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Assessing the feasibility and quality of shared decision making in China: evaluating a clinical encounter intervention for Chinese patients

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机构: [1]Dalian Med Univ, Affiliated Hosp 1, Dept Cardiol, 222 Zhongshan Rd, Dalian 116011, Peoples R China; [2]Capital Med Univ, Beijing An Zhen Hosp, Dept Cardiol, Beijing, Peoples R China; [3]Mayo Clin, Knowledge & Evaluat Res Unit, Rochester, MN USA; [4]Mayo Clin, Mayo Grad Sch, Rochester, MN USA; [5]Univ Hosp Columbia & Cornell, New York Presbyterian Hosp, Value Inst, New York, NY USA; [6]Mayo Clin, Div Endocrinol, Rochester, MN USA
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关键词: Statin Choice decision aid stable angina statin adherence shared decision making China

摘要:
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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出版当年[2015]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 医学:内科
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出版当年[2014]版:
Q2 MEDICINE, GENERAL & INTERNAL
最新[2023]版:
Q2 MEDICINE, GENERAL & INTERNAL

影响因子: 最新[2023版] 最新五年平均 出版当年[2014版] 出版当年五年平均 出版前一年[2013版] 出版后一年[2015版]

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第一作者机构: [1]Dalian Med Univ, Affiliated Hosp 1, Dept Cardiol, 222 Zhongshan Rd, Dalian 116011, Peoples R China;
通讯作者:
通讯机构: [1]Dalian Med Univ, Affiliated Hosp 1, Dept Cardiol, 222 Zhongshan Rd, Dalian 116011, Peoples R China;
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