An effort to spread decision aids in five California primary care practices yielded low distribution, highlighting hurdles.
Health Aff (Millwood)
; 32(2): 311-20, 2013 Feb.
Article
em En
| MEDLINE
| ID: mdl-23381524
ABSTRACT
Despite the proven efficacy of decision aids as interventions for increasing patient engagement and facilitating shared decision making, they are not used routinely in clinical care. Findings from a project designed to achieve such integration, conducted at five primary care practices in 2010-12, document low rates of distribution of decision aids to eligible patients due for colorectal cancer screening (9.3 percent) and experiencing back pain (10.7 percent). There were also no lasting increases in distribution rates in response to training sessions and other promotional activities for physicians and clinic staff. The results of focus groups, ethnographic field notes, and surveys suggest that major structural and cultural changes in health care practice and policy are necessary to achieve the levels of use of decision aids and shared decision making in routine practice envisioned in current policy. Among these changes are ongoing incentives for use, physician training, and a team-based practice model in which all care team members bear formal responsibility for the use of decision aids in routine primary care.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Participação do Paciente
/
Educação de Pacientes como Assunto
/
Técnicas de Apoio para a Decisão
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
/
Qualitative_research
/
Screening_studies
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Health Aff (Millwood)
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Estados Unidos