Smith Michael, Bresolin Marco, McCabe Rose
Glaucoma Unit, West of England Eye Unit, Exeter, UK.
School of Health Sciences, City, University of London, London, UK.
Clin Ophthalmol. 2021 Apr 23;15:1715-1726. doi: 10.2147/OPTH.S292347. eCollection 2021.
This pilot study was undertaken to examine the feasibility of a larger scale trial examining the effect of interventions to improve patient-clinician collaboration. The primary outcome was the extent of clinician-patient collaboration during glaucoma consultations. The secondary outcomes were the results of the Patient Experience Questionnaire and the patients' opinion of how involved they were in decisions about their care and how keen they would be to increase this involvement.
This is an observational study of clinician-patient communication involving 9 glaucoma clinicians and 37 patients attending a glaucoma monitoring clinic. Consultations were videotaped and later assessed for the degree of collaboration. Patients completed a validated Patient Experience Questionnaire and a questionnaire designed to collect the patients' opinion of how involved they were in decisions about their care.
The consultations were largely "clinician centred" with clinicians speaking 58% of the sentences and asking a mean of 8.1 questions compared to the patients 2.6. Glaucoma medications were discussed in 97% of consultations. When a treatment change was recommended in 53% of cases different options were discussed. Patients had an overall positive opinion of the consultations. Although 80% of patients indicated they were happy with how involved they were in decisions about their care 44% said they would like to be more involved, and 47% would welcome written information or information sessions on how to be more involved in decisions about their care.
Glaucoma consultations remain "clinician-centred" and, in view of the evidence of the benefits of good clinician-patient collaboration, further studies to examine interventions to improve clinician-patient collaboration may be of benefit to glaucoma patients. These interventions could target both clinicians and patients, and many patients in this study indicated they would like to be more involved in decisions about their care and would welcome support in achieving this.
本试点研究旨在检验一项更大规模试验的可行性，该试验旨在研究改善患者与临床医生协作的干预措施的效果。主要结局是青光眼会诊期间临床医生与患者的协作程度。次要结局是患者体验问卷的结果，以及患者对自己参与医疗决策程度的看法，以及他们希望增加这种参与度的意愿。
这是一项关于临床医生与患者沟通的观察性研究，涉及9名青光眼临床医生和37名前往青光眼监测诊所就诊的患者。会诊过程被录像，随后评估协作程度。患者完成一份经过验证的患者体验问卷，以及一份旨在收集患者对自己参与医疗决策程度看法的问卷。
会诊在很大程度上以“临床医生为中心”，临床医生说出了58%的句子，平均提问8.1个问题，而患者提问2.6个。97%的会诊讨论了青光眼药物。在53%的病例中，当建议改变治疗方案时，讨论了不同的选择。患者对会诊总体持积极看法。尽管80%的患者表示对自己参与医疗决策的程度感到满意，但44%的患者表示希望更多地参与其中，47%的患者欢迎提供关于如何更多地参与医疗决策的书面信息或信息讲座。
青光眼会诊仍然以“临床医生为中心”，鉴于良好的临床医生与患者协作有益的证据，进一步研究改善临床医生与患者协作的干预措施可能对青光眼患者有益。这些干预措施可以针对临床医生和患者，本研究中的许多患者表示他们希望更多地参与医疗决策，并欢迎在实现这一目标方面得到支持。
