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Sleath B, Beznos B, Carpenter D, Thomas K, Annis I, Tudor G, Garcia N, Adjei A, Anastopoulos A, Leslie L, Coyne I. A pre-visit video/question prompt list intervention to increase youth question-asking about attention deficit hyperactivity disorder during pediatric visits. PATIENT EDUCATION AND COUNSELING 2024; 127:108320. [PMID: 38851012 DOI: 10.1016/j.pec.2024.108320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 04/09/2024] [Accepted: 05/10/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVE To conduct a pragmatic randomized controlled trial to test the effectiveness of an ADHD question prompt list with video intervention to increase youth question-asking and provider education about ADHD during visits. METHODS English-speaking youth ages 11-17 with ADHD and their caregivers were enrolled from two pediatric clinics. Youth were randomized to intervention or usual care groups. Intervention group adolescents watched the video and then completed an ADHD question prompt list before their visits. Multivariable regression was used to analyze the data. RESULTS Twenty-one providers and 102 of their patients participated. Intervention group youth were significantly more likely to ask one or more questions about ADHD and its treatment than usual care youth (odds ratio=5.4, 95 % Confidence Interval (CI)= 1.8, 15.9). Providers were significantly more likely to educate youth who asked one or more questions during visits about more ADHD medication areas (unstandardized beta=0.98, 95 % CI=0.31 to 1.64) and more non-medication strategies for ADHD (unstandardized beta=0.50, 95 % CI=0.13 to 0.88). CONCLUSION The intervention increased youth question-asking about ADHD and its treatment. Providers provided more education to youth who asked one or more questions about ADHD and its treatment. PRACTICE IMPLICATIONS Providers and practices should consider having youth complete ADHD question prompt lists and watch the video before visits to increase youth question-asking during visits.
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Affiliation(s)
- Betsy Sleath
- Department of Pharmaceutical Outcomes and Policy, University of North Carolina Chapel Hill, Chapel Hill, NC, USA; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, NC, USA.
| | - Bethany Beznos
- Department of Pharmaceutical Outcomes and Policy, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
| | - Delesha Carpenter
- Department of Pharmaceutical Outcomes and Policy, University of North Carolina Chapel Hill, Chapel Hill, NC, USA; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, NC, USA.
| | - Kathleen Thomas
- Department of Pharmaceutical Outcomes and Policy, University of North Carolina Chapel Hill, Chapel Hill, NC, USA; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, NC, USA.
| | - Izabela Annis
- Department of Pharmaceutical Outcomes and Policy, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
| | - Gail Tudor
- Southern New Hampshire University, Manchester, NH, USA.
| | - Nacire Garcia
- Department of Pharmaceutical Outcomes and Policy, University of North Carolina Chapel Hill, Chapel Hill, NC, USA; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, NC, USA.
| | - Abena Adjei
- Department of Pharmaceutical Outcomes and Policy, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
| | | | - Laurel Leslie
- American Board of Pediatrics, Chapel Hill, NC, USA; Tufts University School of Medicine, Boston, MA, USA.
| | - Imelda Coyne
- Trinity College Dublin, College Green, Dublin 2, Ireland.
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Kamal AN, Wang CHJ, Triadafilopoulos G, Diehl DL, DuCoin C, Dunst CM, Falk G, Iyer PG, Katzka DA, Konda VJA, Muthusamy R, Otaki F, Pleskow D, Rubenstein JH, Shaheen NJ, Sharma P, Smith MS, Sujka J, Swanstrom LL, Tatum RP, Trindade AJ, Ujiki M, Wani S, Clarke JO. A Delphi Method for Development of a Barrett's Esophagus Question Prompt List as a Communication Tool for Optimal Patient-physician Communication. J Clin Gastroenterol 2024; 58:131-135. [PMID: 36753462 DOI: 10.1097/mcg.0000000000001832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 01/02/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND METHODS The question prompt list content was derived through a modified Delphi process consisting of 3 rounds. In round 1, experts provided 5 answers to the prompts "What general questions should patients ask when given a new diagnosis of Barrett's esophagus" and "What questions do I not hear patients asking, but given my expertise, I believe they should be asking?" Questions were reviewed and categorized into themes. In round 2, experts rated questions on a 5-point Likert scale. In round 3, experts rerated questions modified or reduced after the previous rounds. Only questions rated as "essential" or "important" were included in Barrett's esophagus question prompt list (BE-QPL). To improve usability, questions were reduced to minimize redundancy and simplified to use language at an eighth-grade level (Fig. 1). RESULTS Twenty-one esophageal medical and surgical experts participated in both rounds (91% males; median age 52 years). The expert panel comprised of 33% esophagologists, 24% foregut surgeons, and 24% advanced endoscopists, with a median of 15 years in clinical practice. Most (81%), worked in an academic tertiary referral hospital. In this 3-round Delphi technique, 220 questions were proposed in round 1, 122 (55.5%) were accepted into the BE-QPL and reduced down to 76 questions (round 2), and 67 questions (round 3). These 67 questions reached a Flesch Reading Ease of 68.8, interpreted as easily understood by 13 to 15 years olds. CONCLUSIONS With multidisciplinary input, we have developed a physician-derived BE-QPL to optimize patient-physician communication. Future directions will seek patient feedback to distill the questions further to a smaller number and then assess their usability.
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Affiliation(s)
- Afrin N Kamal
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Redwood City
| | - Chih-Hung Jason Wang
- Department of Pediatrics and Department of Health Policy, Stanford University School of Medicine, Stanford
| | - George Triadafilopoulos
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Redwood City
| | - David L Diehl
- Department of Gastroenterology and Nutrition, Geisinger Medical Center, Geisinger Commonwealth School of Medicine, Danville
| | - Christopher DuCoin
- Department of Surgery, USF Morsani College of Medicine, University of South Florida
| | - Christy M Dunst
- Division of Gastrointestinal and Minimally Invasive Surgery, The Oregon Clinic Center for Advanced Surgery
| | - Gary Falk
- Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Prasad G Iyer
- Division of Gastroenterology and Hepatology, Mayo Clinic Minnesota, Rochester, MN
| | | | - Vani J A Konda
- Department of Medicine, Section of Gastroenterology and Hepatology, Baylor University Medical Center, Dallas, TX
| | - Raman Muthusamy
- Division of Digestive Diseases, Vatche and Tamar Manoukian David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Fouad Otaki
- Division of Gastroenterology and Hepatology, Oregon Health and Science University, Portland, OR
| | - Douglas Pleskow
- Division of Gastroenterology Beth Israel Deaconess Medical Center, Boston, MN
| | - Joel H Rubenstein
- Division of Gastroenterology, Department of Medicine, Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan; Barrett's Esophagus Program, University of Michigan, Ann Arbor, MI
| | - Nicholas J Shaheen
- Division of Gastroenterology and Hepatology, Department of Medicine, Center for Esophageal Diseases and Swallowing, University of North Carolina, Chapel Hill, NC
| | - Prateek Sharma
- Division of Gastroenterology and Hepatology, University of Kansas School of Medicine, Veterans Affairs Medical Center, Kansas City, MS
| | - Michael S Smith
- Division of Gastroenterology and Hepatology, Department of Medicine, Mount Sinai West and Mount Sinai Morningside Hospitals, Icahn School of Medicine at Mount Sinai, New York
| | - Joseph Sujka
- Department of Surgery, Tampa General Hospital, Tampa, FL
| | - Lee L Swanstrom
- Insitute of Image-Guided Surgery, IHU-Strasbourg (Institut Hospitalo-Universitaire), Strasbourg, FR
| | - Roger P Tatum
- Department of Surgery, University of Washington School of Medicine and VA Puget Sound Health Care System, Seattle, WA
| | - Arvind J Trindade
- Division of Gastroenterology, Long Island Jewish Medical Center, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, New Hyde Park, NY
| | - Michael Ujiki
- Department of Surgery, University of Chicago, Pritzker School of Medicine, Chicago, IL
| | - Sachin Wani
- University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO
| | - John O Clarke
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Redwood City
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Seery C, Wrigley M, O'Riordan F, Kilbride K, Bramham J. What adults with ADHD want to know: A Delphi consensus study on the psychoeducational needs of experts by experience. Health Expect 2022; 25:2593-2602. [PMID: 35999687 PMCID: PMC9615057 DOI: 10.1111/hex.13592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION A lack of knowledge about attention-deficit/hyperactivity disorder (ADHD) can contribute to feelings of distress and difficulty in seeking and accepting an ADHD diagnosis. The present study uses a Delphi consensus design to investigate the psychoeducational needs of adults with ADHD and the information about ADHD they would like included in digital health interventions for adults with ADHD. Inclusion of perspectives of service users in developing such interventions ensures that they are evidence based and addresses the risks of engagement barriers. METHODS The expert panel consisted of 43 adults with ADHD (age range: 23-67 years). Panel members were asked to rate the importance of the proposed topics and provide additional suggestions. Suggested topics and topics that did not achieve consensus were included for ranking in the second round. RESULTS Interquartile ratings were used to determine consensus. A high consensus was achieved in both rounds, with an agreement on 94% of topics in the first round and 98% in the second round. Most topics were rated as important or essential. CONCLUSIONS The findings highlighted that adults with ADHD want to learn about many different aspects of ADHD and the importance of considering their perspectives when developing psychosocial interventions. Findings can be applied when creating psychoeducational content for adult ADHD. PATIENT OR PUBLIC CONTRIBUTION Adults with ADHD were recruited to the Delphi panel to use an experts-by-experience approach. In doing so, we are engaging service users in the development of a psychoeducational smartphone app. The evaluation of the app will involve interviews with app users. Additionally, the present study was developed and conducted with ADHD Ireland, a charity based in Ireland that advocates for people with ADHD.
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Affiliation(s)
- Christina Seery
- UCD School of PsychologyUniversity College DublinDublinIreland
| | - Margo Wrigley
- National Clinical Programme for ADHD in AdultsHealth Service ExecutiveDublinIreland
| | - Fiona O'Riordan
- National Clinical Programme for ADHD in AdultsHealth Service ExecutiveDublinIreland
| | | | - Jessica Bramham
- UCD School of PsychologyUniversity College DublinDublinIreland
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Gacki-Smith J, Kuramitsu BR, Downey M, Vanterpool KB, Nordstrom MJ, Luken M, Riggleman T, Altema W, Fichter S, Cooney CM, Dumanian GA, Jensen SE, Brandacher G, Tintle S, Levan M, Gordon EJ. Information needs and development of a question prompt sheet for upper extremity vascularized composite allotransplantation: A mixed methods study. Front Psychol 2022; 13:960373. [PMID: 36132190 PMCID: PMC9484522 DOI: 10.3389/fpsyg.2022.960373] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/20/2022] [Indexed: 11/24/2022] Open
Abstract
Background People with upper extremity (UE) amputations report receiving insufficient information about treatment options. Furthermore, patients commonly report not knowing what questions to ask providers. A question prompt sheet (QPS), or list of questions, can support patient-centered care by empowering patients to ask questions important to them, promoting patient-provider communication, and increasing patient knowledge. This study assessed information needs among people with UE amputations about UE vascularized composite allotransplantation (VCA) and developed a UE VCA-QPS. Methods This multi-site, cross-sectional, mixed-methods study involved in-depth and semi-structured interviews with people with UE amputations to assess information needs and develop a UE VCA-QPS. Qualitative data were analyzed by thematic analysis; quantitative data were analyzed by descriptive statistics. The initial UE VCA-QPS included 130 items across 18 topics. Results Eighty-nine people with UE amputations participated. Most were male (73%), had a mean age of 46 years, and had a unilateral (84%) and below-elbow amputation (56%). Participants desired information about UE VCA eligibility, evaluation process, surgery, risks, rehabilitation, and functional outcomes. After refinement, the final UE VCA-QPS included 35 items, across 9 topics. All items were written at a ≤ 6th grade reading level. Most semi-structured interview participants (86%) reported being ‘completely’ or ‘very’ likely to use a UE VCA-QPS. Conclusion People with UE amputations have extensive information needs about UE VCA. The UE VCA-QPS aims to address patients’ information needs and foster patient-centered care. Future research should assess whether the UE VCA-QPS facilitates patient-provider discussion and informed decision-making for UE VCA.
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Affiliation(s)
- Jessica Gacki-Smith
- Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Brianna R. Kuramitsu
- Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Max Downey
- Center for Surgical and Transplant Applied Research, Department of Surgery, NYU Langone Health Transplant Institute, New York University Grossman School of Medicine, New York, NY, United States
| | - Karen B. Vanterpool
- Center for Surgical and Transplant Applied Research, Department of Surgery, NYU Langone Health Transplant Institute, New York University Grossman School of Medicine, New York, NY, United States
| | - Michelle J. Nordstrom
- Center for Rehabilitation Sciences Research, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Michelle Luken
- Henry M. Jackson Foundation, Center for Rehabilitation Sciences Research, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Tiffany Riggleman
- Henry M. Jackson Foundation, Center for Rehabilitation Sciences Research, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Withney Altema
- Henry M. Jackson Foundation, Center for Rehabilitation Sciences Research, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Shannon Fichter
- Henry M. Jackson Foundation, Center for Rehabilitation Sciences Research, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Carisa M. Cooney
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Greg A. Dumanian
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sally E. Jensen
- Department of Medical Social Sciences and Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Gerald Brandacher
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Scott Tintle
- Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Macey Levan
- Center for Surgical and Transplant Applied Research, Department of Surgery and Department of Population Health, NYU Langone Health Transplant Institute, New York University Grossman School of Medicine, New York, NY, United States
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Elisa J. Gordon
- Department of Surgery-Division of Transplantation, Center for Health Services and Outcomes Research, Center for Bioethics and Medical Humanities, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- *Correspondence: Elisa J. Gordon,
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Munoz-Blanco S, Boss RD, DeCamp LR, Donohue PK. Developing an audio-based communication tool for NICU discharge of Latino families with limited English proficiency. PATIENT EDUCATION AND COUNSELING 2022; 105:1524-1531. [PMID: 34674921 DOI: 10.1016/j.pec.2021.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/01/2021] [Accepted: 09/04/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Research shows NICU Latino parents with limited English proficiency (LEP) feel less comfortable asking questions and participating in medical decision-making, which may negatively affect transition to community healthcare. Question prompt lists (QPL), suggested questions sometimes drawn from families and providers, can improve family-centered communication. We explored clinician and parent perceptions to inform development of and pilot a NICU discharge QPL. METHODS Focus groups with NICU and primary care providers explored perceived educational needs of Latino parents LEP and barriers to effective transition to community healthcare. Semi-structured interviews with Latino parents LEP explored perceptions of knowledge gaps and recommendations to improve the transition process. A Spanish audio QPL for parents and an English written version for providers were developed and pilot tested for acceptability. RESULTS Provider focus groups (n = 27) and parent interviews (n = 19) identified themes: decreased parent activation, knowledge gaps, limited-use interpreters, unfamiliarity with healthcare system, and social isolation as barriers to smooth NICU-to-home transition. Providers (n = 11) and parents (n = 10) favored QPL introduction early in NICU admission, finding it useful to improve communication and transition processes for families. CONCLUSION Our QPL may address challenges faced by Latino parents LEP when transitioning home. PRACTICE IMPLICATIONS QPLs may improve Latino NICU infants' healthcare outcomes.
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Affiliation(s)
- Sara Munoz-Blanco
- Johns Hopkins School of Medicine, Department of Pediatrics, 1800 Orleans St., Baltimore, MD 21287, United States.
| | - Renee D Boss
- Johns Hopkins School of Medicine, Department of Pediatrics, 1800 Orleans St., Baltimore, MD 21287, United States; Johns Hopkins Berman Institute of Bioethics, 1809 Ashland Ave, Baltimore, MD 21205, United States.
| | - Lisa Ross DeCamp
- Johns Hopkins School of Medicine, Department of Pediatrics, 1800 Orleans St., Baltimore, MD 21287, United States.
| | - Pamela K Donohue
- Johns Hopkins School of Medicine, Department of Pediatrics, 1800 Orleans St., Baltimore, MD 21287, United States; Johns Hopkins Bloomberg School of Public Health, 615N Wolfe St., Baltimore, MD 21205, United States.
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Do HTT, Edwards H, Finlayson K. Development of a surgical wound assessment tool to measure healing and risk factors for delayed wound healing in Vietnam: a Delphi process. J Wound Care 2022; 31:446-458. [PMID: 35579318 DOI: 10.12968/jowc.2022.31.5.446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To identify items and develop a surgical wound assessment tool (SWAT) to measure progress in healing and early detection of risk factors for delayed healing in surgical wounds in patients in Vietnam. METHOD The development process included two phases: (i) development of the initial SWAT based on evidence-based guidelines, results of a literature review and consultation with surgeons; and (ii) a Delphi process with wound care nurse experts to refine and provide consensus on a final version of the SWAT. Data collection took place between April-August 2017. RESULTS In phase one, 22 items were included and were evaluated by ten Vietnamese surgeons, with item-content validity index (I-CVI) scores of 1.00 in 17 out of 22 items. The remaining items had I-CVI ranking of 0.8 to 0.9. The overall scale-content validity index was 0.97. Eight more items were recommended for inclusion, increasing the total to 30 items. In phase two, 21 Vietnamese nurse wound care experts completed all three rounds of the Delphi process. After three rounds, 24 items out of 30 reached full consensus for the final tool. CONCLUSION This study was the first step to confirm the content validity of the newly developed SWAT. Further development of the tool including the evaluation of validity and reliability was undertaken to strengthen the tool.
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Affiliation(s)
- Hien Thi Thu Do
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,Nursing department, Haiduong Medical Technical University, Vietnam
| | - Helen Edwards
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Kathleen Finlayson
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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Wessels MD, Paap MCS, van der Putten AAJ. The content validity of the Behavioural Appraisal Scales in people with profound intellectual and multiple disabilities: A Delphi study. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2022. [DOI: 10.1111/jppi.12409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Marleen D. Wessels
- Department of Inclusive and Special Needs Education, Faculty of Behavioural and Social Sciences University of Groningen Groningen The Netherlands
| | - Muirne C. S. Paap
- Department of Inclusive and Special Needs Education, Faculty of Behavioural and Social Sciences University of Groningen Groningen The Netherlands
- Department of Child and Family Welfare, Faculty of Behavioural and Social Sciences University of Groningen Groningen The Netherlands
| | - Annette A. J. van der Putten
- Department of Inclusive and Special Needs Education, Faculty of Behavioural and Social Sciences University of Groningen Groningen The Netherlands
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Smaga I, Frankowska M, Filip M. N-acetylcysteine as a new prominent approach for treating psychiatric disorders. Br J Pharmacol 2021; 178:2569-2594. [PMID: 33760228 DOI: 10.1111/bph.15456] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/26/2021] [Accepted: 03/14/2021] [Indexed: 12/17/2022] Open
Abstract
N-acetylcysteine (NAC) is a well-known and safe mucolytic agent, also used in patients with paracetamol overdose. In addition to these effects, recent preclinical and clinical studies have shown that NAC exerts beneficial effects on different psychiatric disorders. Many potential mechanisms have been proposed to underlie the therapeutic effects of NAC, including the regulation of several neurotransmitters, oxidative homeostasis, and inflammatory mediators. In this paper, we summarize the current knowledge on the ability of NAC to ameliorate symptoms and neuropathologies related to different psychiatric disorders, including attention deficit hyperactivity disorder, anxiety, bipolar disorder, depression, obsessive-compulsive disorder, obsessive-compulsive-related disorder, posttraumatic stress disorder, and schizophrenia. Although preclinical studies have shown a positive effect of NAC on animal models of psychiatric disorders, the clinical efficacy of NAC is not fully established. NAC remains a strong candidate for adjunct treatment for many psychiatric disorders, but additional preclinical and clinical studies are needed.
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Affiliation(s)
- Irena Smaga
- Department of Drug Addiction Pharmacology, Maj Institute of Pharmacology Polish Academy of Sciences, Kraków, Poland
| | - Małgorzata Frankowska
- Department of Drug Addiction Pharmacology, Maj Institute of Pharmacology Polish Academy of Sciences, Kraków, Poland
| | - Małgorzata Filip
- Department of Drug Addiction Pharmacology, Maj Institute of Pharmacology Polish Academy of Sciences, Kraków, Poland
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Chawak S, Chittem M, Maya S, Dhillon HM, Butow PN. The Question-prompt list (QPL): Why it is needed in the Indian oncology setting? Cancer Rep (Hoboken) 2021; 4:e1316. [PMID: 33295152 PMCID: PMC8451377 DOI: 10.1002/cnr2.1316] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND In India, caregivers are an integral part of the illness experience, especially in cancer, to the extent that they can become proxy decision-makers for the patient. Further, owing to acute resource constraints in the Indian healthcare system, it may be difficult for oncologists to assess and elicit questions from each patient/caregiver. Consequently, there is a need to address these unique aspects of oncology care in India to improve patient outcomes and understanding of their illness and treatment. This can be achieved through a Question Prompt List (QPL), a checklist used by care recipients during medical consultations. RECENT FINDINGS This narrative review will first introduce research on the development and effectiveness of the QPL, and then it will highlight current gaps in oncology care in India and explore how the QPL may aid in closing these gaps. A literature search of the empirical research focused on the development, feasibility and acceptability of the QPL in oncology settings was conducted. The final review included 40 articles pertaining to QPL research. Additionally, psycho-oncology research in India centered on information needs and experiences was reviewed. Current Indian psycho-oncology research reports patients' want to be actively involved in their cancer care and a need for more illness information. However, a high demand on physicians' resources and the family caregivers' interference can be barriers to meeting patients' information/communication needs. International research demonstrates that a QPL helps structure and decrease consultation time, improves patient satisfaction with care, and improves the quality of communication during medical encounters. CONCLUSION QPLs for Indian patients and caregivers may focus on the scope of medical consultations to address patient needs while influencing the course and content of the patient-caregiver-physician interactions. Further, it can address the resource constraints in Indian oncology care settings, thus reducing the physician's burden.
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Affiliation(s)
- Shweta Chawak
- Department of Liberal ArtsIndian Institute of Technology HyderabadHyderabadIndia
| | - Mahati Chittem
- Department of Liberal ArtsIndian Institute of Technology HyderabadHyderabadIndia
| | - Sravannthi Maya
- Department of Liberal ArtsIndian Institute of Technology HyderabadHyderabadIndia
| | - Haryana M. Dhillon
- Centre for Medical Psychology & Evidence‐based Decision‐making, School of PsychologyThe University of SydneySydneyNew South WalesAustralia
| | - Phyllis N. Butow
- Centre for Medical Psychology & Evidence‐based Decision‐making, School of PsychologyThe University of SydneySydneyNew South WalesAustralia
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Abdu-Aguye SN, Labaran KS, Danjuma NM, Mohammed S. Minimum content of medication counselling for outpatients in North-Western Nigeria—a modified e-Delphi study. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2021. [DOI: 10.1093/jphsr/rmaa013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objective
The main objective of this study was to conduct a modified e-Delphi study to achieve consensus on the minimum content of medication counselling required by majority of outpatients in North-Western Nigeria. A secondary objective was to collect feedback from the panel members.
Methods
A two round e-Delphi study was conducted between March and May 2020 with pharmacists working in hospital, community or academic settings in North-Western Nigeria. During the first round, panel members were asked to use a five point scale to rate how important they felt it was to provide information about 17 items during medication counselling. Consensus was defined as any item that 90% or more of respondents rated as ‘essential or important’. Items that did not reach this level of consensus were re-rated again during the second round, where respondents were also asked to rate their level of agreement with nine statements.
Key findings
Thirty-four panel members completed the first round, while 29 completed the second round. Majority of them (76.5%) had practiced for between 5–10 years. After the first round, eight items achieved consensus, and were retained. After the second round, three of the initially equivocal items also achieved consensus. Majority of respondents believed that a minimum medication counselling standard would be useful for both dispensers and patients.
Conclusions
Consensus was achieved for 11 of the 17 items rated by the panelists. Feedback received about the research process was also largely positive, with many of them agreeing that the study's proposed outcome would encourage better medication counselling.
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Affiliation(s)
- Samirah N Abdu-Aguye
- Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Kamilu S Labaran
- Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Nuhu M Danjuma
- Department of Pharmacology & Therapeutics, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Shafiu Mohammed
- Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
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Development of a Preliminary Question Prompt List as a Communication Tool for Adults With Gastroesophageal Reflux Disease: A Modified Delphi Study. J Clin Gastroenterol 2020; 54:857-863. [PMID: 31985713 DOI: 10.1097/mcg.0000000000001300] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Question prompt lists (QPLs) are structured sets of disease-specific questions intended for patient use, encouraging patients to ask questions to facilitate their consultation with their physician. AIM The aim of this study was to develop a QPL specific to adults with gastroesophageal reflux disease (GERD), created by esophageal experts. METHODS The QPL content (78 questions) was derived through a modified Delphi method consisting of 2 rounds. In round 1, 18 esophageal experts provided 5 answers to the prompt "What you wish your patients would ask" and "What questions do patients often not ask, that I wish they would ask?" In round 2, the experts rated each question on a 5-point Likert scale, and responses rated as "essential" or "important," determined by an a priori threshold of ≥4.0, were accepted for the QPL. RESULTS Twelve esophageal experts participated. Of 143 questions from round 1, 110 (76.9%) were accepted for inclusion in the QPL, meeting a median value of ≥4.0, and, subsequently, it reduced to 78, minimizing redundancy. Median values ranged between 4.0 and 5.0, with the highest agreement median (5.0) for questions asking dosing and timing of proton pump inhibitor therapy, and surveillance in Barrett's. Questions were categorized into the following categories: "What does this illness mean," "lifestyle modifications," "general treatment," "treatment with proton pump inhibitors," "What I should expect for my future," and "Barrett's." The largest number of questions covered lifestyle modifications (21.8%), with the highest agreement median (5.0) for "How helpful are lifestyle modifications in GERD?" CONCLUSIONS A preliminary GERD-specific QPL, the first of its kind, was developed by esophageal experts. Modification after more patient consultation and feedback is planned in subsequent versions to create a GERD-QPL for eventual use in clinical gastroenterology.
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Satteson ES, Roe AK, Eppler SL, Yao J, Shapiro LM, Kamal RN. Development and Testing of a Question Prompt List for Common Hand Conditions: An Exploratory Sequential Mixed-Methods Study. J Hand Surg Am 2020; 45:1087.e1-1087.e10. [PMID: 32693988 PMCID: PMC8080683 DOI: 10.1016/j.jhsa.2020.05.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 04/16/2020] [Accepted: 05/26/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE A question prompt list (QPL) is a tool that lists possible questions a patient may want to ask their surgeon. Its purpose is to improve patient-physician communication and increase patient engagement. Although QPLs have been developed in other specialties, one does not exist for hand conditions. We sought to develop a QPL for use in the hand surgery clinic using a mixed-methods design. METHODS We drafted a QPL based on prior work outside of hand surgery and then used an exploratory sequential mixed-methods design (both qualitative and quantitative methods) to finalize the QPL. Qualitative evaluation included both a written questionnaire completed by a patient advisory board, hand therapists, and hand surgeons, as well as cognitive interviews conducted with clinic patients using the tool. Revisions to the QPL were made after each phase of qualitative analysis. The final QPL was then evaluated quantitatively using the system usability score (SUS) questionnaire to assess its usability. RESULTS A patient advisory board consisting of 6 patients, 5 hand therapists, and 6 hand surgeons completed the written questionnaire. Thirteen patients completed a cognitive interview of the QPL. We completed a content analysis of the qualitative data and incorporated the findings into the QPL. Twenty patients then reviewed the final QPL pamphlet and completed the SUS questionnaire. The resulting SUS score of 78.8 indicated above-average usability of the QPL tool. CONCLUSIONS The QPL developed in this study, from the perspective of multiple stakeholders, provides a usable tool to engage and prompt patients in asking questions during their visit with their hand surgeon with the potential to improve communication and patient-centered care. CLINICAL RELEVANCE This study provides clinicians with a QPL developed for use in the hand surgery clinic setting, aimed at facilitating more thorough patient-provider discussion.
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Affiliation(s)
- Ellen S Satteson
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA
| | - Allison K Roe
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA
| | - Sara L Eppler
- Department of Orthopaedic Surgery, VOICES Health Policy Research Center, Stanford University, Redwood City, CA
| | - Jeffrey Yao
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA
| | - Lauren M Shapiro
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA
| | - Robin N Kamal
- Department of Orthopaedic Surgery, VOICES Health Policy Research Center, Stanford University, Redwood City, CA; Department of Orthopaedic Surgery, Stanford University, Redwood City, CA.
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Ekberg S, Herbert A, Johns K, Tarrant G, Sansone H, Yates P, Danby S, Bradford NK. Finding a way with words: Delphi study to develop a discussion prompt list for paediatric palliative care. Palliat Med 2020; 34:291-299. [PMID: 31752593 DOI: 10.1177/0269216319888988] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Effective communication is a cornerstone of quality paediatric palliative care. Families report struggling, however, to know what to discuss, with whom, and when. Although question prompt lists exist for adult palliative care, they do not suit the unique circumstances of paediatric palliative care. AIM To develop a prompt list suitable for paediatric palliative care. DESIGN Underpinned by Delphi methodology, a six-phase procedure was adopted: (1) drafting items based on the findings of a literature review, (2) condensing the list of items based on group discussion, (3) refining items based on a survey of expert healthcare professionals, (4) additional refining of items based on another survey of professionals, (5) further refining of items based on cognitive interviews with family members, and (6) final review by healthcare professional and family member groups. PARTICIPANTS Three participant groups were involved during various phases: (1) members of an Australasian paediatric palliative care national reference group, (2) healthcare professionals associated with a local paediatric palliative care service, and (3) family members who were users of the same local service. RESULTS Through multi-phase consultation across participant groups, the draft question prompt list was refined progressively to 28 items, split across two booklets to allow end-of-life items to be provided separately, and reconceptualised as a discussion prompt list rather than a question prompt list. CONCLUSION By involving representatives of major stakeholder groups, this study has facilitated the design of a prompt list suited to the circumstances of paediatric palliative care. Future research should trial the effectiveness of this resource.
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Affiliation(s)
- Stuart Ekberg
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Centre for Children's Health Research, South Brisbane, QLD, Australia
| | - Anthony Herbert
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Centre for Children's Health Research, South Brisbane, QLD, Australia.,Children's Health Queensland Hospital and Health Service, South Brisbane, QLD, Australia.,School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
| | - Kristi Johns
- Centre for Children's Health Research, South Brisbane, QLD, Australia.,Children's Health Queensland Hospital and Health Service, South Brisbane, QLD, Australia
| | - Gabrielle Tarrant
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
| | - Holly Sansone
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Centre for Children's Health Research, South Brisbane, QLD, Australia
| | - Patsy Yates
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Centre for Children's Health Research, South Brisbane, QLD, Australia.,School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
| | - Susan Danby
- Centre for Children's Health Research, South Brisbane, QLD, Australia.,School of Early Childhood and Inclusive Education, Queensland University of Technology, Brisbane, QLD, Australia
| | - Natalie K Bradford
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Centre for Children's Health Research, South Brisbane, QLD, Australia.,School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
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Rocha KSS, Cerqueira Santos S, Boaventura TC, Dos Santos Júnior GA, de Araújo DCSA, Silvestre CC, de Jesus EMS, de Lyra Júnior DP. Development and content validation of an instrument to support pharmaceutical counselling for dispensing of prescribed medicines. J Eval Clin Pract 2020; 26:134-141. [PMID: 30701631 DOI: 10.1111/jep.13102] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 02/05/2023]
Abstract
RATIONALE, AIMS, AND OBJECTIVES Counselling is essential in drug dispensing, since it enables patients to receive and understand the information to correctly use their medicines. Although counselling is a quality indicator on drug dispensing, models that guide pharmacists in this practice are scarce. Thus, this study aimed to develop and validate the content of an instrument to support pharmaceutical counselling for dispensing of prescribed medicines. METHOD A two-stage validation study was conducted out from February to October 2017. The first stage involved the development of the instrument, and the second involved content validation. Instrument development included the following three steps: (1) drafting of the prototype; (2) an academic brainstorming meeting, and (3) a pre-Delphi process. Content validation was then conducted using the Delphi technique. At this stage, 40 pharmacists who were experts in drug dispensing, were invited to assess the instrument. Consensus among experts was calculated according to the content validity index (CVI). RESULTS The development stage generated three versions of the instrument: the prototype, Version 1 (modified after brainstorming meeting), and Version 2 (modified after the pre-Delphi process). Version 2 underwent the content validation process, in which 29 pharmacists participated during the first round (rate of return: 72.5%) and 23 of these during the second round (rate of return: 79.31%). All items obtained CVI > 0.82 and were thus considered to be validated. The final instrument comprised three components: suggestions for questions, dispensing process reasoning, and suggestions for counselling, and other conduct in 11 stages, each representing a step in the clinical reasoning process. CONCLUSIONS An instrument was developed to support pharmaceutical counselling for dispensing of prescribed medicines, suggesting main questions, counselling, and conduct to be taken by pharmacists, and its content validity was verified.
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Affiliation(s)
- Kérilin Stancine Santos Rocha
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
| | - Sabrina Cerqueira Santos
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
| | - Thays Carneiro Boaventura
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
| | - Genival Araujo Dos Santos Júnior
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
| | | | | | - Elisdete Maria Santos de Jesus
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
| | - Divaldo Pereira de Lyra Júnior
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
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Lemmon ME, Huffstetler HE, Donohue P, Katz M, Barks MC, Schindler E, Brandon D, Boss RD, Ubel PA. Neurodevelopmental Risk: A Tool to Enhance Conversations With Families of Infants. J Child Neurol 2019; 34:653-659. [PMID: 31137987 PMCID: PMC7282194 DOI: 10.1177/0883073819844927] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Parents of infants at risk of neurodevelopmental impairment require clear and individualized information about what to expect for their child, yet data suggest they have difficulty knowing how to ask for this information. Here, we pilot a Question Prompt List (QPL) with parents of infants at risk of neurodevelopmental impairment. To assess real-time use of the QPL, we recorded family meetings and collected data from parents and clinicians about the QPL experience. Qualitative data were analyzed using directed content analysis. Ten parents were enrolled. In family meetings, clinicians universally acknowledged the QPL and most used the QPL to guide meeting content. All parents who used the QPL found it useful and would recommend the tool to others. In interviews, parents described that the QPL offered novel questions and facilitated more prepared answers from the team. Future studies should test the impact of this QPL on parent understanding and communication quality.
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Affiliation(s)
- Monica E. Lemmon
- Department of Pediatrics, Duke University Medical Center, Durham, NC, USA,Department of Neurology, Johns Hopkins Hospital, Baltimore, MD, USA,Margolis Center for Health Policy, Duke University, Durham, DC, USA
| | | | - Pamela Donohue
- Division of Neonatology, Department of Pediatrics, Johns Hopkins Hospital, Baltimore, MD, USA,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Madelaine Katz
- Margolis Center for Health Policy, Duke University, Durham, DC, USA
| | - Mary C. Barks
- Margolis Center for Health Policy, Duke University, Durham, DC, USA
| | - Emma Schindler
- Margolis Center for Health Policy, Duke University, Durham, DC, USA
| | - Debra Brandon
- Department of Pediatrics, Duke University Medical Center, Durham, NC, USA,School of Nursing, Duke University, Durham, NC, USA
| | - Renee D. Boss
- Division of Neonatology, Department of Pediatrics, Johns Hopkins Hospital, Baltimore, MD, USA,Johns Hopkins Berman Institute of Bioethics, Baltimore, MD, USA
| | - Peter A. Ubel
- Fuqua School of Business, Sanford School of Public Policy, School of Medicine, Duke University, Durham, NC, USA
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Cerqueira-Santos S, Rocha KSS, Boaventura TC, Jesus EMS, Silvestre CC, Alves BMCS, de Lyra DP. Development and content validation of an instrument to document the dispensing of prescribed medicines. J Clin Pharm Ther 2019; 44:430-439. [PMID: 30701567 DOI: 10.1111/jcpt.12803] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 12/23/2018] [Accepted: 12/26/2018] [Indexed: 12/27/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Qualified dispensing is fundamental for the promotion of the rational use of medicines. Documentation is an indicator of quality and one of the essential steps in the care process. However, in Brazil, there are no models of clinical documentation applicable to dispensing practices. Thus, the objective of this study was to develop and validate an instrument to document the dispensing process of prescribed medicines. METHODS A methodological development study was carried out from February 2017 to October 2017 in two stages, which were (i) the development of the instrument and (ii) content validation of the proposed instrument. The development phase comprised three stages, which were (i) the elaboration of the prototype based on a previously performed systematic review, (ii) academic brainstorming and (iii) a pre-Delphi consensus. The content validation process was performed using the Delphi technique. The instrument was sent to 40 experts with experience in dispensing, and the consensus among them was calculated using the content validity index (CVI). The study was approved by the Ethics Committee, and all participants signed an informed consent document detailing the terms of the study. RESULTS In the development stage, three versions of the instrument were generated, which were the prototype, version 1 (changed after academic brainstorming) and version 2 (changed after the pre-Delphi). In the content validation process of version 2 of the instrument, 23 experts returned their evaluation in the first round of the Delphi process and 17 in the second. All the items obtained a CVI >0.83, which resulted in the validation of the instrument. The final instrument comprised the following sections: general information, the identification of technical and legal problems of prescriptions, the conduct for the resolution of the technical and legal problems of prescriptions, medication dispensed, suspected drug-related problems, verbal guidance, written guidance, referral and the referral result. WHAT IS NEW AND CONCLUSION The developed and validated instrument presents the main variables that should be documented during the dispensing process.
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Affiliation(s)
- Sabrina Cerqueira-Santos
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
| | - Kérilin S S Rocha
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
| | - Thays C Boaventura
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
| | - Elisdete M S Jesus
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
| | - Carina C Silvestre
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
| | - Bárbara M C Sodré- Alves
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
| | - Divaldo P de Lyra
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
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17
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Development of a question prompt list for women with polycystic ovary syndrome. Fertil Steril 2018; 110:514-522. [DOI: 10.1016/j.fertnstert.2018.04.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/02/2018] [Accepted: 04/17/2018] [Indexed: 01/11/2023]
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Ahmed R, McCaffery KJ, Silove N, Butow P, Clarke S, Kohn M, Aslani P. The evaluation of a question prompt list for attention-deficit/hyperactivity disorder in pediatric care: A pilot study. Res Social Adm Pharm 2017; 13:172-186. [DOI: 10.1016/j.sapharm.2016.01.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 01/29/2016] [Accepted: 01/29/2016] [Indexed: 10/22/2022]
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Lederer S, Fischer MJ, Gordon HS, Wadhwa A, Popli S, Gordon EJ. A question prompt sheet for adult patients with chronic kidney disease. BMC Nephrol 2016; 17:155. [PMID: 27760524 PMCID: PMC5070305 DOI: 10.1186/s12882-016-0362-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 09/29/2016] [Indexed: 02/07/2023] Open
Abstract
Background Patients with chronic kidney disease (CKD) commonly have unmet information needs. Greater patient participation in healthcare discussions can address these needs and improve health outcomes. We developed a patient-centered question prompt sheet (QPS) to engage CKD patients in healthcare conversations. Methods We conducted a two phase, mixed-methods, cross-sectional study involving semi-structured telephone interviews. Patients with an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2, on dialysis, or with a kidney transplant were recruited from one Veterans Affairs (VA) nephrology clinic. Phase 1 interviews included open-ended questions assessing patients’ CKD-related information needs and generated a preliminary 67-item QPS. Phase 2 interview participants rated the importance of asking each question on a 5-point Likert scale and provided open-ended feedback. All participants rated their willingness to use a CKD-QPS. Input from patient ratings, a multidisciplinary team, and from members of the National Kidney Disease Education Program (NKDEP) Coordinating Panel helped to shorten and refine the QPS. A qualitative thematic approach was used to analyze open-ended responses. Quantitative data were analyzed for means and proportions. Results Eighty-five patients participated. Most were male (97 %), non-Hispanic white (71 %), and mean age was 67 years. Patients desired more information about CKD, particularly dialysis/transplant, and the relationship between CKD and comorbid medical conditions. The final QPS included 31-questions divided into 7 CKD subtopics. Most patients (88 %) reported being ‘completely’ or ‘very’ willing to use a CKD-QPS in future doctor visits. Conclusions CKD patients have unmet information needs. We developed a QPS to engage CKD patients in healthcare discussions and to facilitate patient-centered care. Future research should assess whether the CKD-QPS addresses patients’ information needs, enhances doctor-patient communication, and improves health outcomes. Electronic supplementary material The online version of this article (doi:10.1186/s12882-016-0362-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Swati Lederer
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, USA.,Jesse Brown VA Medical Center, Chicago, IL, USA.,Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USA
| | - Michael J Fischer
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, USA.,Jesse Brown VA Medical Center, Chicago, IL, USA.,Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USA
| | - Howard S Gordon
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, USA.,Jesse Brown VA Medical Center, Chicago, IL, USA.,Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USA
| | - Anuradha Wadhwa
- Department of Medicine, Edward Hines Jr. VA Hospital, Hines, IL, USA.,Loyola University Medical Center, Maywood, IL, USA
| | - Subhash Popli
- Department of Medicine, Edward Hines Jr. VA Hospital, Hines, IL, USA.,Loyola University Medical Center, Maywood, IL, USA
| | - Elisa J Gordon
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, USA. .,Center for Healthcare Studies, and Department of Surgery, Division of Transplantation, Northwestern University Feinberg School of Medicine, 633 N. St. Clair, 20th Floor, Chicago, IL, 60611, USA.
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Lemmon ME, Donohue PK, Parkinson C, Northington FJ, Boss RD. Communication Challenges in Neonatal Encephalopathy. Pediatrics 2016; 138:peds.2016-1234. [PMID: 27489296 PMCID: PMC5005027 DOI: 10.1542/peds.2016-1234] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Families must process complex information related to neonatal encephalopathy and therapeutic hypothermia. METHODS In this mixed methods study, semi-structured interviews were performed with parents whose infants were enrolled in an existing longitudinal cohort study of therapeutic hypothermia between 2011 and 2014. RESULTS Thematic saturation was achieved after 20 interviews. Parental experience of communicating with clinicians was characterized by 3 principle themes. Theme 1 highlighted that a fragmented communication process mirrored the chaotic maternal and neonatal course. Parents often received key information about neonatal encephalopathy and therapeutic hypothermia from maternal clinicians. Infant medical information was often given to 1 family member (60%), who felt burdened by the responsibility to relay that information to others. Families universally valued the role of the bedside nurse, who was perceived as the primary source of communication for most (75%) families. Theme 2 encompassed the challenges of discussing the complex therapy of therapeutic hypothermia: families appreciated clinicians who used lay language and provided written material, and they often felt overwhelmed by technical information that made it hard to understand the "big picture" of their infant's medical course. Theme 3 involved the uncertain prognosis after neonatal encephalopathy. Parents appreciated specific expectations about their infant's long-term development, and experienced long-term distress about prognostic uncertainty. CONCLUSIONS Communicating complex and large volumes of information in the midst of perinatal crisis presents inherent challenges for both clinicians and families. We identified an actionable set of communication challenges that can be addressed with targeted interventions.
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Affiliation(s)
- Monica E. Lemmon
- Department of Neurology, Division of Pediatric Neurology,,Department of Pediatrics, Division of Pediatric Neurology, Duke University Medical Center, Durham, North Carolina;,Neurosciences Intensive Care Nursery, The Johns Hopkins Hospital, Baltimore, Maryland; and
| | - Pamela K. Donohue
- Department of Pediatrics, Division of Neonatology, and,Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Charlamaine Parkinson
- Department of Pediatrics, Division of Neonatology, and,Neurosciences Intensive Care Nursery, The Johns Hopkins Hospital, Baltimore, Maryland; and
| | - Frances J. Northington
- Department of Pediatrics, Division of Neonatology, and,Neurosciences Intensive Care Nursery, The Johns Hopkins Hospital, Baltimore, Maryland; and
| | - Renee D. Boss
- Department of Pediatrics, Division of Neonatology, and,Berman Institute of Bioethics, Johns Hopkins School of Medicine, Baltimore, Maryland
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Murphy M, Hollinghurst S, Salisbury C. Agreeing the content of a patient-reported outcome measure for primary care: a Delphi consensus study. Health Expect 2016; 20:335-348. [PMID: 27123987 PMCID: PMC5354062 DOI: 10.1111/hex.12462] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND As the first contact for any health-related need, primary care clinicians often address multiple patient problems, with a range of possible outcomes. There is currently no patient-reported outcome measure (PROM) which covers this range of outcomes. Therefore, many research studies into primary care services use PROMs that do not capture the full impact of these services. OBJECTIVE The study aim was to identify outcomes sought by primary care patients which clinicians can influence, thus providing the basis for a new primary care PROM. METHODS We used a Delphi process starting with an outcomes list inductively derived in a prior qualitative study. Thirty-five experts were recruited into patient, clinician and academic panels. Participants rated each outcome on whether it was (i) relevant to health, (ii) influenced by primary care and (iii) detectable by patients. In each round, outcomes which passed/failed preset levels of agreement were accepted/rejected. Remaining outcomes continued to the next round. RESULTS The process resulted in a set of outcomes occupying the domains of health status, health empowerment (internal and external), and health perceptions. Twenty-six of 36 outcomes were accepted for inclusion in a PROM. Primary care having insufficient influence was the main reason for exclusion. CONCLUSIONS To our knowledge, this is the first time PROM outcomes have been agreed through criteria which explicitly exclude outcomes less relevant to health, uninfluenced by primary care or undetected by patients. The PROM in development covers a unique set of outcomes and offers an opportunity for enhanced research into primary care.
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Affiliation(s)
- Mairead Murphy
- Centre for Academic Primary Care, School for Social and Community Medicine, University of Bristol, Bristol, UK
| | - Sandra Hollinghurst
- Centre for Academic Primary Care, School for Social and Community Medicine, University of Bristol, Bristol, UK
| | - Chris Salisbury
- Centre for Academic Primary Care, School for Social and Community Medicine, University of Bristol, Bristol, UK
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Abstract
Introduction The Nominal Group Technique (NGT) and Delphi Technique are consensus methods used in research that is directed at problem-solving, idea-generation, or determining priorities. While consensus methods are commonly used in health services literature, few studies in pharmacy practice use these methods. This paper provides an overview of the NGT and Delphi technique, including the steps involved and the types of research questions best suited to each method, with examples from the pharmacy literature. Methodology The NGT entails face-to-face discussion in small groups, and provides a prompt result for researchers. The classic NGT involves four key stages: silent generation, round robin, clarification and voting (ranking). Variations have occurred in relation to generating ideas, and how 'consensus' is obtained from participants. The Delphi technique uses a multistage self-completed questionnaire with individual feedback, to determine consensus from a larger group of 'experts.' Questionnaires have been mailed, or more recently, e-mailed to participants. When to use The NGT has been used to explore consumer and stakeholder views, while the Delphi technique is commonly used to develop guidelines with health professionals. Method choice is influenced by various factors, including the research question, the perception of consensus required, and associated practicalities such as time and geography. Limitations The NGT requires participants to personally attend a meeting. This may prove difficult to organise and geography may limit attendance. The Delphi technique can take weeks or months to conclude, especially if multiple rounds are required, and may be complex for lay people to complete.
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Affiliation(s)
- Sara S McMillan
- School of Pharmacy, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, QLD, Australia
| | - Michelle King
- School of Pharmacy, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, QLD, Australia
| | - Mary P Tully
- Manchester Pharmacy School, University of Manchester, Oxford Road, Manchester, UK.
- Manchester Academic Health Sciences Centre, Oxford Road, Manchester, UK.
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How to use the nominal group and Delphi techniques. Int J Clin Pharm 2016; 38:655-62. [PMID: 26846316 PMCID: PMC4909789 DOI: 10.1007/s11096-016-0257-x] [Citation(s) in RCA: 455] [Impact Index Per Article: 56.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 01/17/2016] [Indexed: 11/13/2022]
Abstract
Introduction The Nominal Group Technique (NGT) and Delphi Technique are consensus methods used in research that is directed at problem-solving, idea-generation, or determining priorities. While consensus methods are commonly used in health services literature, few studies in pharmacy practice use these methods. This paper provides an overview of the NGT and Delphi technique, including the steps involved and the types of research questions best suited to each method, with examples from the pharmacy literature. Methodology The NGT entails face-to-face discussion in small groups, and provides a prompt result for researchers. The classic NGT involves four key stages: silent generation, round robin, clarification and voting (ranking). Variations have occurred in relation to generating ideas, and how ‘consensus’ is obtained from participants. The Delphi technique uses a multistage self-completed questionnaire with individual feedback, to determine consensus from a larger group of ‘experts.’ Questionnaires have been mailed, or more recently, e-mailed to participants. When to use The NGT has been used to explore consumer and stakeholder views, while the Delphi technique is commonly used to develop guidelines with health professionals. Method choice is influenced by various factors, including the research question, the perception of consensus required, and associated practicalities such as time and geography. Limitations The NGT requires participants to personally attend a meeting. This may prove difficult to organise and geography may limit attendance. The Delphi technique can take weeks or months to conclude, especially if multiple rounds are required, and may be complex for lay people to complete.
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