Effects of a shared decision making intervention for older adults with multiple chronic conditions: the DICO study
| العنوان: | Effects of a shared decision making intervention for older adults with multiple chronic conditions: the DICO study |
|---|---|
| المؤلفون: | Ruth E. Pel-Littel, Bianca M. Buurman, Marjolein H. van de Pol, Jos W.R. Twisk, Linda R. Tulner, Mirella M. Minkman, Wilma J.M. Scholte op Reimer, Julia C.M. van Weert |
| المساهمون: | Geriatrics, APH - Aging & Later Life, APH - Quality of Care, Cardiology, Nursing, ACS - Heart failure & arrhythmias, Epidemiology and Data Science, APH - Health Behaviors & Chronic Diseases, APH - Methodology, Persuasive Communication (ASCoR, FMG) |
| المصدر: | BMC medical informatics and decision making, 23(1):42. BioMed Central BMC Medical Informatics and Decision Making, 23(1):42. BioMed Central Pel-Littel, R E, Buurman, B M, van de Pol, M H, Twisk, J W R, Tulner, L R, Minkman, M M, Scholte op Reimer, W J M & van Weert, J C M 2023, ' Effects of a shared decision making intervention for older adults with multiple chronic conditions : the DICO study ', BMC Medical Informatics and Decision Making, vol. 23, no. 1, 42 . https://doi.org/10.1186/s12911-023-02099-2 BMC Medical Informatics and Decision Making, 23:42. BioMed Central |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | Preparatory tool, Multiple chronic conditions, Health Policy, Older patients, SDM, Geriatricians, Health Informatics, Informal caregivers, Communication training, Pragmatic trial, Shared decision making, Computer Science Applications |
| الوصف: | Background To evaluate the effects of a shared decision making (SDM) intervention for older adults with multiple chronic conditions (MCCs). Methods A pragmatic trial evaluated the effects of the SDMMCC intervention, existing of SDM training for nine geriatricians in two hospitals and a preparatory tool for patients. A prospective pre-intervention post-intervention multi-center clinical study was conducted in which an usual care group of older patients with MCC and their informal caregivers was included before the implementation of the intervention and a new cohort of patients and informal caregivers after the implementation of the intervention. SDM was observed using the OPTIONMCC during video-recorded consultations. Patient- and caregivers reported outcomes regarding their role in SDM, involvement, perceived SDM and decisional conflict were measured. The differences between groups regarding the level of observed SDM (OPTIONMCC) were analyzed with a mixed model analysis. Dichotomous patient-reported outcomes were analyzed with a logistic mixed model. Results From two outpatient geriatric clinics 216 patients with MCCs participated. The mean age was 77.3 years, and 56.3% of patients were female. No significant difference was found in the overall level of SDM as measured with the OPTIONMCC or in patient-reported outcomes. However, at item level the items discussing ‘goals’, ‘options’, and ‘decision making’ significantly improved after the intervention. The items discussing ‘partnership’ and ‘evaluating the decision-making process’ showed a significant decrease. Fifty-two percent of the patients completed the preparatory tool, but the results were only discussed in 12% of the consultations. Conclusion This study provides scope for improvement of SDM in geriatrics. Engaging older adults with MCCs and informal caregivers in the decision making process should be an essential part of SDM training for geriatricians, beyond the SDM steps of explaining options, benefits and harms. More attention should be paid to the integration of preparatory work in the consultation. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1472-6947 |
| DOI: | 10.1186/s12911-023-02099-2 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::96c1a8830e299be47a527896258d1efc https://pure.amc.nl/en/publications/effects-of-a-shared-decision-making-intervention-for-older-adults-with-multiple-chronic-conditions(f29f915a-e62e-49ac-b492-7b6300f905a8).html |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....96c1a8830e299be47a527896258d1efc |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14726947 |
|---|---|
| DOI: | 10.1186/s12911-023-02099-2 |