Colleen A McHorney1, Donald Earl Bricker. 1. Department of Medicine, Indiana University School of Medicine, Regenstrief Institute for Health Care, Indiana University Center for Aging Research, and Roudebush Veterans Administration Medical Center, Indianapolis 46202, USA. cmchorney@regenstrief.org
Abstract
BACKGROUND: Interest has increased in using patient-based measures of health status in everyday clinical practice. Patient reports of functioning and well-being have been most commonly used in clinical-practice settings at the group-level for research rather than at the individual-patient level for clinical decision-making. OBJECTIVES: Little is known about patients' and physicians' preferences for practice-based functional health assessment. Qualitative methods were used to discover patient and physician attitudes about the use of functional health assessment tools in everyday clinical practice. RESEARCH DESIGN: Six focus groups were conducted with 39 asthma patients who had been invited to participate in practice-based functional health assessment (FHA). Thirty in-depth, semistructured interviews were conducted with physicians in a single health maintenance organization to discover their attitudes about practice-based FHA. SETTING: A large group-model health maintenance organization in Southeastern Wisconsin that consists of 200,000 members and 315 providers across 22 locations. Patients were selected from the Asthma Clinic and physicians were selected among all MD providers. RESULTS: Patients identified numerous practical implementation problems with practice-based FHA, including the site of data collection, feedback on their responses, and who would have access to the data. Patients also identified several barriers and benefits of practice-based FHA. Before they would commit financial and human capital resources and time, clinicians wanted information about the effectiveness and value of practice-based FHA. CONCLUSIONS: Several barriers to practice-based FHA were identified by patients and physicians. The evidence-based barrier identified by physicians needs to be overcome with additional intervention studies that push the envelope on several fronts including: (1) the type of tool; (2) the type of patient; (3) the type of setting; and (4) the recipients of the information. Interpretation guides and assessment linkage steps need to be developed and tested.
BACKGROUND: Interest has increased in using patient-based measures of health status in everyday clinical practice. Patient reports of functioning and well-being have been most commonly used in clinical-practice settings at the group-level for research rather than at the individual-patient level for clinical decision-making. OBJECTIVES: Little is known about patients' and physicians' preferences for practice-based functional health assessment. Qualitative methods were used to discover patient and physician attitudes about the use of functional health assessment tools in everyday clinical practice. RESEARCH DESIGN: Six focus groups were conducted with 39 asthmapatients who had been invited to participate in practice-based functional health assessment (FHA). Thirty in-depth, semistructured interviews were conducted with physicians in a single health maintenance organization to discover their attitudes about practice-based FHA. SETTING: A large group-model health maintenance organization in Southeastern Wisconsin that consists of 200,000 members and 315 providers across 22 locations. Patients were selected from the Asthma Clinic and physicians were selected among all MD providers. RESULTS:Patients identified numerous practical implementation problems with practice-based FHA, including the site of data collection, feedback on their responses, and who would have access to the data. Patients also identified several barriers and benefits of practice-based FHA. Before they would commit financial and human capital resources and time, clinicians wanted information about the effectiveness and value of practice-based FHA. CONCLUSIONS: Several barriers to practice-based FHA were identified by patients and physicians. The evidence-based barrier identified by physicians needs to be overcome with additional intervention studies that push the envelope on several fronts including: (1) the type of tool; (2) the type of patient; (3) the type of setting; and (4) the recipients of the information. Interpretation guides and assessment linkage steps need to be developed and tested.
Authors: Francesca M Nicosia; Malena J Spar; Michael A Steinman; Sei J Lee; Rebecca T Brown Journal: J Am Geriatr Soc Date: 2018-12-02 Impact factor: 5.562
Authors: Terry M Silvestrin; Anna W Steenrod; Karin S Coyne; David E Gross; Canan B Esinduy; Angela B Kodsi; Gayle J Slifka; Lucy Abraham; Anna L Araiza; Andrew G Bushmakin; Xuemei Luo Journal: Womens Health (Lond) Date: 2016-08-24
Authors: Alan M Jette; Christine M McDonough; Stephen M Haley; Pengsheng Ni; Sippy Olarsch; Nancy Latham; Ronald K Hambleton; David Felson; Young-Jo Kim; David Hunter Journal: J Clin Epidemiol Date: 2009-02-12 Impact factor: 6.437
Authors: Alan M Jette; Stephen M Haley; Pengsheng Ni; Sippy Olarsch; Richard Moed Journal: J Gerontol A Biol Sci Med Sci Date: 2008-11 Impact factor: 6.053
Authors: Jolie J Gutteling; Jan J V Busschbach; Robert A de Man; Anne-Sophie E Darlington Journal: Health Qual Life Outcomes Date: 2008-11-10 Impact factor: 3.186
Authors: Alan M Jette; Christine M McDonough; Pengsheng Ni; Stephen M Haley; Ronald K Hambleton; Sippy Olarsch; David J Hunter; Young-jo Kim; David T Felson Journal: Arthritis Res Ther Date: 2009-07-09 Impact factor: 5.156