Encounter Decision Aid vs. Clinical Decision Support or Usual Care to Support Patient-Centered Treatment Decisions in Osteoporosis: The Osteoporosis Choice Randomized Trial II
Encounter Decision Aid vs. Clinical Decision Support or Usual Care to Support Patient-Centered Treatment Decisions in Osteoporosis: The Osteoporosis Choice Randomized Trial II
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DOI：
10.1371/journal.pone.0128063
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发表时间：
2015-05-26
期刊：
影响因子：
3.7
通讯作者：
Montori, Victor M.
中科院分区：
文献类型：
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作者：
LeBlanc, Annie;Wang, Amy T.;Montori, Victor M.
目的骨质疏松症选择，一个遇到的决策援助，可以参与患者和临床医生在共同决策有关骨质疏松症的治疗。它的有效性相比，常规提供给临床医生的病人的估计风险骨折使用FRAX计算器是unknow.MethodsPatient水平，随机，三臂试验招募妇女超过50骨量减少或骨质疏松症的治疗资格与双膦酸盐，其中使用骨质疏松症的选择相比，FRAX只和平时的照顾，以确定对病人的知识，决策冲突，参与决策过程中，决定开始和坚持bisphosphonates.ResultsWe招募了79名妇女在三个武器。因为单独FRAX估计和常规护理产生了相似的结果，我们将它们分组进行分析。相比之下，使用骨质疏松选择增加了患者的知识（中位数评分6 vs. 4，p = 0.01），提高了对骨折风险的理解，并降低了双膦酸盐的风险（p = 0.01和p
PurposeOsteoporosis Choice, an encounter decision aid, can engage patients and clinicians in shared decision making about osteoporosis treatment. Its effectiveness compared to the routine provision to clinicians of the patient's estimated risk of fracture using the FRAX calculator is unknown.MethodsPatient-level, randomized, three-arm trial enrolling women over 50 with osteopenia or osteoporosis eligible for treatment with bisphosphonates, where the use of Osteoporosis Choice was compared to FRAX only and to usual care to determine impact on patient knowledge, decisional conflict, involvement in the decision-making process, decision to start and adherence to bisphosphonates.ResultsWe enrolled 79 women in the three arms. Because FRAX estimation alone and usual care produced similar results, we grouped them for analysis. Compared to these, use of Osteoporosis Choice increased patient knowledge (median score 6 vs. 4, p = .01), improved understanding of fracture risk and risk reduction with bisphosphonates (p = .01 and p