National Healthcare Quality and Disparities Report
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- Cancer (2)
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- (-) Patient and Family Engagement (32)
- Patient Experience (6)
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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 25 of 32 Research Studies DisplayedFisher KA, Tan ASL, Matlock DD
Keeping the patient in the center: common challenges in the practice of shared decision making.
This study examines the practice of shared-decision making (SDM) to achieve patient-centered decisions. It was determined that not all circumstances make it possible for that to happen and there have to be some basic elements present. Those elements include the patients’ health literacy, their emotional state, their relationship with the clinician and the nature of the decision.
AHRQ-funded; HS024596.
Citation: Fisher KA, Tan ASL, Matlock DD .
Keeping the patient in the center: common challenges in the practice of shared decision making.
Patient Educ Couns 2018 Dec;101(12):2195-201. doi: 10.1016/j.pec.2018.08.007..
Keywords: Clinician-Patient Communication, Shared Decision Making, Health Literacy, Patient-Centered Healthcare, Patient and Family Engagement
Cornelius T, Moise N, Birk JL
The presence of companions during emergency department evaluation and its impact on perceptions of clinician-patient communication.
Investigators studies whether having a companion present during an emergency department visit improves clinician-patient communication. An observation cohort of patients with suspected acute coronary syndrome were recruited at an academic medical center from 2013-2016. There was no observational difference except when the patient had a high school education or less.
AHRQ-funded; HS025198.
Citation: Cornelius T, Moise N, Birk JL .
The presence of companions during emergency department evaluation and its impact on perceptions of clinician-patient communication.
Emerg Med J 2018 Nov;35(11):701-03. doi: 10.1136/emermed-2018-207735..
Keywords: Clinician-Patient Communication, Shared Decision Making, Emergency Department, Patient and Family Engagement
Schoenfeld EM, Kanzaria HK, Quigley DD
Patient preferences regarding shared decision making in the emergency department: findings from a multisite survey.
In this study, the investigators sought to determine patients' desired level of involvement in medical decisions and their perceptions of potential barriers and facilitators to shared decision making in the emergency department (ED). They found that the majority of ED patients wanted to be involved in medical decisions, especially in the case of a "serious" medical problem, and felt that they had the ability to do so. Nevertheless, many patients were unlikely to actively seek involvement and defaulted to allowing the physician to make decisions during the ED visit.
AHRQ-funded; HS025701.
Citation: Schoenfeld EM, Kanzaria HK, Quigley DD .
Patient preferences regarding shared decision making in the emergency department: findings from a multisite survey.
Acad Emerg Med 2018 Oct;25(10):1118-28. doi: 10.1111/acem.13499..
Keywords: Clinician-Patient Communication, Shared Decision Making, Emergency Department, Patient and Family Engagement, Patient Experience
Hall SF, Wright NC, Wolinsky FD
The prevalence of overtreatment of osteoporosis: results from the PAADRN trial.
There is a robust body of literature addressing undertreatment in osteoporosis, but limited data addressing overtreatment. In this study, the investigators sought to understand overtreatment as this understanding is important to minimizing harm and decrease costs. The investigators found that in their sample of older adults, overuse of osteoporosis pharmacotherapy was only 8.1%. Nevertheless, they concluded, overtreatment exposed patients to possible risk with negligible chance of benefit and should be minimized.
AHRQ-funded; HS023009.
Citation: Hall SF, Wright NC, Wolinsky FD .
The prevalence of overtreatment of osteoporosis: results from the PAADRN trial.
Arch Osteoporos 2018 Sep 28;13(1):103. doi: 10.1007/s11657-018-0517-6..
Keywords: Osteoporosis, Shared Decision Making, Medication, Elderly, Patient-Centered Healthcare, Patient and Family Engagement, Care Management
Schoenfeld EM, Goff SL, Downs G
A qualitative analysis of patients' perceptions of shared decision making in the emergency department: "let me know i have a choice.".
In this study, the investigators sought to explore the use of shared decision making (SDM) from the perspectives of emergency department (ED) patients, focusing on what affects patients' desired level of involvement and what barriers and facilitators patients found most relevant to their experience. The investigators concluded that this exploration suggested that most patients wanted some degree of involvement in medical decision making but more proactive engagement of patients by clinicians was often needed.
AHRQ-funded; HS024311.
Citation: Schoenfeld EM, Goff SL, Downs G .
A qualitative analysis of patients' perceptions of shared decision making in the emergency department: "let me know i have a choice.".
Acad Emerg Med 2018 Jul;25(7):716-27. doi: 10.1111/acem.13416.
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Keywords: Clinician-Patient Communication, Shared Decision Making, Emergency Department, Patient and Family Engagement, Patient Experience
Bardach NS, Burkhart Q, Richardson LP
Hospital-based quality measures for pediatric mental health care.
The objective of this study was to develop and test medical record-based measures used to assess quality of pediatric mental health care in the emergency department (ED) and inpatient settings. The investigators drafted an evidence-based set of pediatric mental health care quality measures for the ED and inpatient settings and used them to identify sex and race disparities and substantial hospital variation.
AHRQ-funded; HS020506.
Citation: Bardach NS, Burkhart Q, Richardson LP .
Hospital-based quality measures for pediatric mental health care.
Pediatrics 2018 Jun;141(6). doi: 10.1542/peds.2017-3554..
Keywords: Cancer, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Shared Decision Making, Diagnostic Safety and Quality, Patient Experience, Patient and Family Engagement
Hoffman AS, Sepucha KR, Abhyankar P
Explanation and elaboration of the Standards for UNiversal reporting of patient Decision Aid Evaluations (SUNDAE) guidelines: examples of reporting SUNDAE items from patient decision aid evaluation literature.
This Explanation and Elaboration article expands on the 26 items in the SUNDAE guidelines, providing a rationale for each item, and including examples for how each item has been reported in published papers evaluating patient decision aids. Authors and reviewers may wish to use it broadly to inform structuring of patient decision aid evaluation reports, or use it as a reference to obtain details about how to report individual checklist items.
AHRQ-funded; HS024250.
Citation: Hoffman AS, Sepucha KR, Abhyankar P .
Explanation and elaboration of the Standards for UNiversal reporting of patient Decision Aid Evaluations (SUNDAE) guidelines: examples of reporting SUNDAE items from patient decision aid evaluation literature.
BMJ Qual Saf 2018 May;27(5):389-412. doi: 10.1136/bmjqs-2017-006985..
Keywords: Shared Decision Making, Guidelines, Patient-Centered Healthcare, Patient and Family Engagement, Quality of Care
Hoffman AS, Sepucha KR, Abhyankar P
Explanation and elaboration of the Standards for UNiversal reporting of patient Decision Aid Evaluations (SUNDAE) guidelines: examples of reporting SUNDAE items from patient decision aid evaluation literature.
This Explanation and Elaboration article expands on the 26 items in the SUNDAE guidelines, providing a rationale for each item, and including examples for how each item has been reported in published papers evaluating patient decision aids. Authors and reviewers may wish to use it broadly to inform structuring of patient decision aid evaluation reports, or use it as a reference to obtain details about how to report individual checklist items.
AHRQ-funded; HS024250.
Citation: Hoffman AS, Sepucha KR, Abhyankar P .
Explanation and elaboration of the Standards for UNiversal reporting of patient Decision Aid Evaluations (SUNDAE) guidelines: examples of reporting SUNDAE items from patient decision aid evaluation literature.
BMJ Qual Saf 2018 May;27(5):389-412. doi: 10.1136/bmjqs-2017-006985..
Keywords: Shared Decision Making, Guidelines, Patient-Centered Healthcare, Patient and Family Engagement, Quality of Care
Shaffer VA, Focella ES, Hathaway A
On the usefulness of narratives: an interdisciplinary review and theoretical model.
This article addresses the questions: How can stories from other people be used to promote better health experiences, improve judgments about health, and increase the quality of medical decisions without introducing bias, persuading listeners to change their attitudes or altering behaviors? Should narratives be used in health education, promotion, or behavior change interventions? Researchers conducted a review of literature on narratives from several disciplines to gain a better understanding about what narratives do, including their roles in communication, engagement, recall, persuasion, and health behavior change. Broad theories about information processing and persuasion from psychology and models about narrative messaging found in the health communication and marketing literature were also reviewed to provide insight into the processes by which narratives have their effect on health behavior. The researchers conclude there are important communication gaps in areas of behavioral medicine that could be addressed with narratives, but more work is needed to employ narrative messaging systematically.
AHRQ-funded; HS021681; HS023328.
Citation: Shaffer VA, Focella ES, Hathaway A .
On the usefulness of narratives: an interdisciplinary review and theoretical model.
Ann Behav Med 2018 Apr 19;52(5):429-42. doi: 10.1093/abm/kax008..
Keywords: Clinician-Patient Communication, Communication, Shared Decision Making, Patient Experience, Patient and Family Engagement
Armstrong MJ, Gronseth GS
Approach to assessing and using clinical practice guidelines.
Knowing when to use guidelines in clinical practice requires neurologists to assess the rigor of published guidelines. This review briefly describes guideline definitions and the American Academy of Neurology process for guideline development, outlines key elements for assessing guideline quality, and details a practical approach for incorporating guideline recommendations when partnering with patients in shared decision-making.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Gronseth GS .
Approach to assessing and using clinical practice guidelines.
Neurol Clin Pract 2018 Feb;8(1):58-61. doi: 10.1212/cpj.0000000000000417.
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Keywords: Shared Decision Making, Evidence-Based Practice, Guidelines, Patient and Family Engagement, Implementation
Holmes-Rovner M, Srikanth A, Henry SG
Decision aid use during post-biopsy consultations for localized prostate cancer.
The purpose of this study was to characterize the content and communicative function of high-quality decision aids during diagnostic clinic visits for prostate cancer. Results showed that good decision aids, systematically provided to patients, appeared to function not to open up deliberations about how to balance benefits and harms of competing treatments, but rather to allow patients to ask narrow technical questions about recommended treatments.
AHRQ-funded; HS021764.
Citation: Holmes-Rovner M, Srikanth A, Henry SG .
Decision aid use during post-biopsy consultations for localized prostate cancer.
Health Expect 2018 Feb;21(1):279-87. doi: 10.1111/hex.12613..
Keywords: Cancer: Prostate Cancer, Shared Decision Making, Evidence-Based Practice, Patient and Family Engagement, Patient-Centered Healthcare, Clinician-Patient Communication
Spatz ES, Krumholz HM, Moulton BW
Prime time for shared decision making.
To guide the implementation of high-quality and achievable shared decision making, policy makers and health systems may consider the following key steps: 1) clearly define shared decision making; 2) certify decision aids and provide incentives for their evaluation and maintenance; 3) promote competency in shared decision making; 4) develop measures of shared decisionmaking; and 5) foster a culture of shared decisionmaking through easy additions to work flow and positive incentives.
AHRQ-funded; HS023000.
Citation: Spatz ES, Krumholz HM, Moulton BW .
Prime time for shared decision making.
JAMA 2017 Apr;317(13):1309-10. doi: 10.1001/jama.2017.0616.
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Keywords: Shared Decision Making, Clinician-Patient Communication, Patient and Family Engagement, Patient-Centered Outcomes Research
Jolles MP, Wells R
Does caregiver participation in decision making within child welfare agencies influence children's primary and mental health care service use?
This study uses a national sample of children involved with child welfare to compare their health service use between those children served through a participatory decision making (PDM) practice and those who did not experience it. It concluded that lower-risk families were more likely to be served through PDM which was positively associated with child use of primary health services.
AHRQ-funded; HS000032.
Citation: Jolles MP, Wells R .
Does caregiver participation in decision making within child welfare agencies influence children's primary and mental health care service use?
Child Care Health Dev 2017 Mar;43(2):192-201. doi: 10.1111/cch.12384.
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Keywords: Caregiving, Children/Adolescents, Shared Decision Making, Health Services Research (HSR), Patient and Family Engagement
Raj M, Choi SW, Platt J
A qualitative exploration of the informed consent process in hematopoietic cell transplantation clinical research and opportunities for improvement.
This study found that providers understand informed consent to be a collaborative process requiring engagement and participation of providers, patients and caregivers. 'Markers of success' were identified including cognitive, affective and procedural markers focusing on patient understanding and comfort with the decision to participate. Opportunities for innovating the process included use of decision aids and tablet-based technology, and better use of patient portals.
AHRQ-funded; HS023613.
Citation: Raj M, Choi SW, Platt J .
A qualitative exploration of the informed consent process in hematopoietic cell transplantation clinical research and opportunities for improvement.
Bone Marrow Transplant 2017 Feb;52(2):292-98. doi: 10.1038/bmt.2016.252.
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Keywords: Shared Decision Making, Patient and Family Engagement, Transplantation
Armstrong MJ, Mullins CD
Value assessment at the point of care: incorporating patient values throughout care delivery and a draft taxonomy of patient values.
In this commentary, the authors propose a taxonomy of values underlying patient decision making and provide examples of how these impact provision of health care. Their draft taxonomy describes four categories of patient values: global, decisional, situational, and external, highlights different values impacting decision making and facilitates a more complete value assessment at the point of care.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Mullins CD .
Value assessment at the point of care: incorporating patient values throughout care delivery and a draft taxonomy of patient values.
Value Health 2017 Feb;20(2):292-95. doi: 10.1016/j.jval.2016.11.008.
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Keywords: Shared Decision Making, Healthcare Delivery, Patient and Family Engagement
Makam AN, Nguyen OK
An evidence-based medicine approach to antihyperglycemic therapy in diabetes mellitus to overcome overtreatment.
This article discusses the importance of (1) using absolute rather than relative estimates of benefits to inform treatment decisions; (2) considering the time horizon to benefit of treatments; (3) balancing potential harms and benefits; and (4) using shared decision making by physicians to incorporate the patient's values and preferences into treatment decisions.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK .
An evidence-based medicine approach to antihyperglycemic therapy in diabetes mellitus to overcome overtreatment.
Circulation 2017 Jan 10;135(2):180-95. doi: 10.1161/circulationaha.116.022622.
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Keywords: Shared Decision Making, Diabetes, Evidence-Based Practice, Patient and Family Engagement, Patient-Centered Outcomes Research
Cohen MD
AHRQ Author: Cohen MD
Engaging patients in understanding and using evidence to inform shared decision making.
The authors discuss various issues surrounding effective shared decision making, a collaborative process in which patients and members of their clinical teams work together to make health care decisions. These issues include some of the barriers – and facilitators – to engaging patients in understanding and using evidence to inform shared decision making and strategies that organizations can use to fully engage patients in creating and using evidence in decision making.
AHRQ-authored.
Citation: Cohen MD .
Engaging patients in understanding and using evidence to inform shared decision making.
Patient Educ Couns 2017 Jan;100(1):2-3. doi: 10.1016/j.pec.2016.11.013.
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Keywords: Shared Decision Making, Evidence-Based Practice, Patient and Family Engagement, Clinician-Patient Communication
Tjia J, Lemay CA, Bonner A
Informed family member involvement to improve the quality of dementia care in nursing homes.
Researchers described the extent to which nursing homes engaged families in antipsychotic initiation decisions in the year before surveyor guidance revisions were implemented. Under existing federal regulations but before guidance revisions were implemented in 2013, more than 40 percent of families reported being involved in nonpharmacological behavior management of family members, but fewer than one in four reported being involved throughout the entire antipsychotic prescribing process.
AHRQ-funded; HS019351.
Citation: Tjia J, Lemay CA, Bonner A .
Informed family member involvement to improve the quality of dementia care in nursing homes.
J Am Geriatr Soc 2017 Jan;65(1):59-65. doi: 10.1111/jgs.14299.
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Keywords: Shared Decision Making, Dementia, Medication, Nursing Homes, Patient and Family Engagement
Scherr KA, Fagerlin A, Hofer T
Physician recommendations trump patient preferences in prostate cancer treatment decisions.
This study assessed the influence of patient preferences and urologist recommendations in treatment decisions for clinically localized prostate cancer. It found that patients' initial treatment preferences did not predict receipt of active treatment versus surveillance. Instead, receipt of active treatment was predicted primarily by urologists' recommendations.
AHRQ-funded; HS021764.
Citation: Scherr KA, Fagerlin A, Hofer T .
Physician recommendations trump patient preferences in prostate cancer treatment decisions.
Med Decis Making 2017 Jan;37(1):56-69. doi: 10.1177/0272989x16662841.
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Keywords: Cancer: Prostate Cancer, Shared Decision Making, Patient and Family Engagement, Patient-Centered Healthcare, Clinician-Patient Communication
Smith MA, Bednarz L, Nordby PA
Increasing consumer engagement by tailoring a public reporting website on the quality of diabetes care: a qualitative study.
The goal of this study was to determine if tailoring quality reports to persons with diabetes mellitus and co-occurring chronic conditions would increase user engagement with a website that publicly reports the quality of diabetes care. It concluded that tailoring can be used to improve public reporting sites for individuals with chronic conditions, ultimately allowing consumers to make more informed health care decisions.
AHRQ-funded; HS021899.
Citation: Smith MA, Bednarz L, Nordby PA .
Increasing consumer engagement by tailoring a public reporting website on the quality of diabetes care: a qualitative study.
J Med Internet Res 2016 Dec 21;18(12):e332. doi: 10.2196/jmir.6555.
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Keywords: Chronic Conditions, Shared Decision Making, Diabetes, Patient and Family Engagement, Web-Based
Gordon HS, Street RL
How physicians, patients, and observers compare on the use of qualitative and quantitative measures of physician-patient communication.
The purpose of this study was to compare several different measures of physician-patient communication. Communication was measured with rating scales completed by patients and physicians and by two groups of external observers who used rating scales or coded the frequency of communication behaviors. The findings highlight the potential for using observers' ratings as an alternate measure of communication to more labor intensive frequency measures.
AHRQ-funded; HS010876.
Citation: Gordon HS, Street RL .
How physicians, patients, and observers compare on the use of qualitative and quantitative measures of physician-patient communication.
Eval Health Prof 2016 Dec;39(4):496-511. doi: 10.1177/0163278715625737.
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Keywords: Communication, Shared Decision Making, Patient and Family Engagement, Clinician-Patient Communication
Castaneda-Guarderas A, Glassbereg J, Grudzen CR
Shared decision making with vulnerable populations in the emergency department.
The authors introduce a research agenda that includes community-engaged approaches, mixed-methods studies, and cost-effectiveness analyses to address questions of shared decision making (SDM) among vulnerable groups at a disadvantage in the healthcare system, as well as changes that are needed, and how to cultivate and teach these competencies.
AHRQ-funded; HS024172.
Citation: Castaneda-Guarderas A, Glassbereg J, Grudzen CR .
Shared decision making with vulnerable populations in the emergency department.
Acad Emerg Med 2016 Dec;23(12):1410-16. doi: 10.1111/acem.13134.
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Keywords: Cultural Competence, Shared Decision Making, Emergency Department, Patient and Family Engagement, Vulnerable Populations
Tyler Ellis C, Charlton ME, Stitzenberg KB
Patient-reported roles, preferences, and expectations regarding treatment of stage i rectal cancer in the cancer care outcomes research and surveillance consortium.
The researchers identified patient roles, preferences, and expectations as they relate to treatment decision making for patients with stage I rectal cancer. They found that, in this study of 154 adults with newly-diagnosed and surgically treated stage 1 rectal cancer, the preferred decision-making role for patients did not match the actual decision-making process. They recommended that future efforts focus on bridging the gap between the decision-making process and patient preferences regarding various treatment approaches.
AHRQ-funded; HS000032.
Citation: Tyler Ellis C, Charlton ME, Stitzenberg KB .
Patient-reported roles, preferences, and expectations regarding treatment of stage i rectal cancer in the cancer care outcomes research and surveillance consortium.
Dis Colon Rectum 2016 Oct;59(10):907-15. doi: 10.1097/dcr.0000000000000662.
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Keywords: Cancer: Colorectal Cancer, Shared Decision Making, Patient-Centered Outcomes Research, Patient Experience, Patient and Family Engagement
Gulbrandsen P, Clayman ML, Beach MC
Shared decision-making as an existential journey: aiming for restored autonomous capacity.
The researchers described the different ways in which illness represents an existential problem, and its implications for shared decision-making. They found that the fundamental uncertainty, state of vulnerability, and lack of power of the ill patient, imbue shared decision-making with a deeper existential significance and call for greater attention to the emotional and relational dimensions of care. They propose that the aim of shared decision-making should be restoration of the patient's autonomous capacity.
AHRQ-funded; HS022932.
Citation: Gulbrandsen P, Clayman ML, Beach MC .
Shared decision-making as an existential journey: aiming for restored autonomous capacity.
Patient Educ Couns 2016 Sep;99(9):1505-10. doi: 10.1016/j.pec.2016.07.014.
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Keywords: Communication, Shared Decision Making, Patient-Centered Healthcare, Patient and Family Engagement, Clinician-Patient Communication
Kostick KM, Minard CG, Wilhelms LA
Development and validation of a patient-centered knowledge scale for left ventricular assist device placement.
The authors presented a comprehensive and valid methodology for developing a clinically informed and patient-centered measure of knowledge about left ventricular assist device (LVAD) therapy to facilitate discussion and measure candidate understanding of treatment options. They concluded that the LVAD knowledge scale may be useful in clinical settings to identify gaps in knowledge among patient candidates considering LVAD treatment; to better tailor education and discussion with patients and their caregivers; and to enhance informed decision-making before treatment decisions are made.
AHRQ-funded; HS024849.
Citation: Kostick KM, Minard CG, Wilhelms LA .
Development and validation of a patient-centered knowledge scale for left ventricular assist device placement.
J Heart Lung Transplant 2016 Jun;35(6):768-76. doi: 10.1016/j.healun.2016.01.015.
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Keywords: Shared Decision Making, Heart Disease and Health, Medical Devices, Patient and Family Engagement, Patient-Centered Outcomes Research