Training clinicians in how to use patient-reported outcome measures in routine clinical practice
Training clinicians in how to use patient-reported outcome measures in routine clinical practice
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DOI：
10.1007/s11136-014-0903-5
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发表时间：
2015-07-01
影响因子：
3.5
通讯作者：
Velikova, Galina
中科院分区：
文献类型：
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作者：
Santana, Maria J.;Haverman, Lotte;Velikova, Galina
最初开发了由患者报告的结果指标（PRO）来比较临床试验和人群研究中的人群，并将结果用于支持治疗建议或为卫生政策提供信息，但对提供PRO数据的参与者没有直接的好处。但是，随着使用这些措施的经验增加，在日常实践中使用单个患者专业人士的临床价值显然成为识别/监测症状，评估治疗结果并支持共同决策。限制成功实施的一个关键问题是临床医生对如何有效利用Pros数据的知识缺乏知识。使用变更管理理论框架，本文介绍了三个计划的开发和实施，以使培训临床医生有效地在常规练习。在三个具有不同医疗保健系统的国家 /地区，培训计划在三个不同的临床领域（成人肿瘤学，肺移植和儿科），因此提供了一个难得的机会，可以在识别特定环境的同时拔出共同的方法。对于每个计划，我们描述了临床和组织环境，计划计划和开发，培训课程的内容，支持材料，随后监视优点使用以及采用证据。确定了共同的成功组成部分和实用步骤，从而导致讨论和未来的建议。这三个培训计划的结果被描述为实施。在肿瘤学计划中，PRO数据已经开发并正在评估；在肺移植计划中，Pro数据用于日常实践，并且与电子患者记录的集成正在开发中；在小儿计划中，自实施开始以来，PRO数据已全面实施了约7,600次咨询。主教学习计划教临床医生如何在临床实践中使用和行动在临床实践中，是支持患者参与和参与共同决策的关键步骤-制作。来自不同临床领域的研究人员和临床医生应合作分享思想，制定指南并促进以患者为中心的护理方面的良好实践。
Patient-reported outcome measures (PROs) were originally developed for comparing groups of people in clinical trials and population studies, and the results were used to support treatment recommendations or inform health policy, but there was not direct benefit for the participants providing PROs data. However, as the experience in using those measures increased, it became obvious the clinical value in using individual patient PROs profiles in daily practice to identify/monitor symptoms, evaluate treatment outcomes and support shared decision-making. A key issue limiting successful implementation is clinicians' lack of knowledge on how to effectively utilize PROs data in their clinical encounters.Using a change management theoretical framework, this paper describes the development and implementation of three programs for training clinicians to effectively use PRO data in routine practice. The training programs are in three diverse clinical areas (adult oncology, lung transplant and paediatrics), in three countries with different healthcare systems, thus providing a rare opportunity to pull out common approaches whilst recognizing specific settings. For each program, we describe the clinical and organizational setting, the program planning and development, the content of the training session with supporting material, subsequent monitoring of PROs use and evidence of adoption. The common successful components and practical steps are identified, leading to discussion and future recommendations.The results of the three training programs are described as the implementation. In the oncology program, PRO data have been developed and are currently evaluated; in the lung transplant program, PRO data are used in daily practice and the integration with electronic patient records is under development; and in the paediatric program, PRO data are fully implemented with around 7,600 consultations since the start of the implementation.Adult learning programs teaching clinicians how to use and act on PROs in clinical practice are a key steps in supporting patient engagement and participation in shared decision-making. Researchers and clinicians from different clinical areas should collaborate to share ideas, develop guidelines and promote good practice in patient-centred care.