Transcript of ©PPRNet 2014 Impact of Patient Engagement on Treatment Decisions and Patient-Centered Outcomes in...
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- PPRNet 2014 Impact of Patient Engagement on Treatment Decisions
and Patient-Centered Outcomes in the Implementation of New
Guidelines for the Treatment of Blood Cholesterol
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- PPRNet 2014 GOALS Update members on recently submitted PCORI
application Highlight PPRNets planned approach to patient-centered
and patient engaged research in implementation of cholesterol
guidelines
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- PPRNet 2014 PATIENT-CENTERED OUTCOMES RESEARCH INSTITUTE
Independent, non-profit organization authorized under Affordable
Care Act Fund research that will provide patients, their caregivers
and clinicians with the evidence-based information needed to make
better-informed health care decisions Funded >$200 million in
research in 2013
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- PPRNet 2014
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- PCORI PRIORITIES Research will help answer these questions:
Given my personal characteristics, conditions and preferences, what
should I expect will happen to me? What are my options and what are
the potential benefits and harms of those options?
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- PPRNet 2014 PCORI PRIORITIES Research will help answer these
questions: What can I do to improve the outcomes that are most
important to me? How can clinicians and the care delivery systems
they work in help me make the best decisions about my health and
healthcare?
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- PPRNet 2014 PPRNET RESEARCH AND THE PCORI VISION New approach
to projects Patient and stakeholder engagement Input on project
design Identifying outcomes of interest Monitoring project progress
Dissemination of results
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- PPRNet 2014 WHAT WE KNOW Cardiovascular disease remains a
relevant problem Cholesterol is a key modifiable risk factor for
atherosclerotic cardiovascular disease (ASCVD)
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- PPRNet 2014 WHAT WE KNOW American College of
Cardiology/American Heart Association published revised guideline
on the Treatment of Blood Cholesterol (TBC) in late 2013 Major
shift in focus Emphasis on patient- centered approach Clinical
controversies
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- PPRNet 2014 WHAT WE KNOW Statin Benefit Groups (SBGs) Statin
Dose Recommendation 1 Patients with clinical ASCVD 21-75 years of
ageHigh-intensity Patients with clinical ASCVD over 75 years of
ageModerate-intensity 2 Patients with primary elevations of LDL-C
(greater than or equal to 190 mg/dL) High-intensity 3 Patients with
diabetes, age 40-75 years with LDL-C 70-189 mg/dL, estimated
10-year ASCVD risk less than 7.5% Moderate-intensity Patients with
diabetes, age 40-75 years with LDL-C 70-189 mg/dL, estimated
10-year ASCVD risk greater than or equal to 7.5% High-intensity 4
Patients with estimated 10-year ASCVD risk of at least 7.5%
Patient-centered discussion prior to initiating moderate-to- high
intensity*
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- PPRNet 2014 ASCVD Risk Reduction Practice-Level Report
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- PPRNet 2014 ASCVD Risk Reduction PLR
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- PPRNet 2014 WHAT WE DONT KNOW How to implement a
patient-centered approach to discussion of treatment options in
real world practice What types of practice-based interventions
promote patient-centered decision making
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- PPRNet 2014 AIMS OF THE PROPOSED PROJECT 1.Compare the impact
of a patient-engaged, practice-based intervention to promote
patient-centered care (PE-TRIP) to Usual PPRNet Implementation on
concordance with the TBC guideline and patient- reported outcomes
among 30 PPRNet practices
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- PPRNet 2014 AIMS OF THE PROPOSED PROJECT 2. Synthesize lessons
learned during TBC guideline implementation to identify a set of
strategies that promote concordance with the TBC guideline and
patient-centered discussions of treatment options in primary care
practice
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- PPRNet 2014 PROJECT ACTIVITIES All practices: typical guideline
implementation Introductory webinar on TBC guideline Quarterly
reports Patient-engaged intervention practices +Site visits +Best
practice meeting + webinars
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- PPRNet 2014 PROJECT ACTIVITIES Patient surveys on patient-
reported outcomes Focus groups among high performing practices
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- PPRNet 2014 ENGAGING CLINICIAN STAKEHOLDERS
PlanningDissemination Expressed interest Initial survey responses
(39 in 10 days!) helped define research question Further input
during webinars and calls Invited patients to participate in survey
Review study findings and provide input during final webinar
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- PPRNet 2014 ENGAGING PATIENTS PlanningDissemination Survey
responses from 57 patients in 10 states on hypothetical scenarios
Two patients volunteered to serve as Research Team Patient Partners
Patient Advisors review study findings with practice team at final
webinar Advisors and Partners invited to present at professional
meetings
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- PPRNet 2014 PATIENT INPUT What matters most to you? I trust the
advice of my doctor What it is in my situation that leads the
doctor to make such a recommendation What should your doctors role
be in helping you make these decisions? Provide information I can
use to self-educate I generally ask what the doctor would do in my
situation
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- PPRNet 2014 PATIENT INPUT I lost my father to a massive
coronary event at the age of 63 and my sister had a heart attack at
50. I had high cholesterol and with diet and medicine that is now
under control. I think the key lies in within our power to prevent.
Being a patient with diabetes that also receives treatment for high
cholesterol this is something very near and dear to my heart.
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- PPRNet 2014 WHAT NEXT? September 2014Funding decisions October
2014Gather additional stakeholder input November 2014 Resubmission
prn December 2014Start project if funded!
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- PPRNet 2014 WHAT IS REQUIRED OF PRACTICES? Open to all members!
Routine PPRNet data extracts Introductory site visit Direct
patients to online survey If randomized to intervention, invite
patients to participate, send representatives to network meeting
and host 4 site visits If invited, send representatives to best
practice focus group
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- PPRNet 2014 INCENTIVES TO PARTICIPATE Opportunity to inform
real-world patient- centered implementation of guidelines
Facilitated PPRNet quality and safety improvement assistance
Concrete example for PCMH Patient Advisory Council objective
Financial incentives for practices ($250/provider/year) and patient
advisors ($25/activity)
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- PPRNet 2014 Input on resubmission Controversial interest in
this? More input from patients? How?
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- PPRNet 2014 WHAT DOES THIS MEAN FOR YOU? We may need your help!
Agree to participate (if funded) Reach out to patients Update
letters of support
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- PPRNet 2014 SUMMARY We are committed to developing meaningful
PCORI applications and look forward to your input! (See next
presentation)