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"Patient values"

Eleanor M Perfetto, Jason Harris, C Daniel Mullins, Susan dosReis
BACKGROUND: Patient engagement is a transformative strategy for improving value assessment. US value framework developers have increased engagement activities, but more needs to be learned about how to best achieve meaningful patient engagement in value assessment. The objective was to glean good practices in patient engagement emerging from patient community experiences, to be used in value assessment. METHODS: The National Health Council Value Workgroup conducted a survey and held a focus group with its member advocacy organizations to gather experiences with value framework developers and views on emerging good practices...
April 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Julie Block
OBJECTIVE: Chronic diseases now represent a cost majority in the United States health care system. Contributing factors to rising costs include expensive novel and emerging therapies, under-treatment of disease, under-management of comorbidities, and patient dissatisfaction with care results. Critical to identifying replicable improvement methods is a reliable model to measure value. STUDY DESIGN: If we understand value within healthcare consumerism to be equal to a patient's health outcome improvement over costs associated with care (Value=Outcomes/Costs), we can use this equation to measure the improvement of value...
April 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
C L Downey, J M Brown, D G Jayne, R Randell
BACKGROUND: Vital signs monitoring is used to identify deteriorating patients in hospital. The most common tool for vital signs monitoring is an early warning score, although emerging technologies allow for remote, continuous patient monitoring. A number of reviews have examined the impact of continuous monitoring on patient outcomes, but little is known about the patient experience. This study aims to discover what patients think of monitoring in hospital, with a particular emphasis on intermittent early warning scores versus remote continuous monitoring, in order to inform future implementations of continuous monitoring technology...
June 2018: International Journal of Medical Informatics
Kanta Kumar, Sabrina R Raizada, Christian D Mallen, Rebecca J Stack
Background: Rheumatoid arthritis (RA) causes painful joint inflammation and is incurable, but treatments control RA. Drug regimens are complex, and patients often do not take their medication as expected. Poor medication adherence can lead to poorly controlled disease and worse patient outcomes. Biologics treatments are expensive and require full engagement from patients. We have previously shown that patients from Black ethnic minority backgrounds do not fully engage into treatment plan...
2018: Patient Preference and Adherence
Carolina Mendoza, Patricia Kraemer, Paloma Herrera, Pamela Burdiles, Dino Sepúlveda, Eliozka Núñez, Cecilia Muñoz, Ignacio Neumann
The Ministry of Health of Chile, aiming to improve the quality of clinical practice guidelines, gradually incorporated the GRADE system (Grading of Recommendations, Assessment, Development and Evaluation) to develop evidence based recommendations. This system summarizes and evaluates the certainty of the available evidence. It moves from evidence to decision in a systematic and transparent manner, based on four main dimensions: balance between benefits and harms, certainty of evidence, patient's values and preferences and use of resources...
November 2017: Revista Médica de Chile
Amber C Mills, Michele Levinson, William A Dunlop, Edward Cheong, Timothy Cowan, Jennifer Hanning, Erin O'Callaghan, Katherine J Walker
OBJECTIVE: There is limited literature to inform the content and format of Goals-of-Care forms, for use by doctors when they are undertaking these important conversations. METHODS: This was a prospective, qualitative and quantitative study evaluating the utility of a new 'Goals-of-Care' form to doctors in a private, tertiary ED, used from December 2016 to February 2017 at Cabrini, Melbourne. A Goals-of-Care form was designed, incorporating medical aims of therapy and patient values and preferences...
April 16, 2018: Emergency Medicine Australasia: EMA
Wil H E Buntinx, In Yu Tan, Albert P Aldenkamp
A significant group of persons affected by refractory epilepsy require a wide range of long-term support from professionals as well as informal support givers. To enhance person-centeredness, it is important to know which patient values are associated with long-term support. An Internet survey produced a total of 1176 statements from 289 persons with epilepsy for analysis. Statements were expressed in the respondent's own words and were related to positive experiences (704) as well as possible areas of improvement (472) regarding the support received in the past six months...
April 4, 2018: Epilepsy & Behavior: E&B
Megan Best, Ainsley J Newson, Bettina Meiser, Ilona Juraskova, David Goldstein, Kathy Tucker, Mandy L Ballinger, Dominique Hess, Timothy E Schlub, Barbara Biesecker, Richard Vines, Kate Vines, David Thomas, Mary-Anne Young, Jacqueline Savard, Chris Jacobs, Phyllis Butow
BACKGROUND: Genomic sequencing in cancer (both tumour and germline), and development of therapies targeted to tumour genetic status, hold great promise for improvement of patient outcomes. However, the imminent introduction of genomics into clinical practice calls for better understanding of how patients value, experience, and cope with this novel technology and its often complex results. Here we describe a protocol for a novel mixed-methods, prospective study (PiGeOn) that aims to examine patients' psychosocial, cognitive, affective and behavioural responses to tumour genomic profiling and to integrate a parallel critical ethical analysis of returning results...
April 5, 2018: BMC Cancer
Stephanie A Kraft, Mildred K Cho, Katherine Gillespie, Meghan Halley, Nina Varsava, Kelly E Ormond, Harold S Luft, Benjamin S Wilfond, Sandra Soo-Jin Lee
With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness...
April 2018: American Journal of Bioethics: AJOB
Carmen Webb, Vishal Sharma, Claire Temple-Oberle
Purpose: To discover missed opportunities for providing information to women undergoing breast reconstruction in an effort to decrease regret and improve patient education, teaching modalities, and satisfaction. Method: Thirty- to 45-minute semi-structured interviews were conducted exploring patient experiences with information provision on breast reconstruction. Purposeful sampling was used to include women with a variety of reconstruction types at different time points along their recovery...
February 2018: Plastic Surgery
Anna Goshua, Samantha Craigie, Gordon H Guyatt, Arnav Agarwal, Regina Li, Justin S Bhullar, Naomi Scott, Jasmine Chahal, Sureka Pavalagantharajah, Yaping Chang, Rachel Couban, Jason W Busse
Objective: Shared-care decision-making between patients and clinicians involves making trade-offs between desirable and undesirable consequences of management strategies. Although patient values and preferences should provide the basis for these trade-offs, few guidelines consider the relevant evidence when formulating recommendations. To inform a guideline for use of opioids in patients with chronic noncancer pain, we conducted a systematic review of studies exploring values and preferences of affected patients toward opioid therapy...
November 22, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
(no author information available yet)
To develop a new evidence-based diagnosis, treatment guideline for rheumatoid arthritis (RA) in China.A multidisciplinary guideline development group was established. The grading of recommendations assessment, development and evaluation (GRADE) system was used to rate the quality of evidence and the strength of recommendations. Recommendations were derived from evidence body, the balance of benefits and harmsand patient's values and preferences.The guideline development group developed 10 recommendations for the diagnosis and treatment of RA...
April 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Ines B Menjak, Katarzyna J Jerzak, Danielle N Desautels, Kathleen I Pritchard
Elderly patients make up a significant proportion of patients with metastatic breast cancer. With several options available in the metastatic setting for hormone positive breast cancer, these patients require an individualized approach to decision-making that considers multiple factors beyond performance status and chronologic age. Areas covered: The authors review the literature on endocrine monotherapy and combinations for hormone positive metastatic breast cancer, with specific commentary on the efficacy and toxicity for elderly patients...
April 2018: Expert Opinion on Pharmacotherapy
Michela Tinelli, Panagiotis Petrou, George Samoutis, George Olympios, Alistair McGuire
Objective: To measure patient preferences for their diabetic care in community setting. Design: Discrete-choice survey. Setting: Community setting (primary physician and hospital sites) in Cyprus. Participants: Diabetic patients attending community sites. Main Outcome Measure(s): Patient preferences, to estimate which components of quality healthcare service people value, their relative importance but also the potential shift to shared decision-making (SDM)...
March 24, 2018: International Journal for Quality in Health Care
Maximilian Herrmann, Philip Boehme, Thomas Mondritzki, Jan P Ehlers, Stylianos Kavadias, Hubert Truebel
BACKGROUND: Digital innovation, introduced across many industries, is a strong force of transformation. Some industries have seen faster transformation, whereas the health care sector only recently came into focus. A context where digital corporations move into health care, payers strive to keep rising costs at bay, and longer-living patients desire continuously improved quality of care points to a digital and value-based transformation with drastic implications for the health care sector...
March 27, 2018: Journal of Medical Internet Research
John F P Bridges, Thomas Lynch, Anne L R Schuster, Norah L Crossnohere, Katherine Clegg Smith, Rebecca A Aslakson
BACKGROUND: Advance care planning (ACP) aids can help prepare patients, family members, and physicians for in-the-moment medical decision-making. We wished to describe the content and approach of paper-based ACP aids in order to characterize existing aids and inform the development of a new ACP aid. METHODS: Paper-based ACP aids were identified through an environmental scan and screened for eligibility. ACP conceptual frameworks and data were gathered via stakeholder engagement and used to inform the coding framework that two investigators used to independently code each aid...
March 27, 2018: BMC Palliative Care
Jacob R Morris, Erik P Hess
In this issue of Academic Emergency Medicine, Schoenfeld et al. report a qualitative analysis of Shared decision-making (SDM) from the perspective of Emergency Department (ED) patients. Shared decision-making is "a collaborative process in which patients and providers make health care decisions together, taking into account the best evidence available, as well as the patient's values and preferences." Drawing on this definition, the investigators in this study explored the degree to which ED patients desired to be involved in SDM, as well as perceived facilitators and barriers to SDM...
March 25, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
N Bradley, M Lloyd-Williams, C Dowrick
Individuals managing the challenges of life-limiting illness require adequate social support to maintain quality of life. Qualitative research reports that patients value highly the social support obtained in palliative care interventions such as day care and group therapies. This systematic review aims to summarise existing quantitative evidence on palliative care interventions that facilitate social support. Research literature was systematically searched using electronic databases and key journals. Searches returned a total of 6,247 unique titles of which sixteen were eligible for inclusion...
March 24, 2018: European Journal of Cancer Care
Kateřina Rusinová, Markéta Červenková, Zuzana Čepelíková, Ondřej Kopecký
Palliative care is an important constituent of widely accepted quality care standard in seriously ill patients. The needs of these patients in perioperative setting or in intensive care are considerable for attending teams. Principal issues discussed include excellent communication skills during decision making before a high-risk surgery, and risk-benefit weighting in order to respect patients values and preferences. This article, based on examples of interventions in both perioperative care and in intensive care units, aims to demonstrate a complex integrated palliative approach...
2018: Casopís Lékar̆ů C̆eských
Emily Nicholls, Victoria Robinson, Lisa Farndon, Wesley Vernon
Background: This narrative review explores the ways in which drawing on theories and methods used in sociological work on footwear and identity can contribute to healthcare research with podiatrists and their patients, highlighting recent research in this field, implications for practice and potential areas for future development.Traditionally, research within Podiatry Services has tended to adopt a quantitative, positivist focus, developing separately from a growing body of sociological work exploring the importance of shoes in constructing identity and self-image...
2018: Journal of Foot and Ankle Research
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