医疗服务提供者对患有青光眼的非裔美国患者采用参与式决策风格。
Provider use of a participatory decision-making style with African American patients with glaucoma.
作者信息
Sleath Betsy, Carpenter Delesha M, Budenz Donald L, Muir Kelly W, Romero Maria S, Tudor Gail, Garcia Nacire, Adjei Abena A, Robin Alan L
机构信息
Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
出版信息
Patient Educ Couns. 2023 Jun;111:107679. doi: 10.1016/j.pec.2023.107679. Epub 2023 Feb 20.
OBJECTIVE
To examine whether non-adherent African American patients with glaucoma who received a question prompt list and video intervention were more likely to be given treatment options, have their input included into treatment regimens, and rate their providers as using more of a participatory decision-making style.
METHODS
African American patients with glaucoma taking one or more glaucoma medications and reported being non-adherent were randomized to a pre-visit video and glaucoma question prompt list intervention or usual care.
RESULTS
189 African American patients with glaucoma participated. Providers gave patients treatment choices during 5.3% of visits and included patient input into treatment regimen decisions during 2.1% of visits. Male patients and patients with more years of education were significantly more likely to rate their providers as using more of a participatory decision-making style.
CONCLUSION
African American patients with glaucoma rated their providers high on using a participatory decision-making style. Yet, providers infrequently presented non-adherent patients with medication treatment options, and it was rare for providers to include patient input into treatment decisions.
PRACTICE IMPLICATIONS
Providers should provide non-adherent patients with different glaucoma treatment options. Non-adherent African American patients with glaucoma should be encouraged to ask their providers for different medication treatment options.
目的
研究接受问题提示清单和视频干预的非依从性非裔美国青光眼患者是否更有可能获得治疗方案、其意见被纳入治疗方案，以及对其医疗服务提供者的评价是否为采用更多参与式决策风格。
方法
正在服用一种或多种青光眼药物且报告为非依从性的非裔美国青光眼患者被随机分为就诊前视频和青光眼问题提示清单干预组或常规护理组。
结果
189名非裔美国青光眼患者参与了研究。医疗服务提供者在5.3%的就诊过程中为患者提供了治疗选择，在2.1%的就诊过程中将患者意见纳入治疗方案决策。男性患者和受教育年限较长的患者更有可能对其医疗服务提供者的评价为采用更多参与式决策风格。
结论
非裔美国青光眼患者对其医疗服务提供者采用参与式决策风格的评价较高。然而，医疗服务提供者很少为非依从性患者提供药物治疗选择，且很少将患者意见纳入治疗决策。
实践意义
医疗服务提供者应为非依从性患者提供不同的青光眼治疗选择。应鼓励非依从性非裔美国青光眼患者向其医疗服务提供者询问不同的药物治疗选择。
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