Implementing Shared Decision Making (SDM) for Individualized CV Prevention (SDM4IP)

实施共享决策 (SDM) 以实现个体化心血管预防 (SDM4IP)

基本信息

批准号：
10611866
负责人：
VICTOR MANUEL MONTORI
金额：
$ 65.21万
依托单位：
MAYO CLINIC ROCHESTER
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-05-01 至 2024-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10611866
关键词：
Address Adoption Adult American American Heart Association Attitude Cardiology Cardiovascular Diseases Cardiovascular system Caring Clinic Visits Cluster randomized trial Consolidated Framework for Implementation Research Decision Making Disease Management Effectiveness Electronics Emotional Evaluation Event Evidence based intervention Exercise Face Fostering Goals Guidelines Health system Human Hybrids Individual Interdisciplinary Study Intervention Life Life Style Light Medical Medicine Methods Morbidity - disease rate Myocardial Infarction Organizational Policy Outcome Patient-Centered Care Patients Persons Pharmaceutical Preparations Populations at Risk Practice Guidelines Prevention Preventive Preventive treatment Primary Care Primary Prevention Process Public Policy Quality of life Randomized Reach, Effectiveness, Adoption, Implementation, and Maintenance Recommendation Regimen Reporting Resources Risk Risk Reduction Stroke Target Populations Time Translating Work analog blind cardiovascular risk factor clinical encounter clinical practice college cost design effectiveness evaluation effectiveness/implementation hybrid evidence base experience glucagon-like peptide 1 high risk implementation evaluation implementation framework implementation outcomes implementation science implementation strategy implementation/effectiveness improved individual patient inhibitor innovation mortality multidisciplinary pharmacologic preference prevent preventive intervention primary care practice primary care setting psychosocial randomized trial research data dissemination routine care routine practice shared decision making systemic barrier theories tool treatment as usual treatment planning treatment risk trend uptake

项目摘要

PROJECT SUMMARY/ABSTRACT The primary prevention of cardiovascular (CV) events is often more intense in individuals at lower risk and vice versa (risk-treatment paradox) in part due to unawareness of each person’s CV risk, of their preferences for prevention interventions, and of their feasibility in each person’s daily life. Extant practice guidelines recommend that clinicians and patients work together to arrive at an effective and feasible prevention plan that is congruent with each person’s CV risk and informed preferences, a process called shared decision making (SDM). An effective and innovative tool that estimates CV risk and shows the impact and features of available lifestyle and pharmacological preventive interventions for use during the clinical encounter to enable SDM, the CV Prevention Choice tool, is available yet remains rarely used in practice. Our broad goal is to promote patient-centered care that effectively reduces the substantial burden of CV disease among Americans. This study, directly responsive to PA-19-166, seeks to identify implementation approaches that foster routine SDM about primary CV prevention in a diverse set of primary care practices across the U.S. This 5-year study – proposed by a multidisciplinary team with expertise in preventive cardiology, SDM, and implementation science – will draw on an implementation framework (Consolidated Framework for Implementation Research), an implementation theory (Normalization Process Theory), and an evaluation framework (RE-AIM) to design, conduct, and report a mixed method, hybrid implementation- effectiveness (Type III), stepped-wedge clustered randomized trial to determine: - Implementation effectiveness (Aim 1) by evaluating practice contexts and engagement of users in implementation strategies, implementation outcomes (e.g., reach, adoption) associated with these strategies, and how implementation fosters routine adoption of SDM and the CV Prevention Choice tool in primary care practices, and - SDM effectiveness (Aim 2) estimated by the extent to which individual CV prevention plans are feasible and congruent with each person’s estimated CV risk and preferences. By the project’s end, we expect to have (a) identified the most effective implementation strategies to embed SDM in routine practice and (b) estimated the effectiveness of SDM to achieve feasible and risk-concordant CV prevention in primary care.

项目摘要/摘要心血管（CV）事件的主要预防在个人中通常更激烈降低风险，反之亦然（风险处理悖论）部分是由于每个人的不知情简历风险，他们对预防干预措施的偏好及其对每个人的可行性日常生活。现有的实践指南建议临床医生和患者共同努力达成有效且可行的预防计划，与每个人的简历风险一致以及知情的偏好，一个称为共享决策（SDM）的过程。有效和估计简历风险并显示可用生活方式的影响和特征的创新工具以及在临床遭遇期间使用的药物预防性干预措施以实现 SDM是CV预防选择工具，但在实践中仍然很少使用。我们的广泛目标是促进以患者为中心的护理，从而有效地减少了实质性的护理美国人中简历疾病的负担。这项直接响应PA-19-166的研究试图确定培养SDM关于预防初级简历预防的实施方法美国各地的各种初级保健实践集，这项为期5年的研究 - 由具有预防性心脏病学专业知识的多学科团队，SDM和实施科学 - 将利用实施框架（合并实施框架研究），实施理论（归一化过程理论）和评估框架（re-aim）设计，进行和报告一种混合方法，混合实施 - 有效性（III型），阶梯式斜向聚类的随机试验确定： - 通过评估实践环境和参与的实施效率（目标1）实施策略，实施成果（例如，覆盖范围，采用）的用户相关通过这些策略，以及实施如何促进SDM和CV的常规采用初级保健实践中的预防选择工具， -SDM有效性（AIM 2）根据单个简历预防计划的程度估算可行，并与每个人的估计简历风险和偏好保持一致。到该项目的结尾，我们希望（a）确定最有效的实施将SDM嵌入常规实践的策略，以及（b）估计SDM的有效性在初级保健中实现可行且风险结合的简历。

项目成果

期刊论文数量（2）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The design and development of an encounter tool to support shared decision making about preventing cardiovascular events.

DOI：
10.1016/j.pmedr.2022.101994
发表时间：
2022-12
期刊：
PREVENTIVE MEDICINE REPORTS
影响因子：
2.8
作者：
Hartasanchez, Sandra A.;Hargraves, Ian G.;Clark, Jennifer E.;Gravholt, Derek;Brito, Juan P.;Branda, Megan E.;Gomez, Yvonne L.;Nautiyal, Vivek;Khurana, Charanjit S.;Thomas, Randal J.;Montori, Victor M.;Ridgeway, Jennifer L.
通讯作者：
Ridgeway, Jennifer L.

Increasing risk-concordant cardiovascular care in diverse health systems: a mixed methods pragmatic stepped wedge cluster randomized implementation trial of shared decision making (SDM4IP).

DOI：
10.1186/s43058-021-00145-6
发表时间：
2021-04-21
期刊：
Implementation science communications
影响因子：
0
作者：
Ridgeway JL;Branda ME;Gravholt D;Brito JP;Hargraves IG;Hartasanchez SA;Leppin AL;Gomez YL;Mann DM;Nautiyal V;Thomas RJ;Behnken EM;Torres Roldan VD;Shah ND;Khurana CS;Montori VM
通讯作者：
Montori VM