Creation and Testing of an Education Decision Aid for Colectomy in Recurrent Diverticulitis

复发性憩室炎结肠切除术教育决策辅助工具的创建和测试

• 批准号: 10451353
• 负责人: Alexander Tharrington Hawkins
• 金额: $ 12.98万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10451353
• 关键词: Acute; Address; Advocate; Ambulatory Care; Antibiotics; Award; Benefits and Risks; Caregivers; Caring; Cessation of life; Chronic; Clinical; Colectomy; Collaborations; Colon; Communication; Communication Tools; Consultations; Cost of Illness; Data; Data Analyses; Decision Aid; Decision Making; Disease; Diverticulitis; Diverticulosis; Education; Educational Intervention; Elements; Emergency department visit; Ensure; Equipoise; Excision; Focus Groups; Goals; Grant; Guidelines; Health; Health system; Hospital Sizes; Hospitalization; Hospitals; Incidence; Inflammatory Bowel Diseases; Intervention; Interview; Knowledge; Lead; Measures; Medical; Medicare; Mentored Patient-Oriented Research Career Development Award; Methods; Modification; Morbidity - disease rate; Natural History; Operative Surgical Procedures; Outcome; Parents; Patient Care; Patient Outcomes Assessments; Patient Participation; Patient Preferences; Patients; Phase; Prevention; Process; Process Assessment; Professional Organizations; Public Health; Quality of life; Randomized Controlled Trials; Recommendation; Recovery; Recurrence; Regrets; Research; Risk; Scientist; Sigmoid colon; Surgeon; Surgical Management; Testing; United States; Variant; Visit; Work; base; career; cost; density; design; experience; flexibility; future implementation; gastrointestinal; health literacy; improved; innovation; intervention effect; mortality; novel; novel strategies; patient population; personalized decision; preference; prevent; primary outcome; prophylactic; shared decision making; skills; standard care; surgical risk; tool; treatment as usual; treatment choice; trial comparing

PROJECT SUMMARY/ABSTRACT Diverticulosis of the sigmoid colon is a significant burden to the US health system. Complications lead to substantial morbidity and mortality. In 2004, diverticular disease was responsible for 313,000 hospitalizations, 1.9 million ambulatory care visits, and 3365 deaths in the United States. Indications for surgical management of chronic or recurrent diverticulitis are poorly defined. A number of studies have revealed that there is minimal mortality benefit to elective surgery for diverticular disease. Rather, the decision to pursue surgery is based on both risk of surgery and potential improvement in quality of life. Despite the need for effective communication about the risks and benefits of surgery, no shared decision-making tools exist to guide the surgeon and patient. This proposal describes a two-year proposal to address this important knowledge gap. The research specific aims are: 1) to develop an interactive decision aid to facilitate communication between patients and surgeons considering surgery for recurrent diverticulitis; 2) conduct a pilot randomized controlled trial comparing use of the decision aid with standard care. These objectives are in concert with the parent K23 application’s goal to evaluate both the decision to undergo surgery and the natural history of Patient Reported Outcomes for patients with recurrent diverticulitis. This application furthers the overall goal of the parent award by using data and analysis from both the mixed methods study and longitudinal assessment to better inform the decision-making process. The proposed educational intervention will be designed specifically to permit dissemination to a variety of care settings including those with vulnerable patient populations, such as those with low health literacy. Overall, this award will advance the P.I.’s experience in shared decision making and generate important data on crucial elements of shared decision making in patients with diverticular disease.

项目总结/摘要 乙状结肠憩室病是美国卫生系统的一个重大负担。并发症导联 发病率和死亡率都很高。2004年，憩室病造成313，000人死亡， 住院治疗，190万次门诊治疗，3365例死亡。适应症 慢性或复发性憩室炎外科治疗定义不明确。 许多研究表明，对于非小细胞肺癌， 憩室病相反，决定进行手术是基于手术的风险和潜在的 提高生活质量。尽管需要就风险和益处进行有效沟通， 在外科手术中，不存在共同的决策工具来指导外科医生和患者。 本提案介绍了一项为期两年的提案，以解决这一重要的知识差距。研究 具体目标是：1）开发交互式决策辅助工具，以促进患者之间的沟通， 考虑手术治疗复发性憩室炎的外科医生; 2）进行一项初步随机对照试验 将决策辅助的使用与标准护理进行比较。 这些目标与父K23应用程序的目标一致，即评估 复发性憩室炎患者的手术和患者报告结局的自然史。 该应用程序通过使用来自混合 方法研究和纵向评估，以更好地为决策过程提供信息。拟议 将专门设计教育干预措施，以便向各种护理环境传播 包括那些脆弱的患者群体，如那些健康素养低的人。总的来说，这个奖项 会让私家侦探我们在共享决策方面的经验，并生成关于关键要素的重要数据 憩室病患者的共同决策。