关于抗血栓治疗预防心房中风的患者决策辅助:一项随机对照试验
M Man-Son-Hing1, A Laupacis, A M O'Connor
1Loeb Health Research Institute, Ottawa Hospital, Department of Medicine, University of Ottawa, Ontario, Canada. mhing@civich.ottawa.on.ca
JAMA
|August 27, 1999
概括
决策辅助工具,如音频小册子,使心房患者能够做出关于抗血栓治疗的明智选择. 这项研究表明,使用音频小册子的患者的理解和决策能力得到了改善.
科学领域:
- 医疗决策的制定 医疗决策的制定
- 患者教育 患者教育
- 心脏病学 心脏病学
背景情况:
- 决策辅助工具是加强患者参与临床决策的关键工具.
- 有效的决策辅助工具可以改善患者对治疗选择和结果的理解.
研究的目的:
- 评估音频小册子 (AB) 帮助决策对参与中风预防心房 (SPAF) III试验的患者的决策过程的影响.
- 评估AB是否影响了参与者对抗血栓治疗的选择.
主要方法:
- 一项随机对照试验,涉及来自SPAF III阿司匹林队列的287名患者.
- 参与者被随机分配,接受通常的护理加上AB决策辅助或仅接受通常的护理.
- 测量结果包括做出选择的能力,坚持,知识,期望,决策冲突和满意度.
主要成果:
- AB组显示,对抗血栓治疗的选择率显著更高 (99%对94%,P=.02).
- 使用AB的患者表现出对中风和出血风险的知识提高和更现实的期望.
- 六个月后,在各组之间,选择治疗的坚持和决策冲突/满意度是相似的.
结论:
- 一本音频小册子的决策辅助工具有效地改善了患者对心房患者治疗益处和风险的理解.
- 该AB促进了研究参与者之间关于抗血栓治疗的最终选择.
- 需要进一步的研究来探索决策辅助在各种临床环境中的更广泛适用性.
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