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Presenting summary reports to patients with chronic health conditions to support values-based discussions and
Amy C Cole1, Chao-Chin Liu2, Jennifer Bissram3
1The University of North Carolina, Carolina Health Informatics Program, Chapel Hill, USA; The University of North Carolina, Division of Healthcare Engineering, Department of Radiation Oncology, Chapel Hill, USA.
Background:
Patient-centered care is the process of aligning medical decisions with patients' preferences, needs, and values. Helping patients clarify their preferences and values may improve shared decision making (SDM).
Objective:
Understand how summary reports impact patient and clinician behaviors for values-based discussions and SDM related to healthcare decisions.
Data Sources:
Searched Embase, PubMed, Scopus, and CINAHL, with a supplemental search in Connected Papers.
Study Selection:
Studies presenting summary reports based on self-reported data from patients with chronic conditions and assessing SDM or decisional conflict as it relates to SDM.
Data Extraction:
We extracted data formats, utilization practices, communication characteristics, communication functions, and study outcomes to evaluate summary reports. Communication characteristics and functions were categorized using Hawkins' "tailoring in health communication framework" and the Online Health Information Tools (OHIT) framework, respectively.
Data Synthesis:
We identified four themes regarding the intent of summary reports. No studies reported using electronic health records for self-reports or summary reports. All studies (N = 21) used at least one communication characteristic from Hawkins' framework, and 90 % (n = 19/21) used one or more functions from the OHIT, with variability among specific characteristics and functions. Significant improvement or positive impacts were found in 53 % (n = 9/17) of studies evaluating SDM. Decisional conflict was lowered in 67 % (n = 8/12) of studies.
Conclusions:
Themes from this systematic review suggest that when summary reports were developed to enhance information exchange, or when patients and clinicians actively discussed values during consultations, SDM often improved. We revealed a gap in understanding how tailoring summary reports can prepare and encourage patients to discuss their values and engage in SDM, specifically when clinicians do not initiate a values-based discussion. PROSPERO registration number CRD42023434558.
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