Interactions between persons—Knowledge, decision making, and the co‐production of practice

Loughlin, Michael; Buetow, Stephen; Cournoyea, Michael; Copeland, Samantha; Chin‐Yee, Benjamin; Fulford, K. W. M.

doi:10.1111/jep.13297

Cited by 16 publications

(24 citation statements)

References 74 publications

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“…Although these earlier reviews provided some insight into the determinants of new medicine uptake, the methodological approaches had limitations (e.g., single author, narrative review, narrow search, no quality assessment of reviewed evidence). Also, healthcare systems have changed rapidly over the last ten years with increasing focus on patient-centred care and patient involvement in decision-making [ 11 ], use of medicines [ 2 ], expenditure on medicines [ 2 ], and new policies being developed to improve patient access to new medicines [ 12 ]. Studies in earlier reviews might not have captured all factors relevant to current healthcare systems and hence an updated review is warranted.…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to the uptake of new medicines into clinical practice: a systematic review

Medlinskiene

Tomlinson

Marques

et al. 2021

BMC Health Serv Res

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Background Implementation and uptake of novel and cost-effective medicines can improve patient health outcomes and healthcare efficiency. However, the uptake of new medicines into practice faces a wide range of obstacles. Earlier reviews provided insights into determinants for new medicine uptake (such as medicine, prescriber, patient, organization, and external environment factors). However, the methodological approaches used had limitations (e.g., single author, narrative review, narrow search, no quality assessment of reviewed evidence). This systematic review aims to identify barriers and facilitators affecting the uptake of new medicines into clinical practice and identify areas for future research. Method A systematic search of literature was undertaken within seven databases: Medline, EMBASE, Web of Science, CINAHL, Cochrane Library, SCOPUS, and PsychINFO. Included in the review were qualitative, quantitative, and mixed-methods studies focused on adult participants (18 years and older) requiring or taking new medicine(s) for any condition, in the context of healthcare organizations and which identified factors affecting the uptake of new medicines. The methodological quality was assessed using QATSDD tool. A narrative synthesis of reported factors was conducted using framework analysis and a conceptual framework was utilised to group them. Results A total of 66 studies were included. Most studies (n = 62) were quantitative and used secondary data (n = 46) from various databases, e.g., insurance databases. The identified factors had a varied impact on the uptake of the different studied new medicines. Differently from earlier reviews, patient factors (patient education, engagement with treatment, therapy preferences), cost of new medicine, reimbursement and formulary conditions, and guidelines were suggested to influence the uptake. Also, the review highlighted that health economics, wider organizational factors, and underlying behaviours of adopters were not or under explored. Conclusion This systematic review has identified a broad range of factors affecting the uptake of new medicines within healthcare organizations, which were grouped into patient, prescriber, medicine, organizational, and external environment factors. This systematic review also identifies additional factors affecting new medicine use not reported in earlier reviews, which included patient influence and education level, cost of new medicines, formulary and reimbursement restrictions, and guidelines. Registration PROSPERO database (CRD42018108536).

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Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to the uptake of new medicines into clinical practice: a systematic review

Medlinskiene

Tomlinson

Marques

et al. 2021

BMC Health Serv Res

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“…16,20,22,24 However, there is a shortage of evidence on the patient's role on the uptake of new medicines, including DOACs, apart from considering their demographic and clinical characteristics. 25 Since patient involvement in medicine-related decision making is an important indicator of good quality healthcare, 4,26,27 prescribing decisions, such as initiating warfarin or a DOAC should be shaped by patient preferences. Involvement of patients with AF in the decision-making about oral anticoagulation therapy has been reported to be minimal to none.…”

Section: Introductionmentioning

confidence: 99%

Patient Perspectives on Factors Affecting Direct Oral Anticoagulant Use for Stroke Prevention in Atrial Fibrillation

Medlinskiene

Richardson

Fylan

et al. 2021

PPA

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Introduction: Oral anticoagulant therapy choices for patients with atrial fibrillation (AF) expanded in the last decade with the introduction of direct oral anticoagulants (DOAC). However, the implementation of DOACs was slow and varied across different health economies in England. There is limited evidence on the patient role in the uptake of new medicines, including DOACs, apart from considering their demographic and clinical characteristics. Hence, this study aimed to address the gap by exploring the view of patients with AF on factors affecting DOAC use. Methods: A qualitative study using semi-structured interviews was conducted in three health economies in the North of England. Adult patients (>18 years) diagnosed with nonvalvular AF, prescribed an oral anticoagulant (vitamin K antagonist or DOAC), and able to give written consent were recruited. Data were collected between August 2018 and April 2019. Audio recorded interviews were transcribed verbatim and analyzed using the framework method. Results: Four themes with eleven subthemes discussed identified factors affecting the use of DOACs. They were linked to limited healthcare financial and workforce resources, patient involvement in decision-making, patient knowledge about DOACs, safety concerns about oral anticoagulants, and oral anticoagulant therapy impact on patients' daily lives. Lack of a) opportunities to voice patient preferences and b) information on available therapy options resulted in some patients experiencing difficulties with the prescribed therapy. This was reported to cause negative impact on their daily lives, adherence, and overall satisfaction with the therapy. Conclusion: Greater patient involvement in decision-making could prevent and resolve difficulties encountered by some patients and potentially improve outcomes plus increase the uptake of DOACs.

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“…There is increasing recognition of the ethical imperative to make important healthcare decisions together with patients [6] . Western countries widely advocate consumer engagement in decision make, namely shared decision-making (SDM), to achieve person-centred care [7] . SDM is an iterative process wherein consumers, their families and health professionals exchange information, discuss options, and reach an agreement [8,9] .…”

Section: Introductionmentioning

confidence: 99%

Shared Decision-making in Healthcare in Mainland China: A Scoping Review Protocol

Li¹,

Zhao²,

Zhang³

et al. 2021

Preprint

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Background: Shared decision-making (SDM) has been increasingly studied and applied to improve patients’ decision qualities and health outcomes. Little is known about its development status in mainland China. The Ottawa Decision Support Framework (ODSF) has been extensively used to guide clinicians and patients facing difficult healthcare decisions. It claims that decision quality can be improved though the implementation of decision support interventions that address patients’ decisional needs. Objective: Based on ODSF, the objective of the scoping review is to systematically map the existing research literature to answer the following three questions: 1) What healthcare decisional needs were examined within Chinese population? 2) What decision support interventions (SDM theories, tools, processes, implementation determinants) were used to address the healthcare decisional needs? and 3) What SDM outcomes were reported? Methods and analysis: We will conduct the scoping review following Arksey and O'Malley’ six-stage methodological framework. Seven databases: Ovid MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, China National Knowledge Infrastructure, Wan Fang Database, The VIP Database, and China Biology Medicine will be searched to identify relevant studies. Four reviewers will independently screen studies based on the eligibility criteria. The ODSF, as a guiding framework, will be used to develop the data extraction form and guide data analysis. All the retrieved information will be coded and mapped into the three key components of ODSF, namely decisional needs, decision support interventions, and decision outcomes. We will report our review findings following the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) reporting guidelines.Discussion: This study will be the first comprehensive and systematic review to understand the SDM research status in mainland China. The results of this review will help us to identify the gaps in current SDM research and inform future theoretical and empirical studies.Registration: Inplasy protocol 202130021. doi: 10.37766/inplasy2021.3.0021

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Interactions between persons—Knowledge, decision making, and the co‐production of practice

Cited by 16 publications

References 74 publications

Barriers and facilitators to the uptake of new medicines into clinical practice: a systematic review

Barriers and facilitators to the uptake of new medicines into clinical practice: a systematic review

Patient Perspectives on Factors Affecting Direct Oral Anticoagulant Use for Stroke Prevention in Atrial Fibrillation

Shared Decision-making in Healthcare in Mainland China: A Scoping Review Protocol

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