Using IT for Patient-Centered Communication and Decision Making about Medications

描述（由申请人提供）：在门诊环境中，药物管理的过程实际上是专家之间的会议：医生是患者关于处方药的主要信息来源，而患者对治疗计划如何适应自己的生活有最好的看法。然而，先前的研究表明，患者与提供者关于药物的沟通是不够的。为了改善药物管理，该项目汇集了西北大学四条充满活力的研发线：健康传播，健康素养，药物安全和信息学。本研究中以患者为中心的信息技术干预措施旨在加强沟通和共享药物决策，重点是增加患者对基本信息的理解并改善药物管理流程。这项建议涉及以下具体目标： 目标1。访视前患者干预：开发和测试一个多媒体程序，以帮助患者了解给予和接受有关药物的准确信息的重要性。 目标2.提供者/系统干预：使用电子病历（EMR）鼓励以患者为中心的药物管理。 目标2A。通过培训护士在患者就诊前立即对当前药物进行以患者为中心的审查，扩展EMR药物管理能力。 目标2B通过开发一个医生可以轻松访问并在屏幕上显示的模板来利用EMR，以参与以患者为中心的关于正在考虑的新药的讨论。 目标3。传播：与我们的基于实践的研究网络合作，传播和跟踪有效干预措施的使用情况，并为促进国家向其他实践的传播创造途径。 这项研究的重点是初级保健，整合干预措施，针对患者，供应商和整个实践系统。所有这些目标都涉及患者和提供者作为研究伙伴，而不仅仅是研究对象。换句话说，干预措施的发展将受益于通过焦点小组和β测试获得的想法和反馈，以及将被聘为研究团队一部分的患者的投入。没有其他研究将患者纳入系统性努力中，以重新设计审查当前药物和讨论新药物的过程。如果我们的干预措施在这项随机临床试验中证明有效，它们可以迅速适应并传播到使用EMR的实践中。

DESCRIPTION (provided by applicant): In the ambulatory setting, the process of medication management is truly a meeting between experts: Physicians are patients' primary source of information about prescription medications, while patients have the best perspective on how a treatment plan fits into their own lives. However, prior research has shown that patient-provider communication about medications is inadequate. To improve medication management, this project brings together four vibrant lines of research and development at Northwestern: health communication, health literacy, medication safety, and informatics. The patient-centered information technology interventions in this study are designed to enhance communication and shared decision making about medications, with a focus on increasing patient understanding of essential information and improving the medication management process. This proposal addresses the following specific aims: Aim 1. Pre-Visit Patient Intervention: Develop and test a multimedia program to help patients understand the importance of both giving and receiving accurate information about medications. Aim 2. Provider/System Intervention: Use the electronic medical record (EMR) to encourage patient-centered medication management. Aim 2A. Extend the EMR medication management capability by training nurses to engage in a patient-centered review of current medications immediately before a patient sees the doctor. Aim 2B. Leverage the EMR by developing a template that physicians can easily access and display on-screen to engage in a patient-centered discussion about new medications under consideration. Aim 3. Dissemination: Work with our Practice-Based Research Network to disseminate and track the use of effective interventions, and create pathways for facilitating national distribution to other practices. This study focuses on primary care, integrating interventions that target patients, providers, and the overall practice system. All of the aims involve patients and providers as research partners, not simply research subjects. In other words, intervention development will benefit from ideas and feedback obtained through focus groups and Beta-tests, as well as the input of a patient who will be hired as part of the research team. No other studies have included patients in systematic efforts to redesign the process of reviewing current medications and discussing new medications. If our interventions prove effective in this randomized clinical trial, they can be rapidly adapted and disseminated to practices that use an EMR.