the SDM process. SDM, as has been shown in other fields of medicine, improved patient satisfaction, patient compliance, and decreased anxiety about the treatment plan. We believe that the implementation of a SDM process in hernia repair surgery will continue to result in increased patient satisfaction, reduce legal exposure, and warrants further investigation as the paradigms in the doctor-patient relationship continue to be disrupted by technology and the internet.


2016 ◽  
Vol 24 (1) ◽  
pp. 44E-54E ◽  
Author(s):  
Kiyomi Tanno ◽  
Seiji Bito ◽  
Yoh Isobe ◽  
Yasuo Takagi

Background and Purpose: In Japanese health care, no current index measures patient satisfaction with decision making during the treatment process. Our research aimed to test a Japanese version of the Decision Regret Scale (DRS) for this purpose. Methods: We distributed a Japanese version of the DRS twice, 3 weeks apart, to 80 postoperative patients younger than the age of 85 years with inguinal hernias, cholelithiasis, cholecystitis, and gallbladder polyps. Results: The reliability (α = .85) and validity of the Japanese version of the DRS was demonstrated among postoperative patients. Conclusion: The Japanese version of the DRS will have significant implications for clinicians in improving their shared decision making with patients.


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