20 / ADOPTION OF PATIENT-CENTERED TOOLS BY CANCER CARE TEAMS: A CLOSER LOOK AT SURVIVORSHIP CARE PLANS AND PATIENT DECISION AIDS

2018 ◽  
Author(s):  
Robin Urquhart
Keyword(s):  
Cancer Care ◽  
Decision Aids ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Patient Centered ◽  
Patient Decision Aids ◽  
Care Plans ◽  
Patient Decision

scholarly journals Adoption of Patient-Centered Tools by Cancer Care Teams: A Closer Look at Survivorship Care Plans and Patient Decision Aids

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 62s-62s
Author(s):  
A. Glenn ◽  
R. Urquhart
Keyword(s):  
Decision Making ◽  
Cancer Care ◽  
Research Evidence ◽  
Decision Aids ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Patient Centered ◽  
Patient Decision Aids ◽  
Care Plans ◽  
Patient Decision

Background: Moving interventions (i.e., new knowledge, tools, and technologies) into clinical practice are often lengthy and challenging processes, even when they are strongly supported by research evidence. Conversely, organizations and providers sometimes adopt interventions in the absence of strong research evidence. Understanding decision-making around the adoption of new interventions is paramount to developing more effective strategies to facilitate the use of evidence-based interventions in practice. Aim: To illuminate the decision-making processes involved in the adoption of patient-centered interventions by cancer care teams, including how research evidence is considered, and identify additional factors influencing these decisions. We focused on two interventions (survivorship care plans [SCPs] and patient decision aids [PtDAs]) due to their differing levels of research evidence and real-world adoption: SCPs = low evidence; high adoption; PtDAs = high evidence; low adoption. Methods: Guided by the principles of grounded theory, we conducted semistructured interviews with clinicians, managers, and administrators of cancer care programs across Canada (n=21). Data were collected and analyzed concurrently, using a constant comparative approach. Data collection ended upon reaching theoretical saturation. Results: Participants emphasized that high-quality research evidence is often unnecessary when making adoption decisions around interventions that are intuitively “good ideas.” Six key factors contributed to adoption/nonadoption decisions around SCPs and PtDAs: 1) alignment (or misalignment) of research evidence with clinical experiences, patient experiences/preferences, and local data; 2) perceived benefit to clinicians themselves; 3) endorsement by respected organizations; 4) existence of local champions; 5) ability to adapt the intervention to local contexts; and 6) ability to routinize the intervention across a large patient population. Conclusion: Many factors influence decisions to adopt patient-centered interventions, including clinicians' experiences and perceived benefits, the existence of organizational and extraorganizational advocates, and ease/reach of implementation.

Digitizing the cancer care continuum: Electronic, shareable survivorship care plans.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. 10101-10101
Author(s):  
Jeremy Warner ◽  
Suzanne E Maddux ◽  
Jeff Brown ◽  
John Turner Hamm ◽  
John C. Krauss ◽  
...  
Keyword(s):  
Cancer Care ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Continuum ◽  
Care Plans ◽  
Cancer Care Continuum

scholarly journals It's Not the Model that Matters—Still Lost in Transition

2013 ◽  
Vol 9 (3) ◽  
pp. 128-129 ◽  
Author(s):  
Michael L. Kappel
Keyword(s):  
Clinical Practice ◽  
Care Coordination ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Patient Centered ◽  
Integration Of Care ◽  
Care Plans

To improve integration of care across the spectrum, oncologists can engage survivors through patient-centered clinical practice and use survivorship care plans to support care coordination.

Using Survivorship Care Plans to Enhance Communication and Cancer Care Coordination: Results of a Pilot Study

2016 ◽  
Vol 43 (5) ◽  
pp. 636-645 ◽  
Author(s):  
Deborah Mayer ◽  
Allison Deal ◽  
Jeffrey Crane ◽  
Ronald Chen ◽  
Gary Asher ◽  
...  
Keyword(s):  
Pilot Study ◽  
Care Coordination ◽  
Cancer Care ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans

scholarly journals User involvement in the development of patient decision aids: A systematic review

2019 ◽  
Author(s):  
Gratianne Vaisson ◽  
Thierry Provencher ◽  
Michele Dugas ◽  
Marie-Eve Trottier ◽  
Selma Chipenda Dansokho ◽  
...  
Keyword(s):  
Decision Aid ◽  
Decision Aids ◽  
User Centered Design ◽  
Patient Decision Aid ◽  
Patient Centered ◽  
Patient Decision Aids ◽  
Patient Decision ◽  
Design Projects ◽  
Development Step ◽  
User Centered

Background: Multiple guidelines recommend involving patients and stakeholders in developing patient decision aids; however, best practices have yet to be identified. User-centered design is a well-established approach for engaging users in developing tools. We aimed to compile reports of patient decision aid development, using a user-centered design framework to synthesize evidence of existing practices and identify potential opportunities for improvement.Methods: We conducted searches in MEDLINE, EMBASE, PubMed, Web of Science, the Cochrane Library, the ACM library, IEEE Xplore and Google Scholar. We included articles describing (1) at least one development step of a patient decision aid, (2) at least one development step of user- or human-centered design of another patient-centered tool, and/or (3) evaluation of included decision aids and other patient-centered tools. Two analysts independently screened for inclusion, assessed study quality, and extracted data.Results: We included 623 articles describing 390 projects: 325 patient decision aid projects and 65 user-centered design projects. Fifty percent of patient decision aid projects reported involving users in at least one development step for understanding users, 35% in at least one development step for developing/refining the prototype and 84% in at least one development step for directly or indirectly observing prospective users’ interaction with the prototype. User-centered design projects reported 91%, 49% and 92%, respectively. Seventy-four percent of patient decision aid projects reported iterative development processes with median 3 development cycles (interquartile range 2-4); 92% of user-centered design projects reported iterativity, with median 3 development cycles (interquartile range 2-3). Sixty-six percent of patient decision aid projects and 89% of user-centered design projects reported preliminary evaluations such as usability testing or feasibility testing.Conclusions: We identified 3 key opportunities for improving the user-centeredness of patient decision aid development: involving users earlier to understand their needs, goals, strengths, limitations, context and intuitive processes; asking about and observing users’ interactions with developing versions of the decision aid; and reporting changes between iterative cycles. Additionally, developers of patient decision aids and other patient-centered tools may wish to more often involve patients, clinicians and other users in co-design of prototypes and in formal advisory or partnership roles.

scholarly journals Shared Decision Making and Choice for Bariatric Surgery

2019 ◽  
Vol 16 (24) ◽  
pp. 4966
Author(s):  
Yi-Chih Lee ◽  
Wei-Li Wu
Keyword(s):  
Bariatric Surgery ◽  
Decision Making ◽  
Shared Decision Making ◽  
Decision Aids ◽  
Shared Decision ◽  
Patient Centered ◽  
Self Assessment ◽  
Patient Decision Aids ◽  
Decision Regret ◽  
Patient Decision

The number of people undergoing bariatric surgery is increasing every year, and their expectations for surgery often differ greatly. The purpose of this study was to develop a patient-centered decision-making aid to help people define their weight loss goals and assist them in discussing their surgical treatment with surgeons. Before the operation, the patients were asked to read the shared decision-making text and conduct a self-assessment. After the operation, we evaluated the program using survey questionnaires. A total of 103 patients were formally included in this study. The results show that patients were very satisfied with the use of patient decision aids (PDAs), with a score of 4.3 points (±0.6), and the postoperative decision-making satisfaction was also very high, at 4.4 points (±0.5), while the postoperative regret score was low, at 1.6 points (±0.6). Their satisfaction with surgical decision making and decision regret were statistically significantly negatively correlated (r = −0.711, p < 0.001). The experience of using PDAs was statistically significantly negatively correlated with decision regret (r = −0.451, p < 0.001); the experience of PDA use was statistically positively correlated with decision satisfaction (r = 0.522, p < 0.001). Patient decision aids are a means of helping patients make informed choices before they seek to undergo bariatric surgery.

scholarly journals A Systematic Review and Meta-Analysis of Patient Decision Aids for Socially Disadvantaged Populations: Update from the International Patient Decision Aid Standards (IDPAS)

2021 ◽  
pp. 0272989X2110203
Author(s):  
Renata W. Yen ◽  
Jenna Smith ◽  
Jaclyn Engel ◽  
Danielle Marie Muscat ◽  
Sian K. Smith ◽  
...  
Keyword(s):  
Relative Risk ◽  
Health Inequalities ◽  
Data Extraction ◽  
Decision Aids ◽  
Mean Difference ◽  
Patient Decision Aids ◽  
Disadvantaged Populations ◽  
Socially Disadvantaged ◽  
Patient Decision ◽  
Intervention Trials

Background The effectiveness of patient decision aids (PtDAs) and other shared decision-making (SDM) interventions for socially disadvantaged populations has not been well studied. Purpose To assess whether PtDAs and other SDM interventions improve outcomes or decrease health inequalities among socially disadvantaged populations and determine the critical features of successful interventions. Data Sources MEDLINE, CINAHL, Cochrane, PsycINFO, and Web of Science from inception to October 2019. Cochrane systematic reviews on PtDAs. Study Selection Randomized controlled trials of PtDAs and SDM interventions that included socially disadvantaged populations. Data Extraction Independent double data extraction using a standardized form and the Template for Intervention Description and Replication checklist. Data Synthesis Twenty-five PtDA and 13 other SDM intervention trials met our inclusion criteria. Compared with usual care, PtDAs improved knowledge (mean difference = 13.91, 95% confidence interval [CI] 9.01, 18.82 [I2 = 96%]) and patient-clinician communication (relative risk = 1.62, 95% CI 1.42, 1.84 [I2 = 0%]). PtDAs reduced decisional conflict (mean difference = −9.59; 95% CI −18.94, −0.24 [I2 = 84%]) and the proportion undecided (relative risk = 0.39; 95% CI 0.28, 0.53 [I2 = 75%]). PtDAs did not affect anxiety (standardized mean difference = 0.02, 95% CI −0.22, 0.26 [I2 = 70%]). Only 1 trial looked at clinical outcomes (hemoglobin A1C). Five of the 12 PtDA studies that compared outcomes by disadvantaged standing found that outcomes improved more for socially disadvantaged participants. No evidence indicated which intervention characteristics were most effective. Results were similar for SDM intervention trials. Limitations Sixteen PtDA studies had an overall unclear risk of bias. Heterogeneity was high for most outcomes. Most studies only had short-term follow-up. Conclusions PtDAs led to better outcomes among socially disadvantaged populations but did not reduce health inequalities. We could not determine which intervention features were most effective. [Box: see text]

scholarly journals Systematic Development of Patient Decision Aids: An Update from the IPDAS Collaboration

2021 ◽  
pp. 0272989X2110141
Author(s):  
Holly O. Witteman ◽  
Kristin G. Maki ◽  
Gratianne Vaisson ◽  
Jeanette Finderup ◽  
Krystina B. Lewis ◽  
...  
Keyword(s):  
Decision Aid ◽  
Decision Aids ◽  
Rapid Development ◽  
User Involvement ◽  
User Centered Design ◽  
Patient Decision Aid ◽  
Patient Decision Aids ◽  
Patient Decision ◽  
Development Processes ◽  
Systematic Development

Background The 2013 update of the evidence informing the quality dimensions behind the International Patient Decision Aid Standards (IPDAS) offered a model process for developers of patient decision aids. Objective To summarize and update the evidence used to inform the systematic development of patient decision aids from the IPDAS Collaboration. Methods To provide further details about design and development methods, we summarized findings from a subgroup ( n = 283 patient decision aid projects) in a recent systematic review of user involvement by Vaisson et al. Using a new measure of user-centeredness (UCD-11), we then rated the degree of user-centeredness reported in 66 articles describing patient decision aid development and citing the 2013 IPDAS update on systematic development. We contacted the 66 articles’ authors to request their self-reports of UCD-11 items. Results The 283 development processes varied substantially from minimal iteration cycles to more complex processes, with multiple iterations, needs assessments, and extensive involvement of end users. We summarized minimal, medium, and maximal processes from the data. Authors of 54 of 66 articles (82%) provided self-reported UCD-11 ratings. Self-reported scores were significantly higher than reviewer ratings (reviewers: mean [SD] = 6.45 [3.10]; authors: mean [SD] = 9.62 [1.16], P < 0.001). Conclusions Decision aid developers have embraced principles of user-centered design in the development of patient decision aids while also underreporting aspects of user involvement in publications about their tools. Templates may reduce the need for extensive development, and new approaches for rapid development of aids have been proposed when a more detailed approach is not feasible. We provide empirically derived benchmark processes and a reporting checklist to support developers in more fully describing their development processes. [Box: see text]

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