scholarly journals Absolute Cardiovascular Disease Risk and Shared Decision Making in Primary Care: A Randomized Controlled Trial

2008 ◽  
Vol 6 (3) ◽  
pp. 218-227 ◽  
Author(s):  
T. Krones ◽  
H. Keller ◽  
A. Sonnichsen ◽  
E.-M. Sadowski ◽  
E. Baum ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Primary Care ◽  
Decision Making ◽  
Randomized Controlled Trial ◽  
Shared Decision Making ◽  
Disease Risk ◽  
Controlled Trial ◽  
Cardiovascular Disease Risk ◽  
Shared Decision ◽  
Randomized Controlled

Integrating shared decision making into primary care: Lessons learned from a multi-centre feasibility randomized controlled trial (Preprint)

2019 ◽  
Author(s):  
Catherine Yu ◽  
Farid Medleg ◽  
Dorothy Choi ◽  
Catherine M Spagnuolo ◽  
Lakmini Pinnaduwage ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Randomized Controlled Trial ◽  
Shared Decision Making ◽  
Controlled Trial ◽  
Clinical Care ◽  
Shared Decision ◽  
Related Factors ◽  
Primary Care Clinics ◽  
Randomized Controlled

BACKGROUND We previously developed MyDiabetesPlan, an evidence-based, online, interactive patient decision-aid to facilitate patient-centred, diabetes-specific goal-setting and action-planning, using shared decision making (SDM) with interprofessional (IP) healthcare teams. OBJECTIVE The aim of this study is to assess the feasibility of (1) integrating MyDiabetesPlan into routine workflows in IP primary care clinics, and (2) conducting a cluster randomized controlled trial (RCT). METHODS We conducted a pilot cluster-RCT in 10 IP primary care clinics with patients living with diabetes and 2+ other comorbidities; half of the clinics were assigned to the MyDiabetesPlan intervention and the remainder were assigned to usual care. For Objective 1, we used RCT conduct logs and financial account summaries to assess recruitment, retention metrics, and resource use. For Objective 2, we used RCT conduct logs and website usage logs to assess intervention fidelity and resource usage. We used audiotapes of clinical encounters in the intervention groups to identify barriers and facilitators to integration of MyDiabetesPlan into clinical care across the IP team. RESULTS Objective 1: 1597 potentially eligible patients were identified through electronic medical record-based searches, of which 1113 patients met eligibility criteria upon detailed chart review. A total of 425 patients were randomly selected; of these, 213 were able to participate and were allocated (intervention: n=102; control: n=111), for a recruitment rate of 50.1%. 151 patients completed the study, for a retention rate of 70.9%. A total of 5745 personnel-hours and $6104 CAD were attributed to recruitment and retention activities. Objective 2: A total of 179 appointments occurred (out of a total of 204 expected appointments - 2 per participant over the 12-month study period; 87.7%). Forty (36%), 25 (23%) and 32 (29%) patients completed MyDiabetesPlan at least twice, once, and zero times respectively. Mean time for completion of MyDiabetesPlan by the clinician and the patient during initial appointments was 37 minutes. From the clinical encounter transcripts, we identified diverse strategies used by health care providers and patients to integrate MyDiabetesPlan into the appointment, characterized by rapport-building and individualization. Barriers to use included MyDiabetesPlan-related factors (e.g. limited selection of potential diabetes management strategies), clinician-related factors (e.g. discomfort with asking certain questions), and patient-related factors (e.g. computer literacy). CONCLUSIONS We evaluated the feasibility of an IPSDM approach using decision aids to help establish treatment priorities in patients with diabetes and found that it would be feasible. A total of 151 (70.9%) patients were retained for 12 months, which required 38 personnel hours and $40.42 CAD per participant who completed the study. Lower than expected numbers of diabetes-specific appointments were observed, and only 39% of patients completed MyDiabetesPlan twice. Addressing facilitators and barriers identified in this study will improve feasibility and promote more complete and seamless integration into clinical care. CLINICALTRIAL Clinicaltrials.gov Identifier: NCT02379078 Date of Registration: February 11, 2015

scholarly journals Integrating shared decision-making into primary care: lessons learned from a multi-centre feasibility randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Catherine H. Yu ◽  
Farid Medleg ◽  
Dorothy Choi ◽  
Catherine M. Spagnuolo ◽  
Lakmini Pinnaduwage ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Randomized Controlled Trial ◽  
Shared Decision Making ◽  
Decision Aid ◽  
Controlled Trial ◽  
Clinical Care ◽  
Shared Decision ◽  
Primary Care Clinics ◽  
Randomized Controlled

Abstract Background MyDiabetesPlan is a web-based, interactive patient decision aid that facilitates patient-centred, diabetes-specific, goal-setting and shared decision-making (SDM) with interprofessional health care teams. Objective Assess the feasibility of (1) conducting a cluster randomized controlled trial (RCT) and (2) integrating MyDiabetesPlan into interprofessional primary care clinics. Methods We conducted a cluster RCT in 10 interprofessional primary care clinics with patients living with diabetes and at least two other comorbidities; half of the clinics were assigned to MyDiabetesPlan and half were assigned to usual care. To assess recruitment, retention, and resource use, we used RCT conduct logs and financial account summaries. To assess intervention fidelity, we used RCT conduct logs and website usage logs. To identify barriers and facilitators to integration of MyDiabetesPlan into clinical care across the IP team, we used audiotapes of clinical encounters in the intervention groups. Results One thousand five hundred and ninety-seven potentially eligible patients were identified through searches of electronic medical records, of which 1113 patients met the eligibility criteria upon detailed chart review. A total of 425 patients were randomly selected; of these, 213 were able to participate and were allocated (intervention: n = 102; control: n = 111), for a recruitment rate of 50.1%. One hundred and fifty-one patients completed the study, for a retention rate of 70.9%. A total of 5745 personnel-hours and $6104 CAD were attributed to recruitment and retention activities. A total of 179 appointments occurred (out of 204 expected appointments—two per participant over the 12-month study period; 87.7%). Forty (36%), 25 (23%), and 32 (29%) patients completed MyDiabetesPlan at least twice, once, and zero times, respectively. Mean time for completion of MyDiabetesPlan by the clinician and the patient during initial appointments was 37 min. From the clinical encounter transcripts, we identified diverse strategies used by clinicians and patients to integrate MyDiabetesPlan into the appointment, characterized by rapport building and individualization. Barriers to use included clinician-related, patient-related, and technical factors. Conclusion An interprofessional approach to SDM using a decision aid was feasible. Lower than expected numbers of diabetes-specific appointments and use of MyDiabetesPlan were observed. Addressing facilitators and barriers identified in this study will promote more seamless integration into clinical care. Trial registration Clinicaltrials.gov Identifier: NCT02379078. Date of Registration: February 11, 2015. Protocol version: Version 1; February 26, 2015.

scholarly journals Randomized Controlled Trial to Assess Reduction of Cardiovascular Disease Risk in Patients With Bipolar Disorder

2013 ◽  
Vol 74 (07) ◽  
pp. e655-e662 ◽  
Author(s):  
Amy M. Kilbourne ◽  
David E. Goodrich ◽  
Zongshan Lai ◽  
Edward P. Post ◽  
Karen Schumacher ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Bipolar Disorder ◽  
Randomized Controlled Trial ◽  
Disease Risk ◽  
Controlled Trial ◽  
Cardiovascular Disease Risk ◽  
Randomized Controlled

scholarly journals A Randomized Controlled Trial of a Motivational Interviewing Intervention to Improve Whole-Person Lifestyle

2020 ◽  
Vol 11 ◽  
pp. 215013272092271 ◽  
Author(s):  
Amanda T. Sawyer ◽  
Jo Wheeler ◽  
Pamela Jennelle ◽  
Julie Pepe ◽  
Patricia Stearnes Robinson
Keyword(s):  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Randomized Controlled Trial ◽  
Motivational Interviewing ◽  
Disease Risk ◽  
Controlled Trial ◽  
Cardiovascular Disease Risk ◽  
Risk Profile ◽  
Randomized Controlled ◽  
Whole Person

The purpose of this randomized controlled trial was to examine the effects of a motivational interviewing intervention to improve whole-person lifestyle and reduce cardiovascular disease risk profile. A sample of 111 adults with type 2 diabetes and/or hypertension was recruited from a primary care physician practice. The intervention was facilitated by a program specialist trained in motivational interviewing. Outcomes included body mass index, cholesterol, hemoglobin A1c, blood pressure, waist circumference, wellness scores, and substance use. Differences in the changes in body mass index and waist circumference existed between the intervention and control groups after 6 months. In the intervention group, the proportion of high wellness scores increased after the program. A whole-person lifestyle intervention with motivational interviewing for patients with metabolic syndrome can improve one’s health in terms of components in the cardiovascular disease risk profile, as well as overall wellness. Efforts to improve the health of these patients may incorporate motivational interviewing to guide goal setting and address mental and spiritual health in addition to physical health.

scholarly journals Investigating a training supporting shared decision making (IT'S SDM 2011): study protocol for a randomized controlled trial

Trials ◽  
2011 ◽  
Vol 12 (1) ◽  
Author(s):  
Friedemann Geiger ◽  
Katrin Liethmann ◽  
Frauke Hoffmann ◽  
Jutta Paschedag ◽  
Jürgen Kasper
Keyword(s):  
Decision Making ◽  
Randomized Controlled Trial ◽  
Shared Decision Making ◽  
Study Protocol ◽  
Controlled Trial ◽  
Shared Decision ◽  
Randomized Controlled
Sign in / Sign up

Export Citation Format

Share Document