Director of Clinical Research, Section of Gastroenterology, Boston Medical Center, Boston, MAStudy Coordinator, Section of Gastroenterology, Boston Medical Center, Boston, MAClinical Director, Section of General Internal Medicine, Boston Medical Center, Boston, MA, USA.
Health Expect. 2014 Feb;17(1):27-35. doi: 10.1111/j.1369-7625.2011.00730.x. Epub 2011 Sep 8.
Decision aids for colorectal cancer (CRC) screening have been shown to enable patients to identify a preferred screening option, but the extent to which such tools facilitate shared decision making (SDM) from the perspective of the provider is less well established.
Our goal was to elicit provider feedback regarding the impact of a CRC screening decision aid on SDM in the primary care setting.
Cross-sectional survey.
Primary care providers participating in a clinical trial evaluating the impact of a novel CRC screening decision aid on SDM and adherence.
Perceptions of the impact of the tool on decision-making and implementation issues.
Twenty-nine of 42 (71%) eligible providers responded, including 27 internists and two nurse practitioners. The majority (>60%) felt that use of the tool complimented their usual approach, increased patient knowledge, helped patients identify a preferred screening option, improved the quality of decision making, saved time and increased patients' desire to get screened. Respondents were more neutral is their assessment of whether the tool improved the overall quality of the patient visit or patient satisfaction. Fewer than 50% felt that the tool would be easy to implement into their practices or that it would be widely used by their colleagues.
Decision aids for CRC screening can improve the quality and efficiency of SDM from the provider perspective but future use is likely to depend on the extent to which barriers to implementation can be addressed.
结直肠癌(CRC)筛查决策辅助工具已被证明能够帮助患者确定首选的筛查方案,但从提供者的角度来看,这些工具在多大程度上促进了共同决策(SDM)尚不清楚。
我们的目标是从提供者的角度了解 CRC 筛查决策辅助工具对初级保健环境中 SDM 的影响。
横断面调查。
参与评估新型 CRC 筛查决策辅助工具对 SDM 和依从性影响的临床试验的初级保健提供者。
对工具对决策和实施问题的影响的看法。
在 42 名符合条件的提供者中,有 29 名(71%)做出了回应,其中包括 27 名内科医生和 2 名执业护士。大多数(>60%)人认为使用该工具补充了他们的常规方法,增加了患者的知识,帮助患者确定了首选的筛查方案,改善了决策质量,节省了时间,并增加了患者接受筛查的意愿。在评估工具是否提高了患者就诊的整体质量或患者满意度方面,受访者的评价更为中立。不到 50%的人认为该工具易于在实践中实施,或者他们的同事会广泛使用该工具。
CRC 筛查决策辅助工具可以从提供者的角度提高 SDM 的质量和效率,但未来的使用可能取决于实施障碍在多大程度上可以得到解决。