Division of Endocrinology and Metabolism, Cumming School of Medicine, University of Calgary, Alberta; Dr David Hanley Osteoporosis Centre, Alberta Health Services, Alberta.
Dr David Hanley Osteoporosis Centre, Alberta Health Services, Alberta.
Br J Gen Pract. 2020 Oct 29;70(700):e801-e808. doi: 10.3399/bjgp20X713081. Print 2020 Nov.
Delivery of patient-centred care is limited by physician time. Group medical consultations may save physician time without compromising patient experience.
To assess patient experience and specialist physician time commitment in a group consultation for osteoporosis.
Prospective pilot study at a tertiary osteoporosis centre in Canada between May 2016 and June 2019.
The authors evaluated women referred for osteoporosis who chose a 2-hour group consultation instead of a one-to-one consultation. Group consultations were led by an osteoporosis nurse and specialist physician, and consisted of individualised fracture risk assessment and education regarding osteoporosis therapies, followed by a decision-making exercise to choose a treatment plan. Patients then followed up with their GPs to implement this plan. Patient experience was assessed via a questionnaire immediately and 3 months post-consultation, at which time GP satisfaction and patient treatment status were also surveyed.
Of 560 referrals received, 18 patients declined osteoporosis specialist assessment, 54 could not be contacted, 303 attended a one-to- one consultation, and 185 attended a group consultation. Mean participant age was 62.8 years (standard deviation [SD] 5.8) and the Fracture Risk Assessment Tool (FRAX) 10-year osteoporotic fracture risk was 13.0 (SD 7.0)%. Immediately post-consultation, 104 (97.2%) patients were satisfied and 102 (95.3%) felt included in decision making. Satisfaction was reported by 95/99 (96.0%) patients and 27/36 (75.0%) GPs. Treatment plans had been enacted by 90 (90.1%) patients. For a matched number of individual consultations, each group session conferred a specialist physician time savings of 5.5 hours.
Group consultations represent a satisfactory and time-efficient alternative to one-to-one consultations for select patients with osteoporosis.
以患者为中心的医疗服务受到医生时间的限制。小组医疗咨询可以节省医生的时间，同时又不会影响患者的体验。
评估骨质疏松症小组咨询对患者体验和专科医生时间投入的影响。
2016 年 5 月至 2019 年 6 月在加拿大一家三级骨质疏松症中心进行的前瞻性试点研究。
作者评估了选择 2 小时小组咨询而不是一对一咨询的骨质疏松症患者。小组咨询由一名骨质疏松症护士和专科医生共同主持，包括个体化骨折风险评估和骨质疏松症治疗教育，然后进行决策练习以选择治疗计划。患者随后与他们的全科医生跟进以实施该计划。通过问卷调查在咨询后即刻和 3 个月评估患者体验，同时还调查了全科医生的满意度和患者的治疗状况。
在收到的 560 份转诊中，18 名患者拒绝接受骨质疏松症专家评估，54 名患者无法联系，303 名患者接受了一对一咨询，185 名患者接受了小组咨询。患者的平均年龄为 62.8 岁（标准差 [SD] 5.8），FRAX 10 年骨质疏松性骨折风险为 13.0（SD 7.0）%。咨询后即刻，104 名（97.2%）患者表示满意，102 名（95.3%）患者感到参与了决策。95/99 名（96.0%）患者和 27/36 名（75.0%）全科医生报告了满意度。90 名（90.1%）患者已实施治疗计划。对于同等数量的个别咨询，每次小组会议可使专科医生的时间节省 5.5 小时。
小组咨询为选择骨质疏松症患者提供了一种令人满意且高效的替代一对一咨询的选择。
