关键词: Clinical practice guidelines Decision aids Patient experience Patient-important outcomes Shared decision-making tools

Mesh : Data Collection Decision Making, Shared Decision Support Techniques Humans Patient Generated Health Data Patient Participation / methods Patient-Centered Care / methods standards Practice Guidelines as Topic Quality Improvement / organization & administration Treatment Outcome

来  源:   DOI:10.1016/j.jclinepi.2020.10.002   PDF(Sci-hub)

Abstract:
The objective of the study was to develop and test feasibility of a framework of patient-important practical issues.
Guidelines and shared decision-making tools help facilitate discussions about patient-important outcomes of care alternatives, but typically ignore practical issues patients consider when implementing care into their daily routines. Using grounded theory, practical issues in the HealthTalk.org registry and in Option Grids were identified and categorized into a framework. We integrated the framework into the MAGIC authoring and publication platform and digitally structured authoring and publication platform and appraised its use in The BMJ Rapid Recommendations.
The framework included the following 15 categories: medication routine, tests and visits, procedure and device, recovery and adaptation, coordination of care, adverse effects, interactions and antidote, physical well-being, emotional well-being, pregnancy and nursing, costs and access, food and drinks, exercise and activities, social life and relationships, work and education, travel and driving. Implementation in 15 BMJ Rapid Recommendations added 283 issues to 35 recommendations. The most frequently used category was procedure and device, and the least frequent was social life and relationship.
Adding practical issues systematically to evidence summaries is feasible and can inform guidelines and tools for shared decision-making. How this inclusion can improve patient-centered care remains to be determined.
摘要:
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