Assessing the feasibility and quality of shared decision making in China

Evaluating a clinical encounter intervention for Chinese patients

Rongchong Huang, Xiantao Song, Jian Wu, Wei Huang, Aaron L. Leppin, Michael Rgionfriddo, Yongxian Liu, Kasey R. Boehmer, Henry H. Ting, Victor Manuel Montori

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: The aim of this study was to evaluate the feasibility of using the Statin Choice decision aid to have discussions about starting a statin medication for cardiovascular risk reduction in Chinese patients with stable coronary artery diseases. Methods: A prospective, pilot study of the Statin Choice decision aid in two teaching hospitals in Northern China was conducted. A total of seven clinicians were enrolled and underwent a 12-hour, group-based, in-person training on shared decision making (SDM) and the Statin Choice decision aid. Then, these clinicians used the Statin Choice decision aid in patients during a clinical encounter. A total of 86 patients aged 40−80 years, who had stable angina, were enrolled. All clinical encounters were video recorded. A team of three researchers viewed and scored all the encounter recordings to evaluate the SDM process and fidelity to the intervention using the OPTION scale and Fidelity scale, respectively. All the patients were followed up for 12 months to record adherence to statin and any major adverse cardiac events (MACEs). Results: The average scores on the OPTION normalized score and Fidelity scale were 21 (range, 3-32; out of a possible, 48) and 10 (range, 6-10; out of a possible, 10), respectively. This suggested that Chinese clinicians who were using Statin Choice in their patients were able to exhibit behaviors consistent with SDM at a level that is similar to that reported in Western countries. After SDM, the statin adherence was 94.5% (69/73), and the proportion of MACEs was 2.9% (2/69). Conclusion: Using an encounter decision aid developed in the US, it was feasible to implement SDM in a referral cardiology practice in Mainland China. Further work to ensure that the encounter aid is pertinent to the Chinese population and that SDM is tested in at-risk patients could contribute to the implementation of SDM across Mainland China.

Original languageEnglish (US)
Pages (from-to)2341-2350
Number of pages10
JournalPatient Preference and Adherence
Volume10
DOIs
StatePublished - Nov 14 2016

Fingerprint

Hydroxymethylglutaryl-CoA Reductase Inhibitors
decision aid
China
Decision Making
Decision Support Techniques
decision making
event
decision making process
Stable Angina
recording
medication
Risk Reduction Behavior
video
Cardiology
Teaching Hospitals
Disease
Coronary Artery Disease
Referral and Consultation
human being
Research Personnel

Keywords

  • China
  • Decision aid
  • Shared decision making
  • Stable angina
  • Statin adherence
  • Statin Choice

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Social Sciences (miscellaneous)
  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
  • Health Policy

Cite this

Assessing the feasibility and quality of shared decision making in China : Evaluating a clinical encounter intervention for Chinese patients. / Huang, Rongchong; Song, Xiantao; Wu, Jian; Huang, Wei; Leppin, Aaron L.; Rgionfriddo, Michael; Liu, Yongxian; Boehmer, Kasey R.; Ting, Henry H.; Montori, Victor Manuel.

In: Patient Preference and Adherence, Vol. 10, 14.11.2016, p. 2341-2350.

Research output: Contribution to journalArticle

Huang, Rongchong ; Song, Xiantao ; Wu, Jian ; Huang, Wei ; Leppin, Aaron L. ; Rgionfriddo, Michael ; Liu, Yongxian ; Boehmer, Kasey R. ; Ting, Henry H. ; Montori, Victor Manuel. / Assessing the feasibility and quality of shared decision making in China : Evaluating a clinical encounter intervention for Chinese patients. In: Patient Preference and Adherence. 2016 ; Vol. 10. pp. 2341-2350.
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abstract = "Background: The aim of this study was to evaluate the feasibility of using the Statin Choice decision aid to have discussions about starting a statin medication for cardiovascular risk reduction in Chinese patients with stable coronary artery diseases. Methods: A prospective, pilot study of the Statin Choice decision aid in two teaching hospitals in Northern China was conducted. A total of seven clinicians were enrolled and underwent a 12-hour, group-based, in-person training on shared decision making (SDM) and the Statin Choice decision aid. Then, these clinicians used the Statin Choice decision aid in patients during a clinical encounter. A total of 86 patients aged 40−80 years, who had stable angina, were enrolled. All clinical encounters were video recorded. A team of three researchers viewed and scored all the encounter recordings to evaluate the SDM process and fidelity to the intervention using the OPTION scale and Fidelity scale, respectively. All the patients were followed up for 12 months to record adherence to statin and any major adverse cardiac events (MACEs). Results: The average scores on the OPTION normalized score and Fidelity scale were 21 (range, 3-32; out of a possible, 48) and 10 (range, 6-10; out of a possible, 10), respectively. This suggested that Chinese clinicians who were using Statin Choice in their patients were able to exhibit behaviors consistent with SDM at a level that is similar to that reported in Western countries. After SDM, the statin adherence was 94.5{\%} (69/73), and the proportion of MACEs was 2.9{\%} (2/69). Conclusion: Using an encounter decision aid developed in the US, it was feasible to implement SDM in a referral cardiology practice in Mainland China. Further work to ensure that the encounter aid is pertinent to the Chinese population and that SDM is tested in at-risk patients could contribute to the implementation of SDM across Mainland China.",
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AB - Background: The aim of this study was to evaluate the feasibility of using the Statin Choice decision aid to have discussions about starting a statin medication for cardiovascular risk reduction in Chinese patients with stable coronary artery diseases. Methods: A prospective, pilot study of the Statin Choice decision aid in two teaching hospitals in Northern China was conducted. A total of seven clinicians were enrolled and underwent a 12-hour, group-based, in-person training on shared decision making (SDM) and the Statin Choice decision aid. Then, these clinicians used the Statin Choice decision aid in patients during a clinical encounter. A total of 86 patients aged 40−80 years, who had stable angina, were enrolled. All clinical encounters were video recorded. A team of three researchers viewed and scored all the encounter recordings to evaluate the SDM process and fidelity to the intervention using the OPTION scale and Fidelity scale, respectively. All the patients were followed up for 12 months to record adherence to statin and any major adverse cardiac events (MACEs). Results: The average scores on the OPTION normalized score and Fidelity scale were 21 (range, 3-32; out of a possible, 48) and 10 (range, 6-10; out of a possible, 10), respectively. This suggested that Chinese clinicians who were using Statin Choice in their patients were able to exhibit behaviors consistent with SDM at a level that is similar to that reported in Western countries. After SDM, the statin adherence was 94.5% (69/73), and the proportion of MACEs was 2.9% (2/69). Conclusion: Using an encounter decision aid developed in the US, it was feasible to implement SDM in a referral cardiology practice in Mainland China. Further work to ensure that the encounter aid is pertinent to the Chinese population and that SDM is tested in at-risk patients could contribute to the implementation of SDM across Mainland China.

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