Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and...
-
Upload
julie-hodges -
Category
Documents
-
view
214 -
download
0
Transcript of Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and...
![Page 1: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/1.jpg)
Decision AidsEnhancing the Patient Experience
Annie LeBlanc PhD
Wiser Choices Program Knowledge and Evaluation Research Unit
![Page 2: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/2.jpg)
Disclosures
Relevant Financial RelationshipsNone
Off Label UsageNone
![Page 3: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/3.jpg)
Our Decision Aids are focused on facilitating a conversation between
health professionals and patientsand thus
designed as tools intended for use during the clinical encounter
![Page 4: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/4.jpg)
![Page 5: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/5.jpg)
Evidence synthesisObservations
clinical encounter
DesignersStudy team
Patients advisory groupsClinicians
Stakeholders
Initial prototype
Field testing Modified prototype
Final Decision Aid
![Page 6: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/6.jpg)
![Page 7: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/7.jpg)
The Wiser Choices Program
Statin Choice Decision aid
![Page 8: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/8.jpg)
Acceptable to patients (OR 2.8)Improved knowledge (2.4/9)
Improved risk estimation (OR 22)Decreased decisional conflict (11/100)
Improved total trust (OR 2.6)Improved action (70% fewer Rx in low risk patients)
Short-term adherence (OR 3.4)
Weymiller et al. Arch Intern Med 2007
![Page 9: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/9.jpg)
The Wiser Choices Program
Aspirin Choice Decision aid
![Page 10: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/10.jpg)
![Page 11: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/11.jpg)
The Wiser Choices Program
Osteoporosis Choice
![Page 12: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/12.jpg)
Just as acceptable as usual care>75% MDs found helpful (+ 1 min to consultation)
Improved knowledge (1.8/9)Improved risk estimation (~RR 2)
No change in decisional conflict or trustIncreased patient participation in choice (9%)
Same rate of Rx (~50%) in low and high risk patientsAdherence evaluation is pending
Montori VM et al. Submitted
![Page 13: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/13.jpg)
The Wiser Choices ProgramDiabetes Medication Choice Decision Aid
![Page 14: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/14.jpg)
Glucose control in t2 diabetes
No clear evidence for a goal HbA1cComparative effectiveness data of
safety9 types of agents (+ lifestyle
modification)Many attributes per agent
![Page 15: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/15.jpg)
Mullan RJ et al. Archives of Internal Medicine 2009
more helpful (AMD 0.38; 95%CI, 0.04-0.72)
improved knowledge (AMD 1.10; 95%CI, 0.11-2.09); and had more involvement
in making decisions (AMD 21.8; 95%CI, 13.0-30.5)
6-mo perfect medication use (100% of days covered)
better adherence (AMD, 9% more days covered; 95%CI, 4%-14%)
persistence (AMD, 12 more days covered; 95% CI, 3-21 days)
no significant impact on HbA1c levels (AMD, 0.01; 95%CI, −0.49 to 0.50)
![Page 17: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/17.jpg)
Interactive Diabetes Cards
![Page 18: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/18.jpg)
The Wiser Choices ProgramOther Wiser Choices
Decision aids
![Page 19: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/19.jpg)
Chronic care
Depression Choice (AHRQ)Genomic Cardiovasular Choice
HypertensionRosiglitazone (Avandia)
![Page 20: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/20.jpg)
Acute care
Chest Pain Choice AMI Choice
Periop Smoking
![Page 21: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/21.jpg)
13 Wiser Choices Decision aidsChronic & acute care
Primary care & subspecialty & ERIn/out patient settings
Rural & urban communities>50 sites
> 200 clinicians> 600 patients
![Page 22: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/22.jpg)
Shared Decision Making
National Resource Center
Wiser Choices Program Knowledge and Evaluation Research Unit
![Page 23: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/23.jpg)
Contributions Patient Protection and Affordable
Care Act
Develop & evaluate patient decision aidsDefine international standards
Educate and train care providersAdopt and use decision aids at point of
careContribute to statewide implementation
efforts
![Page 24: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/24.jpg)
Internal Partners
AskMayoExpert
Program inProf. & Ethics
MayoClinic.com
PatientEducation
CenterWiser
Choices Program
Center for Innovation
Dept. ofDevelopment
Center for SocialMedia
Health PolicyCenter
OneVoice
SDMNRCenter
![Page 25: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/25.jpg)
Center Websitehttp://shareddecisions.mayoclinic.org
BlogAnnouncements (events)
ResourcesResearch
News articles
![Page 26: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/26.jpg)
Creating a conversation
Evidence synthesisTranslation of evidence into action
Patient important researchDesign of carearound the needs of the patient
Improve value of healthcare to the patientMinimally disruptive
medicineFIT
Shared decision making
![Page 27: Decision Aids Enhancing the Patient Experience Annie LeBlanc PhD Wiser Choices Program Knowledge and Evaluation Research Unit.](https://reader035.fdocuments.net/reader035/viewer/2022070410/56649ed25503460f94be15b5/html5/thumbnails/27.jpg)
http://kerunit.e-bm.orghttp://kercards.e-bm.info
http://shareddecisions.mayoclinic.org