SHARE Approach Workshop Curriculum

Module 2—Using Patient-Centered Outcomes Research (PCOR) in Shared Decision Making: Slides

 Contents

Slide 1. Cover Slide
Slide 2. Module 2
Slide 3. Module 2—Learning objectives
Slide 4. What is patient-centered care?
Slide 5. Patient-centered care
Slide 6. Step 2—Help your patient explore and compare treatment options
Slide 7. Group discussion
Slide 8. What Is PCOR?
Slide 9. What is Patient Centered Outcomes Research?
Slide 10. Group discussion
Slide 11. Patient-centered outcomes
Slide 12. Patient-centered outcomes
Slide 13. Primary aim of PCOR
Slide 14. Informing health care decisions
Slide 15. PCOR—"Tools, not rules"
Slide 16: What PCOR is NOT
Slide 17. Major sponsors of PCOR
Slide 18: Getting the information out
Slide 19: Major sponsors supporting dissemination of PCOR
Slide 20: AHRQ's Effective Health Care Program
Slide 21: Effective Health Care Program activities
Slide 22: Effective Health Care Program Comparative Effectiveness reports
Slide 23: AHRQ's Evidence-Based Practice Centers (EPCs)
Slide 24: Topics
Slide 25: Which of these broad topics may be relevant to your patients?
Slide 26: Topic nomination
Slide 27: Topic selection
Slide 28: Stakeholder involvement in the Effective Health Care Program
Slide 29: Effective Health Care Program activities
Slide 30: Image of Effective Health Care Program products
Slide 31: Effective Health Care Products
Slide 32: Clinician resources
Slide 33: Clinician research summaries
Slide 34: Clinician research summaries
Slide 35: Clinician CME/CE Activities
Slide 36: Clinician faculty slides and resources
Slide 37: Patient resources
Slide 38: Patient resources use health literacy principles
Slide 39: Patient resources use health literacy principles, cont.
Slide 40: PCOR resources for patients to promote shared decision making
Slide 41: Using AHRQ's PCOR resources
Slide 42: AHRQ's interactive decision aids promote shared decision making
Slide 43: AHRQ's interactive decision aids
Slide 44: How might you use these consumer summaries?
Slide 45: Examples of how AHRQ's PCOR resources have been used
Slide 46: Why Use PCOR Tools and Resources?
Slide 47: Sharing decision aids with patients improves patient care and outcomes2
Slide 48: Sharing decision aids with patients improves patient care and outcomes2
Slide 49: Accessing Effective Health Care Program Products
Slide 50: Image of the Effective Health Care Program Web site home page
Slide 51: Are you familiar with AHRQ's Effective Health Care Program?
Slide 52: Image of the Effective Health Care Program Web site—Research Summaries for Consumers, Clinicians and Policymakers
Slide 53: Image of the Effective Health Care Program Web site—Research Summaries for Consumers, Clinicians and Policymakers
Slide 54: Image of the Effective Health Care Program Web site—Landing page for the Consumer Summary titled "Choosing Medicines for High Blood Pressure: A Review of the Research on ACEIs, ARBs, and DRIs"
Slide 55: Image of the Effective Health Care Program Web site Home page
Slide 56: Image of the Effective Health Care Program Web site—landing page for Tools and Resources
Slide 57: Ordering Information
Slide 58: Sign up for email alerts
Slide 59: Sharing Effective Health Care Program Resources and Tools
Slide 60: Effective Health Care Program activities
Slide 61: Effective Health Care Program activities
Slide 62: Key takeaways
Slide 63: Citations


Slide 1: Cover Slide

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Slide Content:

The SHARE Approach. Essential Steps of Shared Decision Making.

Workshop Course

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Slide 2: Module 2

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Slide Content:

Module 2: Using Patient-Centered Outcomes Research (PCOR) in Shared Decision Making

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Slide 3: Module 2—Learning objectives

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At the conclusion of this activity, the participant will be able to:

  • Define patient-centered care and patient-centered outcomes research (PCOR).
  • Discuss attributes/advantages of PCOR in augmenting patient-centered care in the context of shared decision making.
  • Explain AHRQ's role in PCOR and resources.
  • Describe how to incorporate PCOR materials into shared decision making.
  • Explain how to access AHRQ's PCOR resources for patients and clinicians.

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Slide 4: What is patient-centered care?

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  • Institute of Medicine (IOM). Crossing the Quality Chasm: A New Health System for the 21st Century (2001)1.
    • Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.
    • An essential foundation for quality and patient safety.

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Slide 5: Patient-centered care

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  • IOM report1 continued:
    • Systems must be designed to serve the needs of patients; ensure patients are fully informed, retain control, and participate in care delivery whenever possible; and ensure patients receive care that is respectful of their values and preferences.

Shared decision making fosters patient-centered care.

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Slide 6: Step 2—Help your patient explore and compare treatment options

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  • Discuss the benefits and risks of each treatment option.
    • Know the benefits and risks of each option
    • Understand how they relate to your patient's situation and condition.
  • Use evidence-based decision-making resources to compare the treatment options.

Patient-centered outcomes research can help.

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Slide 7: Group discussion

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Question:

How do you keep up with the latest evidence on treatment options?

How do you help your patients compare options?

(Image of a white board.)

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Slide 8: What Is PCOR?

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Slide Content:

What Is PCOR?

(Also known as comparative effectiveness research)

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Slide 9: What is Patient Centered Outcomes Research?

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  • Assesses preventive, diagnostic, therapeutic, palliative, or health delivery system interventions.
  • Compares the benefits and harms of interventions.
  • Aims to find out how well interventions work in everyday practice settings, not just in clinical trial settings.
  • Focuses on outcomes that matter to people.

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Slide 10: Group discussion

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Question:

What are some outcomes that may matter to patients?

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Slide 11: Patient-centered outcomes

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  • Outcomes that patients notice and care about when they make health care decisions
  • Each patient is different, and what matters to one may not matter to another.
    • For example, high blood pressure and high serum cholesterol levels may not cause alarm or lifestyle change for some patients.
  • Good shared decision making means talking with your patients about what is important to them.

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Slide 12: Patient-centered outcomes

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  • Outcomes that matter to patients may include:
    • Quality of life
    • Mobility
    • Ability to carry out certain tasks
    • Ability to focus
    • Ability to return to work
    • Side effects/risks of treatment
    • Symptoms (e.g., pain, nausea)
    • Survival
  • Consider that outcomes might be different for each patient.

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Slide 13: Primary aim of PCOR

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  • To help inform patients, health care providers, and others as they make health care decisions
  • How?
    • In clinical setting, use PCOR as your base in shared decision making.
      • Help your patients compare and weigh options.
      • Learn what is important to them.
      • Engage in two-way communication.

Evidence-based information about treatment options can help your patients be active participants in the shared decision-making process.

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Slide 14: Informing health care decisions

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In other settings, PCOR can inform clinical practice guidelines and policy decisions.

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Slide 15: PCOR—"Tools, not rules"

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  • Informative—Not meant to dictate health decisions.
  • Allows you to help your patients come to a decision that works for their lives.

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Slide 16: What PCOR is NOT

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  • PCOR does NOT:
    • Tell health providers how to practice medicine.
    • Provide guidance by itself; PCOR is informative.
    • Replace clinical judgment tailored to individual patients.
    • Replace clinical practice guidelines or provide clinical recommendations.

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Slide 17: Major sponsors of PCOR

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  • Primary research studies.
    • Patient-Centered Outcomes Research Institute (PCORI) (image of PCORI logo).
      • An independent, quasi-governmental organization that was authorized as part of the Affordable Care Act (ACA) to conduct PCOR.
    • National Institutes of Health (NIH) (image of NIH Logo).

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Slide 18: Getting the information out

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  • PCOR is meant to help inform patient and clinician decision making.
  • It's important to get the research to those who need it.

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Slide 19: Major sponsors supporting dissemination of PCOR

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  • Dissemination of primary research.
    • PCORI
    • Agency for Healthcare Research and Quality (AHRQ).

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Slide 20: AHRQ's Effective Health Care Program

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AHRQ's Effective Health Care Program
http://effectivehealthcare.ahrq.gov/

(Image of the Effective Health Care Program.)

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Slide 21: Effective Health Care Program activities

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  • Evidence synthesis
    • Development of systematic reviews of existing evidence to compare treatment/intervention effectiveness and identifying relevant knowledge gaps.
      • Compare the benefits and harms of treatment options.
      • Explain what is known and what is not known.

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Slide 22: Effective Health Care Program Comparative Effectiveness reports

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  • Comprehensive technical reviews.
  • Executive summary and full report.
  • Available for free online in HTML and PDF formats.

(Image of two AHRQ Comparative Effectiveness Review reports.)

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Slide 23: AHRQ's Evidence-Based Practice Centers (EPCs)

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EPCs:

  • Are independent research organizations and institutions.
  • Have extensive expertise in conducting systematic reviews of literature.
  • Conduct comparative effective reviews under contract to AHRQ.

The EPC Program actively manages any conflict of interest to ensure the reviews are trustworthy and unbiased.

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Slide 24: Topics

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Screen shot image of the Effective Health Care Program Web page showing the lit of topics covered, including:

  • Brain and Nerve Conditions.
  • Breathing Conditions.
  • Cancer.
  • Developmental Delays, ADHD, Autism.
  • Diabetes.
  • Obesity.
  • Digestive System Conditions.
  • Genitourinary Conditions.
  • Gynecology.
  • Heart and Blood Vessel Conditions.
  • Infectious Disease and HIV/AIDs.
  • Mental Health.
  • Muscle, Bone, and Joint Conditions.
  • Nonclinical Topics.
  • Ophthalmologic Conditions.
  • Pregnancy and Childbirth.
  • Renal Disease.

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Slide 25: Which of these broad topics may be relevant to your patients?

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Question:

Which of these broad topics may be relevant to your patients?

Arthritis

Cardiovascular Disease

Diabetes

Mental health disorders

Obesity

Pregnancy and Childbirth

Renal Disease

Others?

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Slide 26: Topic nomination

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  • EHC Program works with stakeholders for topic nomination
  • Topics for review are nominated by non-Federal partners, such as:
    • Professional societies.
    • Health plans.
    • Insurers.
    • Employers.
    • Patients.
    • Clinicians.

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Slide 27: Topic selection

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  • Suggestions considered against a set of criteria
  • Priority is given to the topics that:
    • Address clinical uncertainties.
    • Focus on important subgroups.
    • Will be used to inform decision making.

(Screen shot image of the Effective Health Care Program Web page showing information on how research topics are selected.)

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Slide 28: Stakeholder involvement in the Effective Health Care Program

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  • To ensure each review is relevant to patients and other stakeholders
    • Topic selection.
    • Review and comment on key questions and outcomes studied.
    • Review and comment on draft report.

(Screen shot image of the Effective Health Care Program Web page showing stakeholders can contribute.)

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Slide 29: Effective Health Care Program activities

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Slide Content:

  • Evidence synthesis
    • Conducting systematic reviews of existing evidence to compare treatment/intervention effectiveness and identifying relevant knowledge gaps.
  • Translation
    • Translating PCOR findings into plain language resources and tools for patients, providers, and policymakers

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Slide 30: Image of Effective Health Care Program products

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Slide Content:

(Image of Effective Health Care Program products.)

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Slide 31: Effective Health Care Products

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  • Designed to encourage conversations between clinicians and patients.
  • Available online for viewing and print in PDF format.
  • Accessible on mobile devices and smart phones.
  • Available for order for little or no cost from AHRQ's Publication Clearinghouse.
  • Many available in Spanish.

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Slide 32: Clinician resources

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  • Can help you engage in shared decision making by helping you know the evidence.
  • Based on systematic reviews from the Effective Health Care Program.
  • Available in a variety of easy-to-navigate formats
    • Clinician research summaries.
    • CME/CE modules.
    • Faculty slides.
    • Webcasts.

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Slide 33: Clinician research summaries

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  • Offer Clinical Bottom Line.
  • Highlight the strength of evidence behind the report's conclusions.
  • Describe gaps in evidence.
  • Over 50 in print that you can order.
  • Also downloadable online.

(Image of clinician research summaries.)

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Slide 34: Clinician research summaries

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  • Use them in shared decision making with your patients
    • Serve as quick reference/review to compare treatment options.
    • Help you convey the evidence-based treatment options and how they compare in benefits and risks to your patients.
  • Easy to navigate, download, and share.

(Image of a patient with two health care professionals in an exam room looking at information on an electronic tablet.)

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Slide 35: Clinician CME/CE Activities

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Slide Content:

(Screen shot image of the Effective Health Care Program Web page showing list of clinician CME/CE activities available.)

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Slide 36: Clinician faculty slides and resources

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Slide Content:

  • Faculty slides
  • Webcasts

(Screen shot image of the Effective Health Care Program Web page showing topics for which faculty slide decks are available and a sample slide deck.)

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Slide 37: Patient resources

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  • Consumer research summaries
    • Over 50 print, online, and audio.
    • Patient-friendly.
    • English and Spanish.
    • Compare treatment options—risks and benefits.
    • Questions to ask provider.
  • Interactive patient decision aids
    • Web-based decision aids.

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Slide 38: Patient resources use health literacy principles

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  • Written in plain language for easier comprehension.
  • Tells you from the start (inside cover) who the booklet is for.
  • Uses large type for reading ease.
  • Uses effective line length for optimal readability (less than 6 inches long helps the reader track the line easily).

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Slide 39: Patient resources use health literacy principles, cont.

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  • Uses headers and sub-headers to direct readers.
  • Uses photographs that show action.
  • List questions to ask the doctor.
  • Often available in Spanish.
  • Available in audio version on the Web.

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Slide 40: PCOR resources for patients to promote shared decision making

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  • Aim to involve patients and family members in decision making.
    • Inform patients and their caregivers about options.
    • Help clarify patients' preferences for risks and benefits of options.
    • Encourage patients and family members to discuss their preferences with their clinicians.

(Image of a sample consumer summary and the table of contents of the summary.)

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Slide 41: Using AHRQ's PCOR resources

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(Three images of patients using AHRQ consumer materials. The image on the left shows a couple consulting with a physician and the physician is sharing information on an electronic tablet. The image in the middle shows a patient reading AHRQ information in the waiting room. The image on the right shows a patient reading AHRQ information at home.)

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Slide 42: AHRQ's interactive decision aids promote shared decision making

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  • AHRQ's interactive decision aids:
    • Describe the condition.
    • Present the treatment options.
    • Help patients assess what is important to him or her.
    • Provide tips for talking with their clinician.

(Image of AHRQ's interactive patient decision aid on screening for prostate cancer.)

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Slide 43: AHRQ's interactive decision aids

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Slide Content:

(Image of AHRQ's interactive patient decision aid on treatments for urinary incontinence.)

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Slide 44: How might you use these consumer summaries?

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Question:

Can you think of other ways that you might use these resources with your patients?

When might you introduce them? At the visit, to take home?

(Image of a white board.)

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Slide 45: Examples of how AHRQ's PCOR resources have been used

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  • Urban Health Plan (UHP), a network of New York City health centers serving more than 54,000 mostly Spanish-speaking and low-income patients in the Bronx and Queens, has ordered nearly 2,500 EHC Program summaries to support their English- and Spanish-language patient education efforts.
  • WakeMed Health and Hospitals distributed 1,000 copies of the Treating High Cholesterol consumer research summary at a communitywide health fair.
  • In the past year, more than 28,000 EHC Program publications have been distributed at three NAFC "Communities Are Responding Everyday" (C.A.R.E) health clinics in Washington, DC, Charlotte, NC, and New Orleans, LA.

Note: Refer to page 7, Tool 8 for other examples

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Slide 46: Why Use PCOR Tools and Resources?

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Slide Content:

Why Use PCOR Tools and Resources?

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Slide 47: Sharing decision aids with patients improves patient care and outcomes2

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  • A growing body of literature shows that providing patients with decision aids regarding their health treatment or screening decisions can have positive results.

Note: Refer to pages 3-4, Tool 9 for summary of evidence.

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Slide 48: Sharing decision aids with patients improves patient care and outcomes2

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  • Sharing decision aids with patients:
    • Improves patient knowledge regarding their options.
    • Reduces patients' decisional conflict.
    • Increases patients' active role in decision making.
    • Improves accurate risk perceptions of possible benefits and harms among patients.
    • Increases the likelihood that patients' choices are more consistent with their informed values.
    • Enhances communication between patients and their clinicians.

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Slide 49: Accessing Effective Health Care Program Products

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Accessing Effective Health Care Program Products
http://effectivehealthcare.ahrq.gov/

Note: Refer to handout "Accessing and Navigating AHRQ's Effective Health Care Program Web site"

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Slide 50: Image of the Effective Health Care Program Web site home page

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http://effectivehealthcare.ahrq.gov/

(Image of the Effective Health Care Program Web site home page.)

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Slide 51: Are you familiar with AHRQ's Effective Health Care Program?

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Question:

Have any of you ever visited this Web site?

Have you used any of these resources before?

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Slide 52: Image of the Effective Health Care Program Web site—Research Summaries for Consumers, Clinicians and Policymakers

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(Image of the Effective Health Care Program Web site—Research Summaries for Consumers, Clinicians and Policymakers.)

Note: Refer to page 3 of handout

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Slide 53: Image of the Effective Health Care Program Web site—Research Summaries for Consumers, Clinicians and Policymakers

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Slide Content:

(Image of the Effective Health Care Program Web site—Research Summaries for Consumers, Clinicians and Policymakers.)

Note: Refer to page 4 of handout

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Slide 54: Image of the Effective Health Care Program Web site—Landing page for the Consumer Summary titled "Choosing Medicines for High Blood Pressure: A Review of the Research on ACEIs, ARBs, and DRIs"

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(Image of the Effective Health Care Program Web site—Landing page for the Consumer Summary titled "Choosing Medicines for High Blood Pressure: A Review of the Research on ACEIs, ARBs, and DRIs.")

Note: Refer to page 5 of handout

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Slide 55: Image of the Effective Health Care Program Web site Home page

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Slide Content:

(Image of the Effective Health Care Program Web site and how to access Tools and Resources from the left-hand navigation bar.)

Note: Refer to page 8 of handout

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Slide 56: Image of the Effective Health Care Program Web site—landing page for Tools and Resources

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(Image of the Effective Health Care Program Web site landing page for Tools and Resources. The image show the variety of resources available from this page, including: Patient Decision Aids, CME/CE Activities, Slide Library, Research Resources, Webcasts, Eisenberg Center Conference Series, and Resources for Getting Involved and Involving Others.)

Note: Refer to page 9 of handout

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Slide 57: Ordering Information

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(Image of the Effective Health Care Program Web site page with instructions on how to order print copies of AHRQ's Effective Health Care Program products.)

Order copies of consumer summaries in bulk for little to no cost.

Note: Refer to pages 10-12 of handout

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Slide 58: Sign up for email alerts

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(Image of the Effective Health Care Program Web site page with instructions on how to subscribe to receive electronic updates about new and updated resources from the Effective Health Care Program.)

Note: Refer to page 13 of handout

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Slide 59: Sharing Effective Health Care Program Resources and Tools

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Sharing Effective Health Care Program Resources and Tools

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Slide 60: Effective Health Care Program activities

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Slide Content:

  • Evidence synthesis
    • Conducting systematic reviews of existing evidence to compare treatment/intervention effectiveness and identifying relevant knowledge gaps
  • Translation
    • Translating PCOR findings into plain language resources and tools for patients, providers, and policymakers
  • Dissemination and Implementation
    • Ensuring the tools and resources get into the hands of the people who need them

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Slide 61: Effective Health Care Program activities

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  • Through its dissemination and implementation efforts, AHRQ and the Effective Health Care Program have distributed:
    • More than 4 million PCOR products.
    • Awarded more than 60,000 CME/CE certificates.

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Slide 62: Key takeaways

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  • The primary goal of PCOR is to help inform patients, health care providers, and others as they make health care decisions.
  • AHRQ's Effective Health Care Program offers a variety of evidence-based PCOR resources for health providers and patients to support shared decision making.
  • You can access the materials by ordering or by downloading online.

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Slide 63: Citations

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Slide Content:

  1. Institute of Medicine (IOM). Crossing the Quality Chasm. Crossing the Quality Chasm: A New Health System for the 21st Century. 2001. Washington, D.C: National Academy Press.
  2. Stacey D, Légaré F, Col NF, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2014 Jan 28;1:CD001431. PubMed PMID: 24470076.

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Page last reviewed December 2014
Page originally created September 2014
Internet Citation: SHARE Approach Workshop Curriculum. Content last reviewed December 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/shareddecisionmaking/workshop/module2/shareworkshop-mod2slides.html