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Topics
- Behavioral Health (1)
- (-) Chronic Conditions (4)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 4 of 4 Research Studies DisplayedSchuttner L, Lee JR, Hockett Sherlock S
Primary care physician perspectives on the influence of patient values, health priorities, and preferences on clinical decision-making for complex patients with multimorbidity: a qualitative study.
The purpose of this study was to explore primary care physician (PCP) perspectives on the influence of patients' values, health priorities and goals, and preferences on clinical decisions for patients with multimorbidity and higher psychosocial complexity. Between May and July 2020 the researchers utilized semi-structured telephone interviews with 23 PCPs in patient-centered medical home teams in a nationally integrated health system in the United States. The study found three major themes: (1) The personal values of patients were rarely directly discussed in routine clinical encounters but informed more typically discussed constructs of patient preferences, goals, and priorities; (2) Patient preferences, goals, and priorities were sources of conflicting perspectives about care plans between healthcare teams, patients, and families; (3) Physicians used direct strategies to communicate and negotiate about patient preferences, goals, and priorities when developing care plans. The researchers concluded that during clinical decision-making for complex patients with multimorbidity, primary care physicians perceive patient values, preferences, health priorities and goals as influential.
AHRQ-funded; HS026369.
Citation: Schuttner L, Lee JR, Hockett Sherlock S .
Primary care physician perspectives on the influence of patient values, health priorities, and preferences on clinical decision-making for complex patients with multimorbidity: a qualitative study.
Risk Manag Healthc Policy 2022 Nov 16; 15:2135-46. doi: 10.2147/rmhp.S380021..
Keywords: Primary Care, Provider: Physician, Shared Decision Making, Chronic Conditions
Kagarmanova A, Sparkman H, Laiteerapong N
Improving the management of chronic pain, opioid use, and opioid use disorder in older adults: study protocol for i-cope study.
This article describes a protocol for an upcoming study on the planned implementation and evaluation of I-COPE (Improving Chicago Older Adult Opioid and Pain Management through Patient-centered Clinical Decision Support and Project ECHO®) to improve care for older adults with chronic pain, opioid use, and opioid use disorder (OUD). The study will be implemented in 35 clinical sites across the metropolitan Chicago area for patients aged ≥ 65 with chronic pain, opioid use, or OUD who receive primary care at one of the clinics. I-COPE includes the integration of patient-reported data on symptoms and preferences, clinical decision support tools and shared decision making into routine primary care. Primary care providers will be trained on the tools through web-based videos and an optional Project ECHO® course, entitled "Pain Management and OUD in Older Adults." A framework called RE-AIM will be used to assess the I-COPE implementation. Outcomes considered effective include an increased variety of recommended pain treatments, decreased prescriptions of higher-risk pain treatments, and decreased patient pain scores. Outcomes will be evaluated at 6 and 12 months after implementation, and PCPs participating in Project ECHO® will be evaluated on changes in knowledge, attitudes, and self-efficacy using pre- and post-course surveys.
AHRQ-funded; HS027910.
Citation: Kagarmanova A, Sparkman H, Laiteerapong N .
Improving the management of chronic pain, opioid use, and opioid use disorder in older adults: study protocol for i-cope study.
Trials 2022 Jul 27;23(1):602. doi: 10.1186/s13063-022-06537-w..
Keywords: Elderly, Pain, Chronic Conditions, Opioids, Medication, Substance Abuse, Behavioral Health, Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT)
Schuttner L, Hockett Sherlock S, Simons C
Factors affecting primary care physician decision-making for patients with complex multimorbidity: a qualitative interview study.
Researchers sought to describe factors affecting physician decision-making when care planning for complex patients with multimorbidity within the team-based, patient-centered medical home setting in the integrated healthcare system of the U.S. Department of Veterans Affairs, the Veterans Health Administration (VHA). They found that primary care physicians described internal, external, and relationship-based factors that affected their care planning for high-risk and complex patients with multimorbidity in the VHA.
AHRQ-funded; HS026369.
Citation: Schuttner L, Hockett Sherlock S, Simons C .
Factors affecting primary care physician decision-making for patients with complex multimorbidity: a qualitative interview study.
BMC Prim Care 2022 Feb 5;23(1):25. doi: 10.1186/s12875-022-01633-x..
Keywords: Primary Care, Shared Decision Making, Chronic Conditions, Patient-Centered Healthcare
Kunneman M, Branda ME, Ridgeway JL
Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention.
The purpose of this trial was to determine the effectiveness of a shared decision-making (SDM) tool versus guideline-informed usual care in translating evidence into primary care, and to explore how use of the tool changed patient perspectives about diabetes medication decision making. Findings showed that using an SDM conversation aid improved patient knowledge and involvement in SDM without impacting treatment choice, encounter length, medication adherence, or improved diabetes control in patients with type 2 diabetes.
AHRQ-funded; HS018339.
Citation: Kunneman M, Branda ME, Ridgeway JL .
Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention.
Endocrine 2022 Feb;75(2):377-91. doi: 10.1007/s12020-021-02861-4..
Keywords: Diabetes, Medication, Shared Decision Making, Patient-Centered Healthcare, Clinician-Patient Communication, Chronic Conditions