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Lee L, Hillier LM, Patel T, Gregg S, Hickman K, Lu SK, Lee M, Borrie MJ. A "Patient Preference" Model of Recruitment for Research from Primary-Care-Based Memory Clinics: A Promising New Approach. Can J Aging 2024; 43:275-286. [PMID: 37694538 DOI: 10.1017/s0714980823000533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
Recruiting persons with dementia for clinical trials can be challenging. Building on a guide initially developed to assist primary-care-based memory clinics in their efforts to support research, a key stakeholder working group meeting was held to develop a standardized research recruitment process, with input from patients, care partners, researchers, and clinicians. Discussions in this half-day facilitated meeting focused on the wishes and needs of patients and care partners, policy and procedures for researchers, information provided to patients, and considerations for memory clinics. Patients and care partners valued the opportunity to contribute to science and provided important insights on how to best facilitate recruitment. Discussions regarding proposed processes and procedures for research recruitment highlighted the need for a new, patient-driven approach. Accordingly, a key stakeholder co-designed "Memory Clinic Research Match" program was developed that has the potential to overcome existing barriers and to increase recruitment for dementia-related research.
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Affiliation(s)
- Linda Lee
- Centre for Family Medicine Family Health Team, McMaster University, Department of Family Medicine, Kitchener, ON, Canada
| | | | - Tejal Patel
- University of Waterloo School of Pharmacy, Kitchener, ON, Canada
| | - Susie Gregg
- Canadian Mental Health Association Waterloo Wellington, Guelph, ON, Canada
| | | | - Stephanie K Lu
- Centre for Family Medicine Family Health Team, McMaster University, Department of Family Medicine, Kitchener, ON, Canada
| | - Michael Lee
- Centre for Family Medicine Family Health Team, McMaster University, Department of Family Medicine, Kitchener, ON, Canada
| | - Michael J Borrie
- Department of Medicine, Western University, St. Joseph's Health Care, Parkwood Institute, London, ON, Canada
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Takeshita R, Muramatsu K, Matsuda S. The Current Status of Suicide and Medical Care System in Japan: An Analysis of 81,407 Patients Using the Diagnosis Procedure Combination Database. TOHOKU J EXP MED 2023; 261:291-297. [PMID: 37793882 DOI: 10.1620/tjem.2023.j081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Japan has a high suicide mortality rate compared to other developed countries. To reduce suicide mortality in Japan, it is important to systematically analyze factors related to death of patients with suicide attempt. This study aimed to analyze the characteristics of patients with suicide attempt, and the factors related to their death using the Diagnosis Procedure Combination (DPC) data- a nationally representative inpatient database. We collected 81,407 cases of suicide attempt from 2016 to 2018 from DPC data and performed a multilevel logistic analysis of factors associated with death discharges. The analysis results showed that patients who received psychiatric liaison care had a lower mortality rate, but only 0.6% of surviving patients received psychiatric liaison care after admission. The odds ratio (OR) of death was high for hanging (28.86; p < 0.001) and jumping (16.28; p < 0.001), compared to wrist cutting. Patients without a psychiatric diagnosis were more likely to choose means such as hanging (14.1%) than those with a psychiatric disorder. The weekend cases had a higher OR of death than weekday (Wednesday as reference) cases (Friday 1.14, p = 0.011; Saturday 1.60, p < 0.001; Sunday 1.67, p < 0.001). Based on these findings, we suggest that improving the availability and quality of psychiatric care in acute care hospitals and primary care settings, as well as enhancing the emergency department system on weekends, could help reduce the mortality of suicide attempts.
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Affiliation(s)
- Rina Takeshita
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health
| | - Keiji Muramatsu
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health
| | - Shinya Matsuda
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health
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Lee L, Hillier LM, Patel T, Lu SK, Lee M, Lee C. An innovative approach to recruiting participants for dementia research: primary care and researcher perspectives. Neurodegener Dis Manag 2023; 13:323-334. [PMID: 38284385 DOI: 10.2217/nmt-2022-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024] Open
Abstract
Aim: To describe clinician and researcher perceptions of a new, patient preference focused approach to recruiting patients for research from primary care-based memory clinics. Methods: Memory clinic clinicians completed a survey and key informants completed an individual interview to gather their perceptions of this new program. Results: The majority of clinicians were 'satisfied' or 'very satisfied' with this recruitment approach and indicated that this approach would have minimal negative impact on patient care or create conflict of interest. Key informants valued the program for its patient-centred approach, the integration of research into care and potential for increased recruitment. Discussion: These findings are suggestive of support for this recruitment approach. Pilot testing will inform feasibility, effectiveness and process improvements.
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Affiliation(s)
- Linda Lee
- Centre for Family Medicine Family Health Team, 10 B Victoria Street South, Kitchener, Ontario, N2G 1C5, Canada
- Department of Family Medicine, McMaster University, 100 Main Street West, Hamilton, Ontario, L8P 1H6, Canada
- Schlegel-University of Waterloo Research Institute for Aging, 250 Laurelwood Drive, Waterloo, Ontario, N2J 0E2, Canada
| | - Loretta M Hillier
- GERAS Centre for Aging Research, 88 Maplewood Ave, Hamilton, Ontario, L8M 1W9, Canada
| | - Tejal Patel
- Centre for Family Medicine Family Health Team, 10 B Victoria Street South, Kitchener, Ontario, N2G 1C5, Canada
- School of Pharmacy, University of Waterloo, 10A Victoria Street South, Waterloo, Ontario, N2G 1C5, Canada
| | - Stephanie K Lu
- Centre for Family Medicine Family Health Team, 10 B Victoria Street South, Kitchener, Ontario, N2G 1C5, Canada
| | - Michael Lee
- Centre for Family Medicine Family Health Team, 10 B Victoria Street South, Kitchener, Ontario, N2G 1C5, Canada
| | - Catherine Lee
- Centre for Family Medicine Family Health Team, 10 B Victoria Street South, Kitchener, Ontario, N2G 1C5, Canada
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Family physicians collaborating for health system integration: a scoping review. BMC Health Serv Res 2023; 23:68. [PMID: 36690992 PMCID: PMC9869511 DOI: 10.1186/s12913-023-09063-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/13/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND In Canada, Ontario Health Teams (OHTs) are a new model for integrated healthcare. Core to OHTs are family physicians (FPs) and their ability to collaborate with other FPs and healthcare providers. Whereas the factors for intra-organizational collaboration have been well-studied, inter-organizational collaboration between FPs and other healthcare organizations as an integrated care network, are less understood. This paper aims to explore the structural factors, processes, and theoretical frameworks that support FPs' collaboration for integrated healthcare. METHODS A scoping review was undertaken based on Joanna Briggs Institute (JBI) methodology for scoping review and using the Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Review (PRISMA_ScR) checklist. A search for academic and relevant grey literature published between 2000-2021 was conducted across databases (MEDLINE, EMBASE, EBSCOhost).Thematic analysis was used to identify the key findings of the selected studies. RESULTS Thirty-two studies were included as eligible for this review. Three structural components were identified as critical to FPs' successful participation in inter-organizational partnerships: (1) shared vision/values, (2) leadership by FPs, and (3) defined decision-making procedures. Also, three processes were identified: (1) effective communication, (2) a collective sense of motivation for change, and (3) relationships built on trust. Three theoretical frameworks provided insight into collaborative initiatives: (1) Social Identity Approach, (2) framework of interprofessional collaboration, and (3) competing values framework. CONCLUSION FPs hold unique positions in healthcare and this review is the first to synthesize the best evidence for building collaborations between FPs and other healthcare sectors. These findings will inform collaboration strategies for healthcare integration, including with OHTs.
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Identifying Primary Care Models of Dementia Care that Improve Quality of Life for People Living with Dementia and their Care Partners: An Environmental Scan. Can J Aging 2022; 41:550-564. [PMID: 36482723 DOI: 10.1017/s0714980821000635] [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: 12/14/2022] Open
Abstract
Dementia is a growing concern in Canada, affecting peoples' health and raising the cost of care. Between June and October 2019, we conducted an environmental scan to identify primary care models, strategies, and resources for dementia care from 11 pre-selected countries and assess their impact on quality-of-life measures. Search strategies included a rapid scoping review, grey literature search, and discussions with stakeholders. Eighteen primary care-based models of dementia care were identified. Common factors include team-based care, centralized care/case coordination, individual treatment plans, a stepped-care approach, and support for care partners. Five provinces had released a dementia strategy. Evidence of positive outcomes supported primary care-based models for dementia care, although only one model demonstrated evidence of impact on quality of life. Although these findings are encouraging, further research is needed to identify primary care-based models of dementia care that demonstrably improve quality of life for people living with dementia and their care partners.
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Looman N, de Graaf J, Thoonen B, van Asselt D, de Groot E, Kramer A, Scherpbier N, Fluit C. Designing the learning of intraprofessional collaboration among medical residents. MEDICAL EDUCATION 2022; 56:1017-1031. [PMID: 35791303 PMCID: PMC9543842 DOI: 10.1111/medu.14868] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/30/2022] [Accepted: 07/04/2022] [Indexed: 05/21/2023]
Abstract
BACKGROUND To preserve quality and continuity of care, collaboration between primary-care and secondary-care physicians is becoming increasingly important. Therefore, learning intraprofessional collaboration (intraPC) requires explicit attention during postgraduate training. Hospital placements provide opportunities for intraPC learning, but these opportunities require interventions to support and enhance such learning. Design-Principles guide the design and development of educational activities when theory-driven Design-Principles are tailored into context-sensitive Design-Principles. The aim of this study was to develop and substantiate a set of theory-driven and context-sensitive Design-Principles for intraPC learning during hospital placements. METHODS Based on our earlier research, we formulated nine theory-driven Design-Principles. To enrich, refine and consolidate these principles, three focus group sessions with stakeholders were conducted using a Modified Nominal Group Technique. Next, two work conferences were conducted to test the feasibility and applicability of the Design-Principles for developing intraPC educational activities and to sharpen the principles into a final set of Design-Principles. RESULTS The theoretical Design-Principles were discussed and modified iteratively. Two new Design-Principles were added during focus group 1, and one more Design-Principle was added during focus group 2. The Design-Principles were categorised into three clusters: (i) Culture: building collaborative relations in a psychologically safe context where patterns or feelings of power dynamics between primary and secondary care physicians can be discussed; (ii) Connecting Contexts: making residents and supervisors mutually understand each other's work contexts and activities; and (iii) Making the Implicit Explicit: having supervising teams act as role models demonstrating intraPC and continuously pursuing improvement in intraPC to make intraPC explicit. Participants were unanimous in their view that the Design-Principles in the Culture cluster were prerequisites to facilitate intraPC learning. CONCLUSION This study led to the development of 12 theory-driven and context-sensitive Design-Principles that may guide the design of educational activities to support intraPC learning during hospital placements.
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Affiliation(s)
- Natasja Looman
- Department of Primary and Community CareRadboudumcNijmegenThe Netherlands
| | | | - Bart Thoonen
- Department of Primary and Community CareRadboudumcNijmegenThe Netherlands
| | | | - Esther de Groot
- Julius Center for Health Sciences and Primary CareUMC UtrechtUtrechtThe Netherlands
| | - Anneke Kramer
- Department of Public health and Primary CareLeiden UMCLeidenThe Netherlands
| | - Nynke Scherpbier
- Department of General Practice and Elderly CareUniversity Medical Centre GroningenGroningenThe Netherlands
| | - Cornelia Fluit
- Department for Research in Learning and EducationRadboudumc Health AcademyNijmegenThe Netherlands
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Aggarwal P, Fraser A, Ross S, Scallan S. Learning from the GP-consultant exchange scheme: a qualitative evaluation. MEDEDPUBLISH 2022; 12:51. [PMID: 36168532 PMCID: PMC9427078 DOI: 10.12688/mep.17542.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 11/20/2022] Open
Abstract
Collaborative working across primary and secondary care is crucial to providing high quality patient care. There is still a lack of communication and understanding between primary and secondary care, which can impede collaborative working. The experience of observing colleagues in a different speciality can prompt insight, improve morale and promote collaborative working. The GP-Consultant Exchange Scheme aimed to improve professional understanding, foster deeper partnerships, and ignite opportunities for innovation and/or quality improvement (QI) with co-owned local solutions. This paper gives an overview of how the scheme works and sets out some of the outcomes reported by some 200 Consultants and GPs participants to date. Overall, the participants found the scheme an enjoyable way to reconnect clinicians and allowed them to learn about the challenges faced in different areas within the NHS. This low-cost intervention needs motivated individuals to drive the project forward and make it sustainable, but it can be replicated within any organisation or profession in the NHS.
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Affiliation(s)
- Pritti Aggarwal
- Senior Clinical Lead, Hampshire, Southampton and Isle of Wight (HSIoW) Clinical Commissioning Group, Southampton, SO16 4GX, UK
- Deputy Director of Primary Medical Care, University of Southampton, Southampton, SO17 1BJ, UK
- GP Partner, Living Well Partnership, Southampton, SO19 9GH, UK
| | - Adam Fraser
- GP Partner, Bridges Medical Practice, Weymouth, DT4 7DW, UK
- Programme Director at Dorset GP Centre, Bournemouth University, Bournemouth, BH12 5BB, UK
| | - Sally Ross
- GP Clinical Advisor, NHS England, London, RH6 7DE, UK
- Wessex GP Tutor, Appraiser and Sessional GP, HEE Wessex, Winchester, SO21 2RU, UK
| | - Samantha Scallan
- GP Education Unit, University Hospitals Southampton, Southampton, SO16 6YD, UK
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Ohta R, Ueno A, Kitayuguchi J, Moriwaki Y, Otani J, Sano C. Comprehensive Care through Family Medicine: Improving the Sustainability of Aging Societies. Geriatrics (Basel) 2021; 6:geriatrics6020059. [PMID: 34199871 PMCID: PMC8293036 DOI: 10.3390/geriatrics6020059] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/21/2021] [Accepted: 06/03/2021] [Indexed: 02/07/2023] Open
Abstract
Comprehensive care through family medicine can enhance the approach to multimorbidity, interprofessional collaboration, and community care, and make medical care more sustainable for older people. This study investigated the effect of implementing family medicine and the comprehensiveness of medical care in one of the most rural communities. This implementation research used medical care data from April 2015 to March 2020. Patients' diagnoses were categorized according to the 10th revision of the International Statistical Classification of Disease and Related Health Problems (ICD-10). In 2016, family medicine was implemented in only one general hospital in Unnan. The comprehensiveness rate improved in all ICD-10 disease categories during the study period, especially in the following categories-infections; neoplasms; endocrine, nutritional, and metabolic diseases; mental disorders; nervous system; circulatory system; respiratory system; digestive system; skin and subcutaneous tissue; musculoskeletal system and connective tissue; and the genitourinary system. Implementing family medicine in rural Japanese communities can improve the comprehensiveness of medical care and resolve the issue of fragmentation of care by improving interprofessional collaboration and community care. It can be a solution for the aging of both patient and healthcare professionals. Future research can investigate the relationship between family medicine and patient health outcomes for improved healthcare sustainability.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, Unnan 699-1221, Shimane, Japan; (Y.M.); (J.O.)
- Correspondence: ; Tel.: +81-90-5060-5330
| | - Akinori Ueno
- Unnan Public Health Center, Unnan 699-1311, Shimane, Japan;
| | - Jun Kitayuguchi
- Physical Education and Medicine Research Center Unnan, Unnan 699-1105, Shimane, Japan;
| | - Yoshihiro Moriwaki
- Community Care, Unnan City Hospital, Unnan 699-1221, Shimane, Japan; (Y.M.); (J.O.)
| | - Jun Otani
- Community Care, Unnan City Hospital, Unnan 699-1221, Shimane, Japan; (Y.M.); (J.O.)
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, Izumo 693-8501, Shimane, Japan;
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Multispecialty Interprofessional Team Memory Clinics: Enhancing Collaborative Practice and Health Care Providers' Experience of Dementia Care. Can J Aging 2021; 41:96-109. [PMID: 33926598 DOI: 10.1017/s0714980821000052] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
This study explored whether working within Multispecialty INterprofessional Team (MINT) memory clinics has an impact on health care professionals' perceptions of the challenges, attitudes, and level of collaboration associated with providing dementia care. Surveys were completed by MINT memory clinic members pre- and 6-months post-clinic launch. A total of 228 pre-and-post-training surveys were matched for analysis. After working in the MINT memory clinics for 6 months, there were significant reductions in mean ratings of the level of challenge associated with various aspects of dementia care, and significant increases in the frequency with which respondents experienced enthusiasm, inspiration, and pride in their work in dementia care and in ratings of the extent of collaboration for dementia care. This study provides some insights into the effect of collaborative, interprofessional approaches on health care professionals' perceptions of the challenges and attitudes associated with providing dementia care and level of collaboration with other health professionals.
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10
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Thomas A, Thomas A. Patient Suffering in Chronic Digestive Diseases: Will Primary Care-Specialist Collaboration With Effective Interactive Communication and Integrative Medicine in the Plan of Care Improve Quality of Life? J Patient Exp 2021; 7:989-993. [PMID: 33457535 PMCID: PMC7786766 DOI: 10.1177/2374373520967798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Acute and chronic digestive diseases are causing increased burden to patients and are increasing the United States health care spending. The purpose of this case report was to present how nonconfirmatory and conflicting diagnoses led to increased burden and suffering for a patient thus affecting quality of life. There were many physician visits and multiple tests performed on the patient. However, the primary care physician and specialists could not reach a confirmatory diagnosis. The treatment plans did not offer relief of symptoms, and the patient continues to experience digestive symptoms, enduring this burden for over 2 years. The central theme of this paper is to inform health care providers the importance of utilizing evidence-based primary care specialist collaboration models for better digestive disease outcomes. Consistent with patient’s experience, the authors propose to pilot/adopt the integrative health care approaches that are proven effective for treating digestive diseases.
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Affiliation(s)
- Andrew Thomas
- Bharati Vidyapeeth Medical College, Pune, India.,Research Volunteer, All of US Research Program, University of Illinois Health Sciences System, Chicago, IL, USA
| | - Annie Thomas
- Marcella Niehoff School of Nursing, Loyola University Chicago, BVM Hall, Chicago, IL, USA
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11
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Abbate C, Trimarchi PD, Inglese S, Gallucci A, Tomasini E, Bagarolo R, Giunco F. The Two-Step Strategy Could Be Inadequate and Counteracting to Diagnose Prodromal Dementia or Mild Cognitive Impairment. Front Aging Neurosci 2020; 12:229. [PMID: 32848708 PMCID: PMC7426713 DOI: 10.3389/fnagi.2020.00229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 06/30/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Carlo Abbate
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | | | - Silvia Inglese
- Geriatric Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessia Gallucci
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
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12
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Eneanya ND, Labbe AK, Stallings TL, Percy S, Temel JS, Klaiman TA, Park ER. Caring for older patients with advanced chronic kidney disease and considering their needs: a qualitative study. BMC Nephrol 2020; 21:213. [PMID: 32493235 PMCID: PMC7271389 DOI: 10.1186/s12882-020-01870-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 05/25/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Older patients with advanced chronic kidney disease often do not understand treatment options for renal replacement therapy, conservative kidney management, and advance care planning. It is unclear whether both clinicians and patients have similar perspectives on these treatments and end-of-life care. Thus, the aim of this study was to explore clinician and patient/caregiver perceptions of treatments for end-stage renal disease and advance care planning. METHODS This was a qualitative interview study of nephrologists (n = 8), primary care physicians (n = 8), patients (n = 10, ≥ 65 years and estimated glomerular filtration rate < 20), and their caregivers (n = 5). Interviews were conducted until thematic saturation was reached. Transcripts were transcribed using TranscribeMe. Using Nvivo 12, we identified key themes via narrative analysis. RESULTS We identified three key areas in which nephrologists', primary care physicians', and patients' expectations and/or experiences did not align: 1) dialysis discussions; 2) dialysis decision-making; and 3) processes of advance care planning. Nephrologist felt most comfortable specifically managing renal disease whereas primary care physicians felt their primary role was to advocate for patients and lead advance care planning discussions. Patients and caregivers had many concerns about the impact of dialysis on their lives and did not fully understand advance care planning. Clinicians' perspectives were aligned with each other but not with patient/caregivers. CONCLUSIONS Our findings highlight the differences in experiences and expectations between clinicians, patients, and their caregivers regarding treatment decisions and advance care planning. Despite clinician agreement on their responsibilities, patients and caregivers were unclear about several aspects of their care. Further research is needed to test feasible models of patient-centered education and communication to ensure that all stakeholders are informed and feel engaged.
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Affiliation(s)
- Nwamaka D Eneanya
- Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, 307 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA.
- Palliative and Advanced Illness Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Allison K Labbe
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Taylor L Stallings
- Palliative and Advanced Illness Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Shananssa Percy
- Division of Nephrology, Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School Center, Boston, MA, USA
| | - Jennifer S Temel
- Division of Hematology and Oncology, Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Tamar A Klaiman
- Palliative and Advanced Illness Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elyse R Park
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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13
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Arain M, Rostami M, Zaami M, Kiss V, Ward R. Specialist LINK and primary care network clinical pathways - a new approach to patient referral: a cross-sectional survey of awareness, utilization and usability among family physicians in Calgary. BMC FAMILY PRACTICE 2020; 21:86. [PMID: 32397966 PMCID: PMC7218522 DOI: 10.1186/s12875-020-01159-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 05/03/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Specialist LINK is a real-time, non-urgent telephone collaboration line designed to link family doctors and specialists. The purpose was to reduce wait times, improve efficiency and enhance the coordination of patient care through enhanced communication between primary and specialty care. The aim of this study was to determine the awareness and utilization of Specialist LINK and Primary Care Network (PCN) Clinical Pathways among family physicians. METHODS A family physician experience cross-sectional survey was conducted from March to May 2018 in Calgary and Area. The survey was designed to assess family physicians' awareness and utilization of Specialist LINK and PCN Clinical Pathways. We also used a 1-10 scale for respondents to rate the utility of Specialist LINK (1 was least useful and 10 represented highly useful). To obtain a true representative sample, family physicians were selected through a random sampling method. We applied multiple approaches to ensure a high response rate: paper survey, telephone reminders, and an on-site survey for non-responders. RESULTS A total of 251 participants completed the survey of the 650 randomly selected family physicians (Response rate≈39%). Eighty-nine percent of the family physicians were aware of Specialist LINK [95% Confidence Interval (84-92%)]. The average rating was 8.1 (on a scale of 1-10) for the usefulness of Specialist LINK. We found that the odds of being aware of Specialist LINK were two times higher in female family physicians compared to male physicians. Also, those with less than 5 years of experience, the odds of being aware of Specialist LINK were around five times higher compared to those with 5 or more years of experience. Fifty-five percent of family physicians were aware of PCN Clinical Pathways (95% CI = 48-60%); of those, 82% were accessing and following PCN Clinical Pathways in their clinical practice. The average rating was 7.9 (on a scale of 1-10) for the usefulness of PCN Clinical Pathways. CONCLUSION Most of the respondents in Calgary and area were aware of Specialist LINK and a large proportion of them were using it to access advice for their patients.
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Affiliation(s)
- Mubashir Arain
- Health Systems Evaluation & Evidence, Innovation and Research Management, Research Innovation and Analytics, Alberta Health Services, Southport Tower, Calgary, AB, T2W 1S7, Canada.
| | - Mahnoush Rostami
- Health Systems Evaluation & Evidence, Innovation and Research Management, Research Innovation and Analytics, Alberta Health Services, Southport Tower, Calgary, AB, T2W 1S7, Canada
| | - Mariama Zaami
- Health Systems Evaluation & Evidence, Innovation and Research Management, Research Innovation and Analytics, Alberta Health Services, Southport Tower, Calgary, AB, T2W 1S7, Canada
| | - Valerie Kiss
- Health Systems Evaluation & Evidence, Innovation and Research Management, Research Innovation and Analytics, Alberta Health Services, Southport Tower, Calgary, AB, T2W 1S7, Canada
| | - Richard Ward
- Health Systems Evaluation & Evidence, Innovation and Research Management, Research Innovation and Analytics, Alberta Health Services, Southport Tower, Calgary, AB, T2W 1S7, Canada
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