OBJECTIVE: In this proof-of-concept study, we sought to evaluate whether a value clarification tool enabling patients to view a set of rheumatoid arthritis (RA) treatment preference phenotypes could be used to support shared decision-making at the point-of-care. METHODS: We conducted a pretest/post test study. English-speaking patients with RA presenting to their scheduled outpatient visits were asked to participate. Visits for patients with active RA were transcribed. Shared decision-making components were measured using a quantitative coding scheme based on an established model of shared decision-making. RESULTS: Forty-six visits were included in the pretest and 40 in the post test phases. Providers offered more disease-modifying antirheumatic drugs (DMARDs) (2 or more) in the post test visits (60%) compared to the pretest visits (47.8%). Overall, more patients vocalized their values and/or preferences in the post test visits compared to the pretest visits for treatment escalation decisions including a choice of 1 new DMARD (90.9% versus 56.3%), 2 or more new DMARDs (95.8% versus 86.4%), as well as prednisone (87.5% versus 66.7%). Providers were also more likely to base their recommendations on patients' values and/or preferences in the post test (100% of 6 visits) than the pretest (64.3% of 14 visits) phases during visits in which a recommendation was made. The mean ± SD length of the visit was 29.9 ± 11.6 minutes and 25.1 ± 10.7 minutes in the pretest and post test phases, respectively. CONCLUSION: This study provides an early indication that a value clarification tool allowing patients to consider a set of preference phenotypes can support shared decision-making at the point-of-care without extending visit time.
OBJECTIVE: In this proof-of-concept study, we sought to evaluate whether a value clarification tool enabling patients to view a set of rheumatoid arthritis (RA) treatment preference phenotypes could be used to support shared decision-making at the point-of-care. METHODS: We conducted a pretest/post test study. English-speaking patients with RA presenting to their scheduled outpatient visits were asked to participate. Visits for patients with active RA were transcribed. Shared decision-making components were measured using a quantitative coding scheme based on an established model of shared decision-making. RESULTS: Forty-six visits were included in the pretest and 40 in the post test phases. Providers offered more disease-modifying antirheumatic drugs (DMARDs) (2 or more) in the post test visits (60%) compared to the pretest visits (47.8%). Overall, more patients vocalized their values and/or preferences in the post test visits compared to the pretest visits for treatment escalation decisions including a choice of 1 new DMARD (90.9% versus 56.3%), 2 or more new DMARDs (95.8% versus 86.4%), as well as prednisone (87.5% versus 66.7%). Providers were also more likely to base their recommendations on patients' values and/or preferences in the post test (100% of 6 visits) than the pretest (64.3% of 14 visits) phases during visits in which a recommendation was made. The mean ± SD length of the visit was 29.9 ± 11.6 minutes and 25.1 ± 10.7 minutes in the pretest and post test phases, respectively. CONCLUSION: This study provides an early indication that a value clarification tool allowing patients to consider a set of preference phenotypes can support shared decision-making at the point-of-care without extending visit time.
Authors: Jennifer L Barton; Laura Trupin; Dean Schillinger; Gina Evans-Young; John Imboden; Victor M Montori; Edward Yelin Journal: Arthritis Care Res (Hoboken) Date: 2016-07 Impact factor: 4.794
Authors: Thomas Agoritsas; Anja Fog Heen; Linn Brandt; Pablo Alonso-Coello; Annette Kristiansen; Elie A Akl; Ignacio Neumann; Kari Ao Tikkinen; Trudy van der Weijden; Glyn Elwyn; Victor M Montori; Gordon H Guyatt; Per Olav Vandvik Journal: BMJ Date: 2015-02-10
Authors: Ingrid Nota; Constance H C Drossaert; Erik Taal; Harald E Vonkeman; Cees J Haagsma; Mart A F J van de Laar Journal: Arthritis Res Ther Date: 2016-10-28 Impact factor: 5.156
Authors: Glyn Elwyn; Annette M O'Connor; Carol Bennett; Robert G Newcombe; Mary Politi; Marie-Anne Durand; Elizabeth Drake; Natalie Joseph-Williams; Sara Khangura; Anton Saarimaki; Stephanie Sivell; Mareike Stiel; Steven J Bernstein; Nananda Col; Angela Coulter; Karen Eden; Martin Härter; Margaret Holmes Rovner; Nora Moumjid; Dawn Stacey; Richard Thomson; Tim Whelan; Trudy van der Weijden; Adrian Edwards Journal: PLoS One Date: 2009-03-04 Impact factor: 3.240