Developing Patient-Centered Decision Support for Eosinophilic Esophagitis

项目总结

PROJECT SUMMARY Candidate’s Long-term Career Goal: To become an independently funded physician-scientist developing and testing patient-centered interventions to support shared decision making (SDM) in chronic esophageal diseases. Research Context: As a chronic disease with rapidly rising prevalence, incidence, healthcare costs, and burdens to patient quality of life, eosinophilic esophagitis (EoE) is an understudied, challenging area of care for both patients and providers that requires support in education, decision making, and communication around complex treatment choices to prevent costly complications. As clinical equipoise exists between medication and dietary therapies, understanding stakeholder drivers of decision making and applying SDM are critical gaps in patient-centered EoE care, and are needed to improve long-term disease outcomes. Candidate Background and Achievements: Dr. Chang is an Instructor in Gastroenterology at the University of Michigan (UM) and an awardee of a Consortium of Eosinophilic Gastrointestinal Disease Researchers grant. She received her MD from the University of Maryland and MS from UM. To date she has published 13 original peer-reviewed manuscripts and one book chapter, 10 of which she is first or senior author. Career Development Plan: Dr. Chang proposes to develop new expertise in mixed methods, advanced qualitative research methods, decision sciences, and clinical trial conduct and evaluation to assess the impact of a decision support intervention on outcomes. Her career development goals are supported by stellar mentorship, advanced didactic coursework, and participation in workshops and professional meetings designed to foster collaboration, ensure successful study completion, and support her seamless transition into a successful independent researcher. Aims: 1) Elicit the multilevel factors that influence decision making for EoE management among patients and providers, 2) Develop a multilevel decision support intervention prototype that supports SDM for selection of EoE therapy, and 3) Pilot test and evaluate feasibility, acceptability, and preliminary patient-reported efficacy outcomes associated with use of the decision support intervention. Research Plan: Dr. Chang will 1) use a mixed methods design to interview patients with EoE to identify factors that drive treatment decision making, 2) conduct qualitative interviews of gastroenterologists and allergists to characterize provider perspectives about EoE management and supported decision making, 3) develop a multilevel decision support intervention to facilitate SDM between patients and providers, and 4) assess decision intervention feasibility, acceptability, and influence on preliminary efficacy outcomes comparing 20 patients receiving decision support to 20 patients receiving control content.