Does patient time spent viewing computer-tailored colorectal cancer screening materials predict patient-reported discussion of screening with providers?
Does patient time spent viewing computer-tailored colorectal cancer screening materials predict patient-reported discussion of screening with providers?
复制标题
患者观看计算机定制的结直肠癌筛查材料所花费的时间是否可以预测患者报告的与提供者进行筛查的讨论？
DOI：
10.1093/her/cyw032
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发表时间：
2016
影响因子：
2.4
通讯作者：
Jerant,Anthony
中科院分区：
文献类型：
--
作者：
Sanders,Mechelle;Fiscella,Kevin;Veazie,Peter;Dolan,JamesG;Jerant,Anthony
主要目的是检查患者在初级保健医生（PCP）就诊前查看结直肠癌（CRC）筛查信息的时间是否与就诊期间筛查选择的讨论有关。我们分析了一项多中心随机对照试验的数据，该试验采用定制的交互式多媒体计算机程序（IMCP）来激活患者接受结直肠癌筛查，并在就诊前立即部署在初级保健办公室。我们使用存储在IMCP中的使用时间信息来检查患者使用该程序的时间与患者在就诊期间报告的筛查讨论之间的关系，并根据先前的CRC筛查建议和阅读速度进行调整。病人平均花了33分钟在这个项目上。在调整分析中，使用该程序30分钟与患者与PCP讨论的几率增加41%相关（1.04,1.59,95% CI）。在单独分析裁剪模块；鼓励遵守量身定制的筛查建议和与患者PCP讨论的模块产生了显著的结果。筛选讨论的其他预测因素包括更好的自我报告的身体健康和增加的患者激活。花在这个项目上的时间预示着在相关的访问中，更多的病人和医生对筛查的讨论。IMCPs自动收集的使用时间信息为客观评估患者对某个主题的参与程度以及预测患者与其临床医生之间讨论的可能性提供了希望。
The main aim is to examine whether patients’ viewing time on information about colorectal cancer (CRC) screening before a primary care physician (PCP) visit is associated with discussion of screening options during the visit. We analyzed data from a multi-center randomized controlled trial of a tailored interactive multimedia computer program (IMCP) to activate patients to undergo CRC screening, deployed in primary care offices immediately before a visit. We employed usage time information stored in the IMCP to examine the association of patient time spent using the program with patient-reported discussion of screening during the visit, adjusting for previous CRC screening recommendation and reading speed.On average, patients spent 33 minutes on the program. In adjusted analyses, 30 minutes spent using the program was associated with a 41% increase in the odds of the patient having a discussion with their PCP (1.04, 1.59, 95% CI). In a separate analysis of the tailoring modules; the modules encouraging adherence to the tailored screening recommendation and discussion with the patient’s PCP yielded significant results. Other predictors of screening discussion included better self-reported physical health and increased patient activation. Time spent on the program predicted greater patient-physician discussion of screening during a linked visit.Usage time information gathered automatically by IMCPs offers promise for objectively assessing patient engagement around a topic and predicting likelihood of discussion between patients and their clinician.