Implementation outcomes of a patient decision-aid in a diverse population with systemic lupus erythematosus in 15 US rheumatology clinics.
Objective The objective of this study was to examine the clinical outcomes during the implementation of a self-administered patient decision-aid (PtDA) for lupus. Methods We provided an effective computerized lupus PtDA in 15 rheumatology outpatient clinics 2019–2024 (including the COVID pandemic)....
| Publicado en: | Rheumatology Vol. 64; no. 8; pp. 4631 - 4641 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Aug2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187954727&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 187954727 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14620324 DN9 jtl: Rheumatology issn: 14620324 maglogo: N pubinfo: dt: Aug2025 vid: 64 iid: 8 pid: 622 pub: Oxford University Press / USA artinfo: ui: 187954727 187954727 187954727 10.1093/rheumatology/keaf205 187954727 ppf: 4631 ppct: 10 formats: tig: atl: Implementation outcomes of a patient decision-aid in a diverse population with systemic lupus erythematosus in 15 US rheumatology clinics. aug: au: Singh, Jasvinder A Hearld, Larry R Eisen, Seth Chatham, W Winn Narain, Sonali Annapureddy, Narender Kamen, Diane L Trotter, Kimberly Majithia, Vikas Ching, Cathy Lee Aouhab, Zineb Venuturupalli, Swamy Wallace, Daniel J Ramsey-Goldman, Rosalind Kim, Alfred McMahon, Maureen Lim, S Sam Bhairavarasu, Kalpana Meara, Alexa Kalunian, Kenneth affil: Medicine Service, Michael E. DeBakey VA Medical Center, Houston, TX, USA sug: subj: Decision Support Techniques Decision Making, Computer Assisted Decision Making, Shared Lupus Erythematosus, Systemic Therapy Rheumatology Outpatient Service United States Quality Improvement Funding Source United States Human Male Female Adult Middle Age Psychological Safety Questionnaires Scales COVID-19 Pandemic Summated Rating Scaling Odds Ratio Confidence Intervals Attitude to Change Implementation Science Commitment Academic Medical Centers Private Practice Attitude of Health Personnel Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Objective The objective of this study was to examine the clinical outcomes during the implementation of a self-administered patient decision-aid (PtDA) for lupus. Methods We provided an effective computerized lupus PtDA in 15 rheumatology outpatient clinics 2019–2024 (including the COVID pandemic). We undertook Organizational Readiness to Implement Change Surveys (ORICs) and Team Learning and Psychological Safety Surveys (TLPSSs) at baseline. The primary study outcome objective measure, percent penetration/reach, was defined as the number of patients who viewed the lupus PtDA at the end of the study, divided by the total number of eligible patients (times 100). We used validated clinical personnel surveys to examine the perceived lupus PtDA appropriateness, acceptability, feasibility, success, and permanence, at 4 months, 12 months and 24 months post-PtDA implementation. Results Among the sites, the clinical personnels' (n = 184) baseline ORIC commitment and efficacy scores (a 0–5 scale, higher = better) ranged from 3.5 to 4.2, and 3.4 to 4.4, respectively; the TLPSS scores (a 0–7 scale, higher = better) were 3.9–5.5 for internal learning, 3.7–5.6 for external learning, and 4.3–5.5 for psychological safety. The penetration (primary outcome) among 15 geographically diverse US rheumatology clinics ranged from 3% to 44%. We found that the total number of providers in the clinic was positively associated with higher penetration. Clinical personnel–perceived lupus PtDA outcomes were optimal at 4 months (all scale scores ranged from 1 to 5, higher = better): (i) appropriateness, 3.43 (s. d. 0.86); (ii) acceptability, 3.53 (s. d. 0.83); (iii) feasibility, 3.44 (s. d. 0.71); (iv) success, 3.41 (s. d. 0.73); and (v) permanence, 3.22 (s. d. 0.74). Conclusion We implemented a lupus PtDA with varied success rates during the COVID pandemic; more providers were associated with higher clinic penetration. Clinical personnel perceived high lupus PtDA appropriateness, acceptability, feasibility, success, and permanence that persisted up to 24 months. Trial Registration ClinicalTrials.gov , http://clinicaltrials.gov , NCT03735238. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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