Mostofsky Elizabeth, Dunn Jillian A, Hernández-Díaz Sonia, Johansson Anna C, Mittleman Murray A
Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA, USA,
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA,
Patient Prefer Adherence. 2019 Feb 21;13:339-349. doi: 10.2147/PPA.S178765. eCollection 2019.
Rather than identifying exposures and outcomes for research solely based on interests of medical professionals, there is a need for research that answers questions that are important to patients, so that they may make treatment decisions based on evidence that reflect their individual preferences.
To identify exposures and outcomes of interest that could be studied with electronic health record data from inpatient care.
Mixed-methods analysis of semi-structured interviews administered in 2017 to 76 patients and 26 physicians who receive or provide care at Beth Israel Deaconess Medical Center in Boston, MA.
After conducting detailed semi-structured interviews about topics of interest that can be studied using electronic health records of inpatient care, we used an inductive approach to identify themes about the health care experience.
Participants reported concerns about adverse effects of medication changes, drug interactions, and surgery and other invasive procedures. The outcomes of greatest concern to them were in-hospital deaths and hospital-acquired infections. Participants commented on the importance of clear communication and information transfers, the hospital environment, accurate skills and knowledge, and upholding patient dignity and respect.
Engaging patients and physicians in the research development process provided insight to the exposures and outcomes they consider important. Our questions about exposures and outcomes of interest were restricted to topics that could be studied with electronic health record data from inpatient care, but using a similar approach to elicit feedback about the health care experience could be used to glean insight for other areas of future research.
研究不应仅基于医学专业人员的兴趣来确定研究的暴露因素和结果,而是需要开展能够回答对患者至关重要的问题的研究,以便他们能够基于反映其个人偏好的证据做出治疗决策。
确定可利用住院护理电子健康记录数据进行研究的感兴趣的暴露因素和结果。
设计、设置、参与者:对2017年在马萨诸塞州波士顿贝斯以色列女执事医疗中心接受治疗或提供护理的76名患者和26名医生进行半结构化访谈的混合方法分析。
在就可利用住院护理电子健康记录进行研究的感兴趣主题进行详细的半结构化访谈后,我们采用归纳法确定有关医疗保健经历的主题。
参与者报告了对药物变更、药物相互作用、手术及其他侵入性操作的不良反应的担忧。他们最关注的结果是院内死亡和医院获得性感染。参与者评论了清晰沟通和信息传递、医院环境、准确的技能和知识以及维护患者尊严和尊重的重要性。
让患者和医生参与研究开发过程,为了解他们认为重要的暴露因素和结果提供了见解。我们关于感兴趣的暴露因素和结果的问题仅限于可利用住院护理电子健康记录数据进行研究的主题,但采用类似方法获取有关医疗保健经历的反馈,可用于为未来研究的其他领域收集见解。