The use of PROMs and shared decision-making in medical encounters with patients: An opportunity to deliver value-based health care to patients

被引:106
作者
Damman, Olga C. [1 ]
Jani, Anant [2 ]
de Jong, Brigit A. [3 ]
Becker, Annemarie [4 ,5 ]
Metz, Margot J. [6 ,7 ]
de Bruijne, Martine C. [1 ]
Timmermans, Danielle R. [1 ]
Cornel, Martina C. [8 ]
Ubbink, Dirk T. [9 ]
van der Steen, Marije [10 ]
Gray, Muir [2 ]
van El, Carla [8 ]
机构
[1] Vrije Univ Amsterdam, Amsterdam UMC, Dept Publ & Occupat Hlth, Amsterdam Publ Hlth Res Inst, Amsterdam, Netherlands
[2] Univ Oxford, Dept Primary Care, Value Based Healthcare Programme, Oxford, England
[3] Vrije Univ Amsterdam, Amsterdam UMC, Amsterdam Neurosci Res Inst, Dept Neurol,MS Ctr Amsterdam, Amsterdam, Netherlands
[4] Vrije Univ Amsterdam, Amsterdam UMC, Dept Pulm Dis, Amsterdam, Netherlands
[5] Univ Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
[6] GGz Breburg, Tranzo Sci Ctr Care & Wellbeing, Tilburg Sch Social & Behav Sci, Tilburg, Netherlands
[7] Tilburg Univ, Tilburg, Netherlands
[8] Vrije Univ Amsterdam, Amsterdam Publ Hlth Res Inst, Dept Clin Genet, Amsterdam UMC, Amsterdam, Netherlands
[9] Univ Amsterdam, Amsterdam UMC, Dept Surg, Amsterdam, Netherlands
[10] Vrije Univ Amsterdam, Dept Strategy & Policy, Amsterdam UMC, Amsterdam, Netherlands
基金
欧盟地平线“2020”;
关键词
patient-reported outcome measures; routine outcome monitoring; shared decision-making; value-based health care; REPORTED OUTCOME MEASURES; RADIATION ONCOLOGISTS; QUALITY IMPROVEMENT; CLINICAL-PRACTICE; INFORMATION; CANCER; IMPACT; DESIGN; COMMUNICATION; PROFESSIONALS;
D O I
10.1111/jep.13321
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background The recent emphasis on value-based health care (VBHC) is thought to provide new opportunities for shared decision-making (SDM) in the Netherlands, especially when using patient-reported outcome measures (PROMs) in routine medical encounters. It is still largely unclear about how PROMs could be linked to SDM and what we expect from clinicians in this respect. Aim To describe approaches and lessons learned in the fields of SDM and VBHC implementation that converge in using PROMs in medical encounters. Approach Based on input from three Dutch forerunner case examples and available evidence about SDM and VBHC, we describe barriers and facilitators regarding the use of PROMs and SDM in the medical encounter. Barriers and facilitators were structured according to a conversational model that included monitoring and managing, team talk, option talk, choice talk, and decision talk. Key lessons learned and recommendations were synthesized. Results The use of individual, N = 1 PROMs scores in the medical encounter has been largely achieved in the forerunner projects. Conversation on monitoring and managing is relatively well implemented, and option talk to some extent, unlike team talk, and decision talk. Aggregated PROMs information describing outcomes of treatment options seemed to be scarcely used. Experienced barriers largely corresponded to what is known from the literature, eg, perceived lack of time and lack of tools summarizing the options. Some concerns were identified about increasing health care consumption as a result of using PROMs and SDM in the medical encounter. Conclusion Successful implementation of SDM within VBHC initiatives may not be self-evident, even though individual, N = 1 PROMs scores are being used in the medical encounter. Education and staff resources on meso and macro levels may facilitate the more time-consuming SDM aspects. It seems fruitful to especially target team talk and choice talk in redesigning clinical pathways.
引用
收藏
页码:524 / 540
页数:17
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