Association of shared decision-making on patient-reported health outcomes and healthcare utilization

Hughes, Tasha M.; Merath, Katiuscha; Chen, Qinyu; Sun, Steven; Palmer, Elizabeth; Idrees, Jay J.; Okunrintemi, Victor; Squires, Malcolm H.; Beal, Eliza W.; Pawlik, Timothy M.

doi:10.1016/j.amjsurg.2018.01.011

Cited by 177 publications

(118 citation statements)

References 26 publications

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“…But if you say: <<I can't stand it anymore, I have an abscess>>, they'll find you an appointment, they'll cancel the appointment for the person who isn't sick in order to treat the person who is." (Celesta, 33) In this case, it was stressed that the person was not sick. Other participants, like Gemma, 39, had a similar experience.…”

Section: The Minimizing Messagementioning

confidence: 93%

Physicians communicating with women at genetic risk of breast and ovarian cancer: Are we in the middle of the ford between contradictory messages and unshared decision making?

et al. 2020

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BRCA1/2 genetic testing offers tremendous opportunities for prevention, diagnosis and treatment of breast and ovarian cancer. Women acquire valuable information that can help them to make informed decisions about their health. However, knowing one's susceptibility to developing cancer may be burdensome for several women, as this risk needs to be managed over time through a continuous dialogue with multiple healthcare professionals. We explored how communication between physicians and unaffected women carrying BRCA1/ 2 germline pathogenic variants was experienced by women in relation to their genetic risk. Data came from qualitative interviews conducted in Switzerland with 32 unaffected women carrying BRCA1/2 pathogenic variants and aware of their genetic status for at least 3 years. We identified three different types of message as conveyed by physicians to women: (1) a normative message, (2) an over-empowering message, and (3) a minimizing message. On one hand, we found that women are exposed to contradictory messages, often simultaneously, in their interactions with healthcare professionals during their post-genetic testing journey. On the other hand, women's reports highlighted the absence of shared decisionmaking in such interactions. The combination of these two findings resulted in a strong sense of disorientation, frustration, and powerlessness among participants. Healthcare professionals interacting with high cancer risk women are urged to align in favor of a both concerted and shared decision-making approach when discussing options for managing genetic risk.

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Section: The Minimizing Messagementioning

confidence: 93%

Physicians communicating with women at genetic risk of breast and ovarian cancer: Are we in the middle of the ford between contradictory messages and unshared decision making?

et al. 2020

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“…A similar methodology has been used to create this domain of patient experience and has been described elsewhere. 19 Patient Satisfaction. Respondents were asked to rate the healthcare they received from 0 to 10 where 0 = worst healthcare possible and 10 = best healthcare possible (Supplemental material- Table e1).…”

Section: Study Variables and Outcomesmentioning

confidence: 99%

Association of Income Disparities with Patient-Reported Healthcare Experience

et al. 2019

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“…This has important implications, as shared decision-making can increase treatment satisfaction and may result in better adherence and follow-up care, while reducing the risk of discontinuation, thereby increasing the likelihood of better clinical outcomes. [28][29][30][31] Although some research has examined patient preferences for wAMD treatments, these studies have been conducted in the West and have not included the T&E dosing regimen. [32][33][34] Moreover, no study has examined how patients in Japan value differences in the characteristics of wAMD treatment options.…”

Section: Introductionmentioning

confidence: 99%

<p>Patient Preferences for Anti-Vascular Endothelial Growth Factor Treatment for Wet Age-Related Macular Degeneration in Japan: A Discrete Choice Experiment</p>

Joko¹,

Nagai²,

Mori³

et al. 2020

PPA

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Background: In Japan, intravitreal anti-vascular endothelial growth factor (anti-VEGF) dosing regimens for wet age-related macular degeneration (wAMD) include pro re nata, every 2 months, and treat-and-extend, resulting in different outcomes and patient burden. Although reflecting patient preferences in treatment decision-making is desirable, few studies have examined this in Japan. This study assessed the patients willingness to trade-off between different dosing regimens. Patients and Methods: Patients with wAMD were recruited from four Japanese university hospitals to complete a face-to-face cross-sectional survey. In a discrete choice experiment, patients were asked to choose their preferred option from two anti-VEGF treatment profiles shown side-by-side across a series of choice tasks. The profiles varied on four attributes: number of injections in 12 months, number of physician consultations in 12 months, chance of 1-year visual acuity (VA) improvement, and chance of 2-year VA maintenance. Preference weights were estimated using hierarchical Bayes' models. Results: Overall, 120 patients (30 treatment naïve and 90 anti-VEGF experienced) completed the survey. Patients were willing to accept an increase from three to approximately eight injections in 12 months to increase the chance of 1-year VA improvement from 25% to 40%. They would be willing to accept 11 injections in 12 months if the chance of 2-year VA maintenance increased from 80% to 96%. The most valued attributes were increasing the chance of 2-year VA maintenance and reducing the number of injections in 12 months, which were each about twice as important as decreasing physician consultations in 12 months and increasing the chance of 1-year VA improvement (p<0.001). Among the dosing regimens, patients most preferred treat-and-extend because of its higher chance of 2-year VA maintenance. Conclusion: Informing patients with wAMD about the likelihood of long-term VA maintenance when selecting treatment may increase the acceptance of an optimal treatment regimen and number of injections.

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Association of shared decision-making on patient-reported health outcomes and healthcare utilization

Cited by 177 publications

References 26 publications

Physicians communicating with women at genetic risk of breast and ovarian cancer: Are we in the middle of the ford between contradictory messages and unshared decision making?

Physicians communicating with women at genetic risk of breast and ovarian cancer: Are we in the middle of the ford between contradictory messages and unshared decision making?

Association of Income Disparities with Patient-Reported Healthcare Experience

<p>Patient Preferences for Anti-Vascular Endothelial Growth Factor Treatment for Wet Age-Related Macular Degeneration in Japan: A Discrete Choice Experiment</p>

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