关于SMART OPS的协议文件:共享决策的多学科方法 - 在考虑手术的老年人群中进行随机对照试验
Pragya Ajitsaria1,2,3, Natalie Lott2,3,4, Angela Baker5,2
1Department of Anaesthesia, John Hunter Hospital, Newcastle, New South Wales, Australia pragya.ajitsaria@health.nsw.gov.au.
BMJ open
|July 5, 2023
概括
这项研究为高风险手术患者引入了一种新的共享决策模型,旨在减少决策冲突并改善以患者为中心的结果. 进一步的研究将评估其对生活质量和医疗保健成本的长期影响.
科学领域:
- 老年人手术是一门老年手术.
- 以患者为中心的护理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 澳大利亚的外科医疗人口正在老龄化,脆弱性和并发症增加.
- 共享决策 (SDM) 对于高风险手术中以价值为基础的医疗保健至关重要.
- 虽然SDM的直接好处是已知的,但长期的结果和成本需要研究.
研究的目的:
- 建议和评估一个新的多学科SDM模型,用于外科高风险的外科患者.
- 评估SDM对决策冲突,以患者为中心的结果和医疗保健资源利用的影响.
主要方法:
- 一个前性随机对照试验,比较标准护理与多学科SDM咨询.
- 参与者在一般,血管和头部手术中被随机分类.
- 主要结果:手术前的决策冲突;次要结果:纵向冲突,以患者为中心的指标,发病率,死亡率和医疗资源使用长达1年.
主要成果:
- 目前正在收集关于决策冲突的主要结果数据.
- 还正在收集关于治疗选择,纵向决策冲突,以患者为中心的结果和医疗资源使用的二次结果数据.
- 将对发病率和死亡率进行分析.
结论:
- 这项研究旨在提供多学科SDM模型在高风险手术患者的有效性的证据.
- 结果将阐明SDM对患者决策,生活质量和医疗服务成本的影响.
- 这项研究将为老龄化和复杂的外科手术群体的术后护理提供最佳实践.
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