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The Patient Needs in Asthma Treatment (NEAT) Questionnaire: Further Validation and Preparation of its Application in Routine Care

哮喘治疗患者需求 (NEAT) 问卷：进一步验证和准备其在日常护理中的应用

基本信息

批准号：
231906391
负责人：
Professor Dr. Adrian Loerbroks
金额：
--
依托单位：
Institut für Arbeits-, Sozial- und Umweltmedizin
依托单位国家：
德国
项目类别：
Research Grants
财政年份：
2013
资助国家：
德国
起止时间：
2012-12-31 至 2021-12-31
项目状态：
已结题

来源：
https://gepris.dfg.de/gepris/projekt/231906391?language=en
关键词：
Patient Needs Asthma Treatment NEAT

项目摘要

Background: Prior evidence suggests that major unmet needs exist among asthma patients in the context of their treatment. Addressing those needs may improve the compliance and health outcomes of patients. A prerequisite is though that patient needs can be measured reliably and validly. As such an instrument had been lacking, we have recently developed the Patient Needs in Asthma Treatment (NEAT) questionnaire and gained preliminary insights into its validity. Objectives: While initial insights into the validity of our instrument were encouraging, additional validation work needs to be done before it can be routinely deployed. In particular, we now need to examine further measurement properties, including the predictive validity, responsiveness to change, the minimal clinically important difference (MCID), and test-retest reliability. In addition, we aim to explore what mode of instrument administration in routine patient care would be acceptable to both patient and physicians. Methods: The objectives will be addressed based on a series of four studies. Study 1 will be based on a 3-year follow-up of asthma patients recruited for our prior study which has led to the NEAT questionnaire development. It is estimated that 80% of the sample will be followed-up (n=214) to examine the predictive validity (with regard to established asthma-specific outcomes), responsiveness to change and the MCID (e.g., using anchors) of the NEAT instrument. For Study 2, we will recruit 115 asthma patients and will follow these up after about 4 weeks to examine the test-retest reliability. In Study 3, we will administer the NEAT instrument before and after pulmonary rehabilitation to at least 100 inpatients at two clinics to a) assess the responsiveness to change due to intervention and b) to explore the experiences the health care staff has made with the administration of our tool in clinical practice. Finally, in Study 4 we will explore the characteristics of acceptable approaches to implement the NEAT instrument in routine care. This will be achieved by a qualitative study (focus groups and in-depth interviews) among patients, physicians and potentially other relevant groups of health care professionals. Implications: Further establishment of the validity, responsiveness, and reliability of the NEAT questionnaire will document the suitability of our tool for asthma research. In research, our instrument could be used to identify the distribution and determinants of unmet patient needs with the goal to inform intervention development and their evaluation. Further, by exploring potential approaches to implementation in routine care, we increase the likelihood that the NEAT questionnaire is transferred to clinical practice and thus may be used in clinical decision-making, e.g. to facilitate the delivery of patient-centered asthma care.

背景：先前的证据表明，在哮喘患者的治疗背景下，存在主要未满足的需求。满足这些需求可以改善患者的依从性和健康结果。一个先决条件是，虽然病人的需求可以可靠和有效地衡量。由于缺乏这样的工具，我们最近开发了哮喘治疗中的患者需求（NEAT）问卷，并对其有效性进行了初步研究。目的：虽然对我们仪器有效性的初步了解令人鼓舞，但在常规部署之前还需要进行额外的验证工作。特别是，我们现在需要检查进一步的测量属性，包括预测有效性，对变化的反应，最小临床重要差异（MCID）和重测信度。此外，我们的目的是探讨什么样的模式的仪器管理在常规的病人护理将是可以接受的病人和医生。方法：将根据一系列的四项研究的目标。研究1将基于我们先前研究招募的哮喘患者的3年随访，该研究导致NEAT问卷的开发。据估计，80%的样本将被随访（n=214），以检查预测有效性（关于已确定的哮喘特异性结局）、对变化的反应性和MCID（例如，使用锚）的NEAT仪器。在研究2中，我们将招募115名哮喘患者，并在大约4周后对其进行随访，以检查重测信度。在研究3中，我们将在两个诊所对至少100名住院患者在肺康复前后使用NEAT工具，以a）评估对干预引起的变化的反应性和B）探索医疗保健人员在临床实践中使用我们的工具的经验。最后，在研究4中，我们将探讨在常规护理中实施NEAT工具的可接受方法的特征。这将通过在患者、医生和其他潜在的相关医疗保健专业人员群体中进行定性研究（焦点小组和深入访谈）来实现。含义：NEAT问卷的有效性、反应性和可靠性的进一步建立将证明我们的工具适用于哮喘研究。在研究中，我们的工具可用于确定未满足的患者需求的分布和决定因素，目的是为干预措施的制定和评估提供信息。此外，通过探索在常规护理中实施的潜在方法，我们增加了NEAT问卷转移到临床实践中的可能性，从而可用于临床决策，例如促进以患者为中心的哮喘护理的提供。