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Fontaine S, Gautier L, Diependaele AS, Hamieh M, Morello R, Guillouët S, Bertran F. Impact of educational actions on the quality of life of patients with epilepsy: A randomised controlled trial. Epilepsy Res 2023; 192:107128. [PMID: 37027966 DOI: 10.1016/j.eplepsyres.2023.107128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 02/08/2023] [Accepted: 03/20/2023] [Indexed: 04/07/2023]
Abstract
INTRODUCTION Epilepsy is a common and disabling disease for patients and their families. The care of these patients is no longer limited to the simple control of seizures, but considers, in a more global way, their quality of life (QOL). Improving the QOL is precisely one of the main objectives of therapeutic education. The aim of this study was to evaluate the impact of educational actions on the global QOL of patients with epilepsy. MATERIALS AND METHODS This study was carried out between October 2016 and August 2018. 80 patients were included over 18 years old with an epileptic condition diagnosed for at least 6 months and treated in the University Hospital of Caen Normandy in France. They were randomised to either the control group with usual care or the experimental group with the group educational sessions. The overall score for the QOLIE-31 survey was assessed from the inclusion (M0) and 6 months late. RESULTS At the M0 mark, the score of the control group (58.1 ± 12.3) was significantly lower than that of the experimental group (61.1 ± 14.3). After 6 months, the overall QOL score, was significantly higher for the experimental group compared to the control group (p = 0.002). In the experimental group, the overall score went from 61.1 ± 14.3-69 ± 14.2 and in the control group it went from 58.1 ± 12.3-58 ± 16.2. DISCUSSION The quality-of-life overall score for patients having participated in educational actions provided by epilepsy specialist nurses improved significantly. Complementary research is necessary to assess the sustainability of these effects and interactions with the caregivers.
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Sullivan-Baca E, Rehman R, Towne AR, Haneef Z. Psychiatric co-morbidity of drug-resistant epilepsy in Veterans. Epilepsy Behav 2023; 139:109059. [PMID: 36577335 DOI: 10.1016/j.yebeh.2022.109059] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/24/2022] [Accepted: 12/09/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Psychiatric conditions are frequently co-morbid in epilepsy and studies examining Veterans with epilepsy suggest this population may present with unique psychiatric and clinical features Drug-resistant epilepsy (DRE) may confer a greater risk of psychiatric dysfunction; however, there is a paucity of literature documenting this. To expand our clinical understanding of Veterans with DRE, we assessed a comprehensive Veterans Health Administration (VHA)-wide sample, describing psychiatric conditions, medications, and healthcare utilization. METHODS Psychiatric and hospitalization data were collected on 52,579 Veterans enrolled in VHA healthcare between FY2014-2ndQtr.FY2020 from the VHA Corporate Data Warehouse administrative data. Data examined include psychiatric diagnosis, psychotropic medication use, and utilization of hospital services. RESULTS At least one psychiatric diagnosis was present in 70.2% of patients, while 49.8% had two or more diagnoses. Depression (51.7%), posttraumatic stress disorder (PTSD) (38.8%), and anxiety (38.0%) represented the most common psychiatric co-morbidities. Psychiatric medication use was present in 73.3%. Emergency room (ER) visits were highest in those with suicidality (mean 14.9 visits), followed by bipolar disorder (10.3), and schizophrenia (12.1). Psychiatric-related hospitalizations were highest for schizophrenia (mean 2.5 admissions) and bipolar disorder (2.3). Females had more psychiatric diagnoses (2.4 vs. 1.6, p < 0.001), psychiatric medications (3.4 vs. 2.3, p < 0.001), and ER utilization than males (6.9 vs. 5.5, p < 0.001). SIGNIFICANCE A substantial psychiatric burden exists among Veterans with DRE. Compared to prior epilepsy literature, results suggest that Veterans with DRE evidence more prevalent psychiatric comorbidity, emergency care usage, and inpatient psychiatric admissions. Females were especially impacted, with greater rates of psychiatric conditions and treatment. Considering the relationship of psychiatric comorbidities in epilepsy with psychosocial functioning and quality of life, our findings highlight the need for screening and provision of services for those with DRE.
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Affiliation(s)
- Erin Sullivan-Baca
- Department of Neurology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, United States.
| | - Rizwana Rehman
- Durham VA Medical Center, 508 Fulton St., Durham, NC 27705, United States; Epilepsy Centers of Excellence, Veteran's Health Administration, United States.
| | - Alan R Towne
- Epilepsy Centers of Excellence, Veteran's Health Administration, United States; Department of Neurology, Virginia Commonwealth University School of Medicine, Richmond, VA, United States; Epilepsy Centers of Excellence, Hunter Holmes McGuire VA Medical Center, United States.
| | - Zulfi Haneef
- Department of Neurology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, United States; Epilepsy Centers of Excellence, Veteran's Health Administration, United States; Neurology Care Line, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd., Houston, TX 77030, United States.
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Chuah A, Ding K, Morgado A, McCreary M, Zuberi F, Agostini M, Doyle A. Effects of psychiatric comorbidities in persons with epilepsy on recurrent emergency department visits. Epilepsy Behav 2022; 136:108909. [PMID: 36152383 DOI: 10.1016/j.yebeh.2022.108909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/28/2022] [Accepted: 08/29/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Coexisting mental health disorders in persons with epilepsy present as substantial burdens to patients and healthcare systems. STUDY DESIGN AND METHODS In this retrospective study, we reviewed 160 patients presenting to a safety net hospital Emergency Department (ED) with seizures to investigate whether differences in clinical workup, follow-ups, and ED visit recurrence existed between epilepsy patients with epilepsy with and without a coexisting psychiatric disorder. RESULTS Patients with epilepsy with a psychiatric comorbidity had more subsequent ED visits (45 % vs 26 %, p = 0.01) and fewer outpatient follow-up opportunities (74 % vs 87 %, p = 0.042) compared to patients with epilepsy without psychiatric comorbidities, highlighting a healthcare gap that needs to be addressed. INTERPRETATION Our findings suggest a need for ED providers to shift their clinical practice in favor of offering more outpatient follow-up opportunities, to ensure long-term management of seizures in patients with epilepsy with comorbid psychiatric disorders.
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Affiliation(s)
- Ashleigh Chuah
- UT Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX 75390, USA.
| | - Kan Ding
- UT Southwestern Medical Center, Department of Neurology, 5323 Harry Hines Blvd, Dallas, TX 75390, USA.
| | - Anika Morgado
- UT Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX 75390, USA.
| | - Morgan McCreary
- UT Southwestern Medical Center, Department of Neurology, 5323 Harry Hines Blvd, Dallas, TX 75390, USA.
| | - Fatima Zuberi
- UT Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX 75390, USA.
| | - Mark Agostini
- UT Southwestern Medical Center, Department of Neurology, 5323 Harry Hines Blvd, Dallas, TX 75390, USA.
| | - Alexander Doyle
- UT Southwestern Medical Center, Department of Neurology, 5323 Harry Hines Blvd, Dallas, TX 75390, USA.
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Analysis of Emergency Department Visits and Unplanned Readmission After Bariatric Surgery: An Experience From a Tertiary Referral Center. SURGICAL LAPAROSCOPY, ENDOSCOPY & PERCUTANEOUS TECHNIQUES 2021; 32:107-113. [PMID: 34653112 DOI: 10.1097/sle.0000000000001011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/12/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Bariatric surgery is the most effective treatment of morbid obesity. As the number of bariatric procedures performed has increased, visits to the emergency department (ED) and readmissions have subsequently increased. The present study aimed to assess the rates and indications for of ED visits and readmission after bariatric surgery and to identify the predictors of hospital readmission. PATIENTS AND METHODS This was a retrospective cohort study on patients who underwent bariatric surgery from January 2018 to April 2020. The percentage of ED visits and unplanned readmission was estimated and the indications and management of each were analyzed. The association of age, sex, body mass index, and type of procedure with readmission was assessed. RESULTS Of 582 patients who underwent bariatric surgery in the study period, 204 (35%) required ED visits, and 42 (7.2%) required readmission. The mean age of patients was 33 years, and the mean body mass index was 43 kg/m2. The most common indication for ED visits was abdominal pain (41.2%). In all, 64.8% of ED visits and 43% of readmissions were unrelated to bariatric surgery complications. A total of 94.1% of patients who required ED visits and 71.4% of readmitted patients were managed conservatively. The most common procedure followed by readmission was laparoscopic sleeve gastrectomy (50%) then one-anastomosis gastric bypass (21.4%). Age, sex, body mass index, and procedure type were not significantly associated with higher readmission. CONCLUSIONS The rates of ED visits and readmission in our cohort were 35% and 7.2%, respectively. Most cases of ED visits were not related to adverse effects of bariatric surgery and the majority of which were managed conservatively.
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Chiu ATG, Li J, Chang RSK, Chung CCY, Wong WHS, Ip P, Chan SHS. Prevalence and healthcare utilization of rare neurological diseases in Hong Kong: 2014-2018. Eur J Neurol 2021; 28:2305-2312. [PMID: 33793024 DOI: 10.1111/ene.14852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/22/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND There has been increasing attention focused on the epidemiology of rare diseases (RDs) in recent years. Rare neurological diseases (RNDs) constitute a significant proportion of RDs; however, relevant research is still lacking. METHODS A list of ICD-10 codes corresponding to RNDs was compiled using adaptations from the Orphanet Classification of Rare Diseases, and classified into rare epilepsy, movement-related, neurocutaneous, neuroimmune, neurometabolic and neurodegenerative, neuromuscular and other RNDs. Using the Clinical Data Analysis and Reporting System, which holds public hospital healthcare records of Hong Kong anonymously, we calculated the prevalence and healthcare utilization of RND patients between 2014 and 2018. The list of RNDs was also used to review relevant pharmacological trials within the International Clinical Trials Registry Platform between 2009 and 2018. RESULTS The prevalence of RNDs in Hong Kong is 3.6 in 1,000 individuals. Patients with RNDs had frequent emergency department, outpatient and inpatient healthcare utilization. The average annual cost per patient is estimated at HKD 182,075 (€ 19,688). Different categories of RNDs showed different patterns of healthcare utilization. Moreover, there were only 677 RND-related pharmacological trials during the study period, and no trial was found for 78% of RNDs. CONCLUSIONS This is one of the first population studies on the prevalence and healthcare utilization patterns of RNDs, with comprehensive reviews of RND-related pharmacological research. It shows high healthcare utilization rates among patients with RNDs, as well as a wide research gap in many RNDs. We call for better attention and tailored healthcare for these patients.
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Affiliation(s)
- Annie Ting Gee Chiu
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China
| | - Jingjing Li
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.,Department of Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China
| | - Richard Shek Kwan Chang
- Department of Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China
| | - Claudia Ching Yan Chung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China
| | - Wilfred Hing Sang Wong
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China
| | - Sophelia Hoi Shan Chan
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China
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Min JY, Patel AD, Glynn P, Otgonsuren M, Harridas B, Grinspan ZM. Evaluation of a Care Management Program for Pediatric Epilepsy Patients. J Child Neurol 2021; 36:203-209. [PMID: 33095673 DOI: 10.1177/0883073820964165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the impact of a pediatric epilepsy care management intervention on emergency department visits, hospitalizations, and seizure freedom. METHODS We conducted a prospective observational study at a single academic medical center. Children with epilepsy with high risk of frequent emergency department use were enrolled in the intervention from January through May 2015, which included a baseline visit and follow-up support from a care management team. Controls selected from the same institution received standard of care. Baseline and follow-up information were collected from electronic health records and surveys (Family Impact Scale, Pediatric Epilepsy Medication Self-Management Questionnaire). Propensity score-weighted logistic regression compared emergency department visits, unplanned hospitalizations, and 3-month seizure freedom after 1 year in the intervention vs control groups. RESULTS A total of 56 children were enrolled in the intervention and 359 received standard of care. The intervention group was younger and had greater use of health services at baseline. When comparing the intervention to standard of care after 1 year, we found no significant difference in the risk of any emergency department visit (adjusted odds ratio [OR] 2.2, 95% confidence interval [CI] 0.6-8.5) or seizure freedom (adjusted OR 2.5, 95% CI 0.3-21.5). However, the risk of unplanned hospital admissions remained higher in the intervention group (adjusted OR 23.1, 95% CI 5.1-104). CONCLUSION We did not find that children with epilepsy who received a care management intervention had less use of health services or better clinical outcomes after a year compared with controls. The study is limited by small sample size and nonrandomized study design.
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Affiliation(s)
- Jea Young Min
- Department of Population Health Sciences, 5922Weill Cornell Medicine, New York, NY, USA
| | - Anup D Patel
- 2650Nationwide Children's Hospital, Columbus, OH, USA
| | - Peter Glynn
- 2650Nationwide Children's Hospital, Columbus, OH, USA
| | - Munkhzul Otgonsuren
- Department of Population Health Sciences, 5922Weill Cornell Medicine, New York, NY, USA
| | - Babitha Harridas
- Jacobs School of Medicine and Biomedical Sciences, 12292University at Buffalo, Buffalo, NY, USA
| | - Zachary M Grinspan
- Department of Population Health Sciences, 5922Weill Cornell Medicine, New York, NY, USA.,Department of Pediatrics, 5922Weill Cornell Medicine, New York, NY, USA
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Leonard-Murali S, Nasser H, Ivanics T, Genaw J. Predictors of postoperative emergency department visits after laparoscopic bariatric surgery. Surg Obes Relat Dis 2020; 16:1483-1489. [DOI: 10.1016/j.soard.2020.05.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 04/02/2020] [Accepted: 05/18/2020] [Indexed: 10/24/2022]
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Michel HK, Noll RB, Siripong N, Kim SC. Patterns of Primary, Specialty, Urgent Care, and Emergency Department Care in Children With Inflammatory Bowel Diseases. J Pediatr Gastroenterol Nutr 2020; 71:e28-e34. [PMID: 32142000 PMCID: PMC8083894 DOI: 10.1097/mpg.0000000000002703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Pediatric patients with inflammatory bowel diseases (IBD) require treatment, monitoring, and health maintenance services. We described patterns of primary, specialty, emergency department (ED) and urgent care delivery, and explored patient- and system-related variables that impact ED/urgent care utilization. METHODS We conducted a cross sectional survey of parents of children with IBD at a large tertiary children's hospital. RESULTS One hundred sixty-one parents completed the survey (75% response). Mean patient age 13.9 years (51% boys); 80% Crohn disease, 16% ulcerative colitis, 4% IBD-unspecified. Mean disease duration 4 years (standard deviation [SD] 2.7). Thirty percent had at least 1 other chronic disease, 31% had a history of IBD-related surgery. Parents were predominantly Caucasian (94%), well-educated (61% bachelor's degree/higher), part of a 2-parent household (79%) living in a suburban setting (57%). Seventy-seven percent of patients had private insurance. In the past year, most children had 1 to 2 IBD-related office visits (54%) with their gastroenterology (GI) doctor and no IBD-related hospitalizations (79%). Eighty-eight percent (N = 141) had a primary care provider (PCP), and most (70%) saw their PCP 1 to 2 times. Even so, 86% (N = 139) received medical care from places other than their PCP or GI doctor; 27% in the ED and 45% at urgent care. Children of parents with less than a bachelor's degree, families that lived further from their GI doctor, and children who saw their PCP more often were more likely to utilize ED/urgent care. CONCLUSIONS ED/urgent care utilization in pediatric patients with IBD was greater than expected, potentially contributing to fragmented, costly care and worse outcomes.
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Affiliation(s)
- Hilary K. Michel
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Nationwide Children’s Hospital, Columbus, OH
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center (UPMC) Children’s Hospital of Pittsburgh, Pittsburgh, PA
| | - Robert B. Noll
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA
| | - Nalyn Siripong
- Clinical Translational Science Institute, University of Pittsburgh, Pittsburgh, PA
| | - Sandra C. Kim
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center (UPMC) Children’s Hospital of Pittsburgh, Pittsburgh, PA
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Burrows L, Lennard S, Hudson S, McLean B, Jadav M, Henley W, Sander JW, Shankar R. Exploring epilepsy attendance at the emergency department and interventions which may reduce unnecessary attendances: A scoping review. Seizure 2020; 76:39-46. [PMID: 31999986 DOI: 10.1016/j.seizure.2020.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 01/14/2020] [Accepted: 01/19/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Repeat attendances to emergency departments for seizures, impacts on the individual and burdens health care systems. We conducted a review to identify implementable measures which improve the management of people with epilepsy reducing healthcare costs and their supportive evidence. METHODS A scoping review design using suitable search strategy as outlined by PRISMA-ScR was used to examine seven databases: MEDLINE, EMBASE, CINAHL, AMED, PsychINFO, HMIC and BNI. A manual search of the COCHRANE database and citation searching was also conducted. A thematic analysis was conducted to explore the context and reasons of emergency department attendance for seizures, particularly repeat attendances and the strategies and measures deployed to reduce repeat attendances. RESULTS Twenty-nine reports were included, comprising of a systematic review, a randomised control study, a multi-method study, quantitative studies (n = 17), qualitative studies (n = 6), an audit, a survey and a quality improvement project. Thematic analysis identified four broad areas for reducing repeat attendances. These were developing care pathways, conducting care and treatment reviews, providing educational interventions and role of ambulance staff. CONCLUSION The findings indicate varied reasons for attendance at ED following seizure, including mental health and knowledge of seizure management and lack of education. Implementations of care pathways in ED have been found to reduce admission related costs.
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Affiliation(s)
- Lisa Burrows
- Department of Intellectual Disability Neuropsychiatry, Research Team, Cornwall Partnership NHS Foundation Trust, Truro, TR1 3QB, UK; University of Plymouth, UK
| | - Sarah Lennard
- Department of Intellectual Disability Neuropsychiatry, Research Team, Cornwall Partnership NHS Foundation Trust, Truro, TR1 3QB, UK
| | - Sharon Hudson
- Department of Intellectual Disability Neuropsychiatry, Research Team, Cornwall Partnership NHS Foundation Trust, Truro, TR1 3QB, UK
| | | | - Mark Jadav
- Royal Cornwall Hospital NHS Trust, TR1 3HD, UK
| | - William Henley
- Exeter Medical School, Knowledge Spa, Truro, TR1 3HD, UK
| | - Josemir W Sander
- UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK; Chalfont Centre for Epilepsy, Buckinghamshire, SL9 0RJ, UK; Stichting Epilepsie Instellingen Nederland (SEIN), Achterweg 5, 2103 SW, Heemstede, the Netherlands
| | - Rohit Shankar
- Department of Intellectual Disability Neuropsychiatry, Research Team, Cornwall Partnership NHS Foundation Trust, Truro, TR1 3QB, UK; Exeter Medical School, Knowledge Spa, Truro, TR1 3HD, UK.
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Exploring the Associations Between Patient Affect, Self-Care Actions, and Emergency Department Use for Community-Dwelling Adults. J Nurs Care Qual 2019; 34:175-179. [PMID: 30044270 DOI: 10.1097/ncq.0000000000000348] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nurses and other health care providers need to ensure that patients receive care that addresses their specific needs and wants. PURPOSE This exploratory study examined the associations between patients' self-reported positive and negative affect, the perceived importance of 57 self-care actions, the desire and ability to perform them, and emergency department use in the past 3 months. METHODS A secondary analysis from a cross-sectional survey project that surveyed 250 community-dwelling adults living in the southern United States, 2015-2016. Independent t tests and the χ test were used. RESULTS Positive affect was associated with positive perceptions of self-care actions and having no emergency department visit. Patients with a more negative affect perceived finding and using services that support their health behaviors as being important and expressed a desire to participate in local health screening or wellness events. CONCLUSIONS Patients' perceptions of their self-care actions could lead to better outcomes.
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Winston K, Grendarova P, Rabi D. Video-based patient decision aids: A scoping review. PATIENT EDUCATION AND COUNSELING 2018; 101:558-578. [PMID: 29102063 DOI: 10.1016/j.pec.2017.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 10/06/2017] [Accepted: 10/16/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This study reviews the published literature on the use of video-based decision aids (DA) for patients. The authors describe the areas of medicine in which video-based patient DA have been evaluated, the medical decisions targeted, their reported impact, in which countries studies are being conducted, and publication trends. METHOD The literature review was conducted systematically using Medline, Embase, CINAHL, PsychInfo, and Pubmed databases from inception to 2016. References of identified studies were reviewed, and hand-searches of relevant journals were conducted. RESULTS 488 studies were included and organized based on predefined study characteristics. The most common decisions addressed were cancer screening, risk reduction, advance care planning, and adherence to provider recommendations. Most studies had sample sizes of fewer than 300, and most were performed in the United States. Outcomes were generally reported as positive. This field of study was relatively unknown before 1990s but the number of studies published annually continues to increase. CONCLUSION Videos are largely positive interventions but there are significant remaining knowledge gaps including generalizability across populations. PRACTICE IMPLICATIONS Clinicians should consider incorporating video-based DA in their patient interactions. Future research should focus on less studied areas and the mechanisms underlying effective patient decision aids.
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Affiliation(s)
- Karin Winston
- Alberta Children's Hospital, 2800 Shaganappi Trail NW, Calgary, Alberta, T3B 6A8, Canada.
| | - Petra Grendarova
- University of Calgary, Division of Radiation Oncology, Calgary, Canada
| | - Doreen Rabi
- University of Calgary, Department of Medicine, Calgary, Canada
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Grinspan ZM, Patel AD, Hafeez B, Abramson EL, Kern LM. Predicting frequent emergency department use among children with epilepsy: A retrospective cohort study using electronic health data from 2 centers. Epilepsia 2017; 59:155-169. [DOI: 10.1111/epi.13948] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Zachary M. Grinspan
- Department of Healthcare Policy and Research; Weill Cornell Medicine; New York NY USA
- Department of Pediatrics; Weill Cornell Medicine; New York NY USA
- New York Presbyterian Hospital; New York NY USA
| | | | - Baria Hafeez
- Department of Healthcare Policy and Research; Weill Cornell Medicine; New York NY USA
| | - Erika L. Abramson
- Department of Healthcare Policy and Research; Weill Cornell Medicine; New York NY USA
- Department of Pediatrics; Weill Cornell Medicine; New York NY USA
- New York Presbyterian Hospital; New York NY USA
| | - Lisa M. Kern
- Department of Healthcare Policy and Research; Weill Cornell Medicine; New York NY USA
- New York Presbyterian Hospital; New York NY USA
- Department of Medicine; Weill Cornell Medicine; New York NY USA
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