1
|
Venderbos LDF, Remmers S, Deschamps A, Dowling J, Carl EG, Pereira-Azevedo N, Roobol MJ. The Europa Uomo Patient Reported Outcome Study 2.0-Prostate Cancer Patient-reported Outcomes to Support Treatment Decision-making. Eur Urol Focus 2023; 9:1024-1036. [PMID: 37268512 DOI: 10.1016/j.euf.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/21/2023] [Accepted: 05/23/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND To further strengthen the voice of patients, Europa Uomo initiated the Europa Uomo Patient Reported Outcome Study 2.0 (EUPROMS 2.0) in October 2021. OBJECTIVE To collect the self-reported perspective of prostate cancer (PCa) patients on physical and mental well-being after PCa treatment outside a clinical trial setting to inform future fellow patients about the impact of PCa treatment. DESIGN, SETTING, AND PARTICIPANTS Europa Uomo invited PCa patients to complete a cross-sectional survey including the validated EQ-5D-5L, EORTC-QLQ-C30, and the EPIC-26 questionnaires. Furthermore, the nine-item Shared Decision Making Questionnaire (SDM-Q-9) and diagnostic clinical scenarios were included. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Descriptive statistics was used to assess the demographic and clinical characteristics and to analyze the patient-reported outcome data. RESULTS AND LIMITATIONS Between October 25, 2021 and January 17, 2022, 3571 men from 30 countries completed the EUPROMS 2.0 survey. The median age of respondents was 70 yr (interquartile range 65-75 yr). Half of the respondents underwent one treatment, most often radical prostatectomy. Men who are treated actively experience lower health-related quality of life than men on active surveillance, mainly regarding sexual function, fatigue, and insomnia. Lower urinary incontinence levels were seen for men who underwent radical prostatectomy (single treatment or in combination with other treatments). Of the respondents, 42% indicated that the determination of the prostate-specific antigen (PSA) value was part of a routine blood test; 25% wanted to undergo screening/early detection for PCa, and 20% indicated that the determination of the PSA value had a clinical reason. CONCLUSIONS A large sample of 3571 international patients has contributed patient experience after PCa treatment in the EUPROMS 2.0 study, confirming that treatment for PCa mainly affects urinary incontinence, sexual function, fatigue, and insomnia. Such information can be used to direct toward a better patient-doctor relationship, to offer patients ready access to responsible information and a better understanding of their disease and treatment. PATIENT SUMMARY Through the EUPROMS 2.0 survey, Europa Uomo has strengthened the voice of the patient. Such information can be used to inform future prostate cancer (PCa) patients about the impact of PCa treatment and to engage them in informed and shared decision-making.
Collapse
Affiliation(s)
- Lionne D F Venderbos
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Sebastiaan Remmers
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | | | | | - Nuno Pereira-Azevedo
- Department of Urology, Entre o Douro e Vouga Medical Center, Santa Maria da Feira, Portugal
| | - Monique J Roobol
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
2
|
Lee DL, Hammond JW, Finkel K, Gardner DD, Nelson B, Baptist AP. An Electronic Shared Decision-Making App to Improve Asthma Outcomes: A Randomized Controlled Trial. J Allergy Clin Immunol Pract 2023; 11:3116-3122.e5. [PMID: 37329951 DOI: 10.1016/j.jaip.2023.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/31/2023] [Accepted: 06/08/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Shared decision-making (SDM) incorporates patient values and preferences to optimize asthma management decisions. Available asthma SDM aids primarily focus on medication selection. OBJECTIVE To assess the usability, acceptability, and preliminary effectiveness of an electronic SDM application, the ACTION (Active Conversation in asthma Treatment shared decisION-making) app, that addressed medication, nonmedication, and COVID-19 concerns for asthma. METHODS In this pilot study, 81 participants with asthma were randomized into the control arm or ACTION app intervention. The ACTION app was completed 1 week before a clinic visit, and responses were shared with the medical provider. The primary outcomes were patient satisfaction and SDM quality. Next, ACTION app users (n = 9) and providers (n = 5) provided feedback through separate virtual focus groups. Sessions were coded by comparative analysis. RESULTS The ACTION app group scored higher agreement that providers adequately addressed COVID-19 concerns compared with the control group (4.4 vs 3.7, P = .03). Although the ACTION app group had a higher total 9-item Shared Decision-Making Questionnaire score, this did not reach statistical significance (87.1 vs 83.3, P = .2). However, the ACTION app group demonstrated stronger agreement that their physician knew exactly how they wanted to be involved in decision-making (4.3 vs 3.8, P = .05), providers asked about preferences (4.3 vs 3.8, P = .05), and that different options were thoroughly weighed (4.3 vs 3.8, P = .03). Major focus group themes included that the ACTION app was practical and established a patient-centered agenda. CONCLUSION An electronic asthma SDM app that incorporates patient preferences regarding nonmedication-related, medication-related, and COVID-19-related concerns is well accepted and can improve patient satisfaction and SDM.
Collapse
Affiliation(s)
- Deborah L Lee
- Department of Internal Medicine, Division of Allergy/Clinical Immunology, University of Michigan, Ann Arbor, Mich.
| | - John W Hammond
- Department of Internal Medicine, Division of Allergy/Clinical Immunology, University of Michigan, Ann Arbor, Mich
| | - Kelsey Finkel
- Department of Internal Medicine, Ascension Genesys Hospital, Grand Blanc, Mich
| | | | - Belinda Nelson
- Department of Internal Medicine, Division of Allergy/Clinical Immunology, University of Michigan, Ann Arbor, Mich
| | - Alan P Baptist
- Department of Internal Medicine, Division of Allergy/Clinical Immunology, University of Michigan, Ann Arbor, Mich
| |
Collapse
|
3
|
Freites-Martinez A, Navitski A, Friedman CF, Chan D, Goldfarb S, Lacouture ME, O'Cearbhaill RE. Shared decision making for patients with breast and gynecologic malignancies undergoing chemotherapy associated with persistent alopecia. Gynecol Oncol Rep 2022; 44:101095. [PMID: 36388759 PMCID: PMC9640350 DOI: 10.1016/j.gore.2022.101095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Objective To assess patient-perceived involvement in shared decision making among those diagnosed with breast or gynecologic malignancies undergoing chemotherapy associated with persistent chemotherapy-induced alopecia (pCIA). We also sought to identify factors that influence shared decision making. Methods We recruited patients from the Gynecologic Medical Oncology and Breast Medicine Services at a large academic center for this prospective cohort study. All patients were scheduled to start chemotherapy between June 1, 2017 and December 31, 2017. Following medical consultation, including discussion of the risk of pCIA, patients completed the 9-item Shared Decision Making Questionnaire (SDM-Q-9). Clinical and sociodemographic information was also collected. Univariate analysis was used to evaluate SDM-Q-9 total scores and their constituents for all variables. Results Sixty-one patients completed the survey. The median total SDM-Q-9 score was 95.6 (95% CI: 90-100). Most patients (n = 57, 93%) reported a high level of involvement (SDM-Q-9 total score > 66). There was no difference in total scores between patients with breast compared with gynecologic cancer (P > .05). By individual item, the scores for item Q1 ("My doctor made clear that a decision needs to be made") were significantly lower for Black patients and those with advanced disease (P < .05). Conclusions Most patients indicated they were adequately involved in shared decision making regarding chemotherapy treatment options and their risk for pCIA. Patients from underrepresented populations and those with advanced disease may benefit from additional support from their clinicians to better address the anticipated psychosocial impacts of pCIA and facilitate the provision of optimal and equitable care.
Collapse
Affiliation(s)
- Azael Freites-Martinez
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Anastasia Navitski
- Department of Obstetrics and Gynecology, Augusta University, Augusta, GA, United States
| | - Claire F. Friedman
- Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan, Kettering Cancer Center, New York, NY, United States,Department of Medicine, Weill Cornell Medical College, New York, NY, United States
| | - Donald Chan
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Shari Goldfarb
- Department of Medicine, Weill Cornell Medical College, New York, NY, United States,Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer, Center, New York, NY, United States
| | - Mario E. Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States,Department of Medicine, Weill Cornell Medical College, New York, NY, United States
| | - Roisin E. O'Cearbhaill
- Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan, Kettering Cancer Center, New York, NY, United States,Department of Medicine, Weill Cornell Medical College, New York, NY, United States,Corresponding author at: Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States.
| |
Collapse
|
4
|
Tsuboi H, Kaneko Y, Ikeda K, Aranishi T, Cai Z, Ishizuka T. Current status of shared decision making for rheumatoid arthritis treatment in Japan: a web-based survey on physicians and patients. Curr Med Res Opin 2022; 38:853-861. [PMID: 35260022 DOI: 10.1080/03007995.2022.2050108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To assess the current status of shared decision making (SDM) in rheumatoid arthritis (RA) clinical practice in Japan from the perspectives of physicians and patients. METHODS A web-based survey was conducted to recruit patients with RA who were prescribed, for the first time, a conventional synthetic disease-modifying antirheumatic drug (csDMARD) or a biological drug/Janus kinase (JAK) inhibitor, and physicians who prescribed these treatments to patients with RA. The SDM Questionnaire-Physician version (SDM-Q-Doc) and the 9-item SDM Questionnaire (SDM-Q-9) were used to assess the SDM levels of physicians and patients, respectively. The scale ranged from 0 to 100, and higher scores indicated better SDM status. RESULTS The responses from 107 physicians who treat patients with RA, 107 patients prescribed a csDMARD, and 110 patients prescribed a biological drug/JAK inhibitor were collected. The mean SDM score for SDM-Q-Doc was 74.5 when physicians decided to prescribe a csDMARD and 77.2 when they decided to prescribe a biological drug/JAK inhibitor. However, the mean SDM score for SDM-Q-9 was 62.3 when patients were prescribed csDMARDs and 72.6 when they were prescribed biological drugs/JAK inhibitors. CONCLUSIONS The results showed differences in SDM level between patients and physicians and, from the patient perspective, between treatment types.
Collapse
Affiliation(s)
- Hiroto Tsuboi
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Yuko Kaneko
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kei Ikeda
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan
| | - Toshihiko Aranishi
- Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K, Kobe, Japan
| | - Zhihong Cai
- Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K, Kobe, Japan
| | - Tomoko Ishizuka
- Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K, Kobe, Japan
| |
Collapse
|
5
|
Shunnmugam B, Ng CJ, Aishah Mohd Taib N, Chinna K. Validation of the Malay, English, and Chinese Translations of the 9-Item Shared Decision Making Questionnaire ( SDM-Q-9) in Breast Cancer Patients Making Treatment Decisions. Asia Pac J Public Health 2021; 33:914-922. [PMID: 34467767 DOI: 10.1177/10105395211036625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aims to test the psychometric properties of the Malay, English, and Chinese 9-Item Shared Decision Making Questionnaire (SDM-Q-9) in breast cancer patients making treatment decisions. The original German SDM-Q-9 was translated to Malay using the back-translation method. A total of 222 newly diagnosed breast cancer patients making treatment decisions were sampled conveniently from three breast clinics between August 2015 and February 2016. A total of 66 patients answered the SDM-Q-9 in Malay, 87 in English, and 69 in Chinese. Data were analyzed using SPSS and AMOS software. SDM-Q-9 demonstrated good reliability in the three translations. All the items correlated well except for Item 1 in English. The factor loadings were within acceptable range except for Item 1 in Malay, Items 1 and 2 in English, and Items 7 and 9 in Chinese SDM-Q-9. However, no items were deleted in accordance with experts' opinions and the previous SDM-Q-9 validation studies. The Malay, English, and Chinese SDM-Q-9 demonstrated good reliability and validity.
Collapse
Affiliation(s)
- Bairave Shunnmugam
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nur Aishah Mohd Taib
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | |
Collapse
|
6
|
Nakayama K, Osaka W, Matsubara N, Takeuchi T, Toyoda M, Ohtake N, Uemura H. Shared decision making, physicians' explanations, and treatment satisfaction: a cross-sectional survey of prostate cancer patients. BMC Med Inform Decis Mak 2020; 20:334. [PMID: 33317523 PMCID: PMC7734751 DOI: 10.1186/s12911-020-01355-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 11/30/2020] [Indexed: 11/16/2022] Open
Abstract
Background Hormone therapy is one option for some types of prostate cancer. Shared decision making (SDM) is important in the decision making process, but SDM between prostate cancer patients receiving hormone therapy and physicians is not fully understood. This study tested hypotheses: “Patients’ perception of SDM is associated with treatment satisfaction, mediated by satisfaction with physicians’ explanations and perceived effective decision making” and “The amount of information provided to patients by physicians on diseases and treatment is associated with treatment satisfaction mediated by patients’ perceived SDM and satisfaction with physicians’ explanations.” Methods This cross-sectional study was conducted using an online panel via a private research company in Japan. The participants in this study were patients registered with the panel who had received or were currently receiving hormone therapy for prostate cancer and physicians registered with the panel who were treating patients with prostate cancer. Measures used in this study included a nine-item Shared Decision Making Questionnaire, levels of satisfaction with physicians’ explanations and treatment satisfaction, and effective decision making for patients (feeling the choice is informed, value-based, likely to be implemented and expressing satisfaction with the choice), and a Shared Decision Making Questionnaire for Doctors. The hypotheses were examined using path analysis. Results In total, 124 patients and 150 physicians were included in the analyses. In keeping with our hypotheses, perceived SDM significantly correlated with the physicians’ explanations and perceived effective decision making for patients, and satisfaction with physicians’ explanations and perceived effective decision making for patients were both related to treatment satisfaction. Although the amount of information provided to patients was correlated with the perceived SDM, it was indirectly related to their satisfaction with physicians’ explanations. Conclusions When physicians encourage patients to be actively involved in making decisions about treatment through the SDM process while presenting a wide range of information at the start of hormone therapy, patients’ effective decision making and physicians’ explanations may be improved; consequently, the patients’ overall treatment satisfaction may be improved. Physicians who treat patients with prostate cancer may have underestimated the importance of SDM before starting hormone therapy, even greater extent than patients.
Collapse
Affiliation(s)
- Kazuhiro Nakayama
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan.
| | - Wakako Osaka
- Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan.,The Jikei University School of Medicine, School of Nursing, Tokyo, Japan
| | - Nobuaki Matsubara
- Department of Breast and Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | | | | | | | - Hiroji Uemura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| |
Collapse
|
7
|
Rencz F, Tamási B, Brodszky V, Ruzsa G, Gulácsi L, Péntek M. Did You Get What You Wanted? Patient Satisfaction and Congruence Between Preferred and Perceived Roles in Medical Decision Making in a Hungarian National Survey. Value Health Reg Issues 2020; 22:61-67. [PMID: 32798836 DOI: 10.1016/j.vhri.2020.07.573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/21/2020] [Accepted: 07/02/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVES In a growing number of countries, patient involvement in medical decisions is considered a cornerstone of broader health policy agendas. This study seeks to explore public preferences for and experiences with participation in treatment decisions in Hungary. METHODS A nationally representative online panel survey was conducted in 2019. Outcome measures included the Control Preferences Scale for the preferred and actual role in the decision, the 9-item Shared Decision Making Questionnaire, and a Satisfaction With Decision numeric rating scale. RESULTS A total of 1000 respondents participated in the study, 424 of whom reported having had a treatment decision in the preceding 6 months. Overall, 8%, 18%, 51%, 19%, and 4% of the population preferred an active, semiactive, shared, semipassive, and passive role in decision making, respectively. Corresponding rates for perceived role were as follows: 9%, 15%, 35%, 26%, and 15%. Preferred and perceived roles matched for 52% of the population, whereas 32% preferred more and 16% less participation. Better health status, attaining role congruence, and higher 9-item Shared Decision Making Questionnaire scores were positively associated with satisfaction, accounting for 32% of the variation in Satisfaction With Decision scores (P < .05). CONCLUSIONS This study represents the first national survey on decisional roles in healthcare in Hungary and, more broadly, in Central and Eastern Europe. Shared decision making is the most preferred decisional role in Hungary; nevertheless, there is still room to improve patient involvement in decision making. It seems that patient satisfaction may be improved through tailoring the decisional role to reflect patients' preferences and through practices that encourage shared decision making.
Collapse
Affiliation(s)
- Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary; Premium Postdoctoral Research Programme, Hungarian Academy of Sciences, Budapest, Hungary.
| | - Béla Tamási
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Gábor Ruzsa
- Institute of Psychology, Doctoral School of Psychology, Eötvös Loránd University of Sciences, Budapest, Hungary; Department of Statistics, Corvinus University of Budapest, Budapest, Hungary
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| |
Collapse
|
8
|
Baicus C, Balanescu P, Gurghean A, Badea CG, Padureanu V, Rezus C, Mitu F, Jurcut R, Balanescu AR, Daha I, Balanescu E, Bojinca M, Pinte L, Constantin AM, Dima N, Floria M, Leon-Constantin MM, Roca M, Mitu M, Chiriac S, Badescu CM, Ionescu SD, Mitrea E, Rosu G, Ionescu GD, Visinescu AM, Mihailescu G, Lapadatu R, Oprisan E, Zeh S, Scholl I, Härter M. Romanian version of SDM-Q-9 validation in Internal Medicine and Cardiology setting: a multicentric cross-sectional study. ACTA ACUST UNITED AC 2019; 57:195-200. [PMID: 30721145 DOI: 10.2478/rjim-2019-0002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Shared decision making (SDM) is becoming more and more important for the patient-physician interaction. There has not been a study in Romania evaluating patients' point of view in the SDM process yet. Therefore, the present study aims to evaluate the psychometric parameters of the translated Romanian version of SDM-Q-9. MATERIAL AND METHODS A multicentric cross-sectional study was performed comprising eight recruitment centers. The sample consisted of in- and outpatients who referred to Hospital Units for treatment for atrial fibrillation or collagen diseases. Furthermore, patients who were members of Autoimmune Disease Patient Society were able to participate via an online survey. All participants completed the Romanian translated SDM-Q-9. RESULTS Altogether, 665 questionnaires were filled in within the hospital setting (n = 324; 48.7%) and online (n = 341; 51.3%). The Romanian version had good internal consistency (Cronbach α coefficient of 0.96.) Corrected item correlations were good ranging from 0.64 to 0.89 with low corrected item correlations for item 1 and item 7. PCA found a one-factorial solution (similar with previous reports) but the first item had the lowest loading. CONCLUSION SDM-Q-9 is a useful tool for evaluation and improvement in health care that was validated in Romania and can be used in clinical setting in this country.
Collapse
|
9
|
Baicus C, Balanescu P, Zeh S, Oprisan E, Lapadatu R, Gurghean A, Padureanu V, Rezus C, Mitu F, Jurcut R, Balanescu AR, Daha I, Balanescu E, Bojinca M, Pinte L, Constantin AM, Dima N, Floria M, Leon-Constantin MM, Roca M, Mitu M, Chiriac S, Badescu CM, Ionescu SD, Mitrea E, Rosu G, Rezus E, Ionescu GD, Visinescu AM, Mihailescu G, Badea CG. Characteristics of shared decision making in Romania from the patient perspective: A cross-sectional multicentric study. J Eval Clin Pract 2019; 25:1152-1159. [PMID: 31407420 DOI: 10.1111/jep.13257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Shared decision making (SDM) is very important from patients' perspective. This process has not yet been evaluated in Romania. The study aims to evaluate SDM from the patients' perspective and to evaluate patients' characteristics that associate with SDM. MATERIAL AND METHODS A cross-sectional multicentric study comprising eight recruitment centres was performed. Inpatients and outpatients who referred to Hospital Units treating autoimmune diseases or atrial fibrillation were included. Another sample consisted of members of the Autoimmune Disease Patient Society, who completed an online anonymous questionnaire. All participants completed the Romanian translated version of the 9-item Shared Decision Making Questionnaire (SDM-Q-9), as these samples were used for the validation of this questionnaire, too. Patients had to refer to the visit in which the decision concerning the antithrombotic treatment was taken (atrial fibrillation patients), or the immunosuppressive treatment was last time changed (autoimmune disease patients). Ordinal regression having the total SDM score as dependent variable was used. RESULTS A total of 665 questionnaires were filled in within the hospital setting (n = 324; 48.7%) and online (n = 341; 51.3%). The median score for SDM was 34 of 45, but it differed between hospital completion -39/45 and online completion (anonymous) -20/45 (P < .001). Patients with higher education were influenced most by the setting, giving the best marks in hospital and low marks online, while those with lower education gave lower marks in both settings. In ordinal regression with SDM score as dependent variable, hospital completion of the questionnaire (OR = 9.5, 95% confidence interval, 5.69-16), collagen disease diagnosis (OR = 2.4, 95% confidence interval, 1.39-4.14), and immunosuppressive treatment (OR = 2.16, 95% confidence interval, 1.43-3.26) were independent predictors. CONCLUSION In our study, full anonymity was associated with significantly lower scores for the SDM process. The patients with higher education were most influenced by this condition, while those with the lowest education were the most critical.
Collapse
Affiliation(s)
- Cristian Baicus
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Internal Medicine Department, Colentina Hospital, Bucharest, Romania
| | - Paul Balanescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Internal Medicine Department, Colentina Hospital, Bucharest, Romania
| | - Stefan Zeh
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Emilia Oprisan
- Faculty of Psychology and Educational Sciences, University of Bucharest, Bucharest, Romania
| | - Rozalina Lapadatu
- The Association of Patients with Autoimmune Diseases, Bucharest, Romania
| | - Adriana Gurghean
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Internal Medicine Department, Coltea Hospital, Bucharest, Romania
| | - Vlad Padureanu
- Internal Medicine Department, University of Medicine Craiova, Craiova, Romania
| | - Ciprian Rezus
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.,Internal Medicine Department, Sf Spiridon Emergency County Hospital, Iasi, Romania
| | - Florin Mitu
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.,Cardiovascular Rehabilitation, Rehabilitation Hospital-Iasi, Iasi, Romania
| | - Ruxandra Jurcut
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,CC Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
| | - Andra Rodica Balanescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Rheumatology Department, Sf Maria Hospital, Bucharest, Romania
| | - Ioana Daha
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Internal Medicine Department, Colentina Hospital, Bucharest, Romania
| | - Eugenia Balanescu
- Internal Medicine Department, Colentina Hospital, Bucharest, Romania
| | - Mihai Bojinca
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Rheumatology Department, Cantacuzino Hospital, Bucharest, Romania
| | - Larisa Pinte
- Internal Medicine Department, Colentina Hospital, Bucharest, Romania
| | | | - Nicoleta Dima
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.,Internal Medicine Department, Sf Spiridon Emergency County Hospital, Iasi, Romania
| | - Mariana Floria
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.,Internal Medicine Department, Sf Spiridon Emergency County Hospital, Iasi, Romania
| | - Maria Magdalena Leon-Constantin
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.,Cardiovascular Rehabilitation, Rehabilitation Hospital-Iasi, Iasi, Romania
| | - Mihai Roca
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Magda Mitu
- Cardiovascular Rehabilitation, Rehabilitation Hospital-Iasi, Iasi, Romania
| | - Silvia Chiriac
- Cardiovascular Rehabilitation, Rehabilitation Hospital-Iasi, Iasi, Romania
| | - Codruta Minerva Badescu
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.,Internal Medicine Department, Sf Spiridon Emergency County Hospital, Iasi, Romania
| | | | - Elena Mitrea
- Internal Medicine Department, Sf Spiridon Emergency County Hospital, Iasi, Romania
| | - Gabriel Rosu
- Internal Medicine Department, Sf Spiridon Emergency County Hospital, Iasi, Romania
| | - Elena Rezus
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.,Rheumatology Department, Rehabilitation Hospital-Iasi, Iasi, Romania
| | | | | | - Gabriela Mihailescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Internal Medicine Department, Colentina Hospital, Bucharest, Romania
| | - Camelia Georgeta Badea
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Internal Medicine Department, Colentina Hospital, Bucharest, Romania
| |
Collapse
|
10
|
Rencz F, Tamási B, Brodszky V, Gulácsi L, Weszl M, Péntek M. Validity and reliability of the 9-item Shared Decision Making Questionnaire ( SDM-Q-9) in a national survey in Hungary. Eur J Health Econ 2019; 20:43-55. [PMID: 31111402 PMCID: PMC6544590 DOI: 10.1007/s10198-019-01061-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 04/14/2019] [Indexed: 05/15/2023]
Abstract
BACKGROUND The nine-item Shared Decision Making Questionnaire (SDM-Q-9) is one of the most frequently applied instruments for assessing patients' involvement in medical decision-making. Our objectives were to develop a Hungarian version of SDM-Q-9, to evaluate its psychometric properties and to compare its performance between primary and specialised care settings. METHODS In 2019, a sample of adults (n = 537) representative of the Hungarian general population in terms of age, gender and geographic region completed an online survey with respect to a recent health-related decision. Outcome measures included SDM-Q-9 and Control Preferences Scale-post (CPSpost). Item characteristics, internal consistency reliability and the factor structure of SDM-Q-9 were determined. RESULTS The overall ceiling and floor effects for SDM-Q-9 total scores were 12.3% and 2.2%, respectively. An excellent internal consistency reliability (Cronbach's alpha 0.925) was demonstrated. Exploratory factor analysis resulted in a one-factor model explaining 63.5% of the variance of SDM-Q-9. A confirmatory factor analysis supported the acceptability of this model. Known-groups validity was confirmed with CPSpost categories; mean SDM-Q-9 total scores were higher in the 'Shared decision' category (72.6) compared to both 'Physician decided' (55.1, p = 0.0002) and 'Patient decided' (57.2, p = 0.0086) categories. In most aspects of validity and reliability, there was no statistically significant difference between primary and specialised care. CONCLUSIONS The overall good measurement properties of the Hungarian SDM-Q-9 make the questionnaire suitable for use in both primary and specialised care settings. SDM-Q-9 may be useful for health policies targeting the implementation of shared decision-making and aiming to improve efficiency and quality of care in Hungary.
Collapse
Affiliation(s)
- Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary.
- Premium Postdoctoral Research Programme, Hungarian Academy of Sciences, Nádor u. 7, Budapest, 1051, Hungary.
| | - Béla Tamási
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, Budapest, 1085, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary
| | - Miklós Weszl
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary
| |
Collapse
|
11
|
Ballesteros J, Moral E, Brieva L, Ruiz-Beato E, Prefasi D, Maurino J. Psychometric properties of the SDM-Q-9 questionnaire for shared decision-making in multiple sclerosis: item response theory modelling and confirmatory factor analysis. Health Qual Life Outcomes 2017; 15:79. [PMID: 28431587 PMCID: PMC5401467 DOI: 10.1186/s12955-017-0656-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 04/13/2017] [Indexed: 11/21/2022] Open
Abstract
Background Shared decision-making is a cornerstone of patient-centred care. The 9-item Shared Decision-Making Questionnaire (SDM-Q-9) is a brief self-assessment tool for measuring patients’ perceived level of involvement in decision-making related to their own treatment and care. Information related to the psychometric properties of the SDM-Q-9 for multiple sclerosis (MS) patients is limited. The objective of this study was to assess the performance of the items composing the SDM-Q-9 and its dimensional structure in patients with relapsing-remitting MS. Methods A non-interventional, cross-sectional study in adult patients with relapsing-remitting MS was conducted in 17 MS units throughout Spain. A nonparametric item response theory (IRT) analysis was used to assess the latent construct and dimensional structure underlying the observed responses. A parametric IRT model, General Partial Credit Model, was fitted to obtain estimates of the relationship between the latent construct and item characteristics. The unidimensionality of the SDM-Q-9 instrument was assessed by confirmatory factor analysis. Results A total of 221 patients were studied (mean age = 42.1 ± 9.9 years, 68.3% female). Median Expanded Disability Status Scale score was 2.5 ± 1.5. Most patients reported taking part in each step of the decision-making process. Internal reliability of the instrument was high (Cronbach’s α = 0.91) and the overall scale scalability score was 0.57, indicative of a strong scale. All items, except for the item 1, showed scalability indices higher than 0.30. Four items (items 6 through to 9) conveyed more than half of the SDM-Q-9 overall information (67.3%). The SDM-Q-9 was a good fit for a unidimensional latent structure (comparative fit index = 0.98, root-mean-square error of approximation = 0.07). All freely estimated parameters were statistically significant (P < 0.001). All items presented standardized parameter estimates with salient loadings (>0.40) with the exception of item 1 which presented the lowest loading (0.26). Items 6 through to 8 were the most relevant items for shared decision-making. Conclusions The SDM-Q-9 presents appropriate psychometric properties and is therefore useful for assessing different aspects of shared decision-making in patients with multiple sclerosis.
Collapse
Affiliation(s)
- Javier Ballesteros
- Department of Neurosciences and CIBERSAM, University of Basque Country, Leioa, Spain
| | - Ester Moral
- Department of Neurology, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain
| | - Luis Brieva
- Department of Neurology, Hospital Arnau de Vilanova, Lleida, Spain
| | - Elena Ruiz-Beato
- Health Economics and Outcomes Research Unit, Roche Farma SA, Madrid, Spain
| | - Daniel Prefasi
- Medical Department, Roche Farma SA, Eucalipto 33, 28016, Madrid, Spain
| | - Jorge Maurino
- Medical Department, Roche Farma SA, Eucalipto 33, 28016, Madrid, Spain.
| |
Collapse
|
12
|
De Las Cuevas C, Peñate W, Perestelo-Pérez L, Serrano-Aguilar P. Shared decision making in psychiatric practice and the primary care setting is unique, as measured using a 9-item Shared Decision Making Questionnaire ( SDM-Q-9). Neuropsychiatr Dis Treat 2013; 9:1045-52. [PMID: 23950646 PMCID: PMC3742346 DOI: 10.2147/ndt.s49021] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND To measure and compare the extent to which shared a decision making (SDM) process is implemented both in psychiatric outpatient clinical encounters and in the primary care setting from the patient's perspective. METHODS A total of 1,477 patients recruited from the Canary Islands Health Service mental health and primary care departments were invited to complete the nine-item Shared Decision Making Questionnaire (SDM-Q-9) immediately after their consultation. MANCOVA, Student's t-test, and Pearson correlations were used to assess the relationship and differences between SDM-Q-9 scores in patient samples. RESULTS No differences were found in SDM-Q-9 total scores between the two patient samples, but there were relevant differences when item by item analysis was applied; differences were observed according to the different steps of the SDM process. SDM is present to a very limited extent in the routine psychiatric setting compared to primary care. Patients' age, education, type of appointment, and treatment decision all play a specific role in predicting SDM. CONCLUSION The study provides evidence that SDM is a complex process that needs to be analyzed according to its different steps. SDM patterns were different in the primary care and psychiatric outpatient care settings and reflect quite a different perspective of the decision making process.
Collapse
Affiliation(s)
- Carlos De Las Cuevas
- Department of Psychiatry, University of La Laguna, Tenerife, Spain ; Health Services Research Network for Chronic Diseases (REDISSEC), Tenerife, Spain
| | | | | | | |
Collapse
|