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A group-randomized trial of shared decision making for non-steroidal anti-inflammatory drug risk awareness: primary results and lessons learned
UMass Chan Affiliations
Department of Quantitative Health SciencesDocument Type
Journal ArticlePublication Date
2014-10-01Keywords
*Adverse Drug Reaction Reporting SystemsAged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal
*Awareness
Cross-Sectional Studies
Female
Humans
Male
*Patient Education as Topic
Patient Participation
Risk Assessment
Risk Factors
Community Health and Preventive Medicine
Health Services Research
Public Health Education and Promotion
Metadata
Show full item recordAbstract
RATIONALE, AIMS AND OBJECTIVES: Frequent use and serious adverse effects related to non-steroidal anti-inflammatory drugs (NSAIDs) underscore the need to raise patient awareness about potential risks. Partial success of patient- or provider-based interventions has recently led to interest in combined approaches focusing on both patient and physician. This research tested a shared decision-making intervention for increasing patient-reported awareness of NSAID risk. METHODS: A group randomized trial was performed in Alabama from 2005 to 2007. Intervention group doctor practices received continuing medical education (CME) about NSAIDs and patient activation tools promoting risk assessment and communication during visits. Comparison group doctor practices received only CME. Cross-sectional data were collected before and after the intervention. Generalized linear latent and mixed models with logistic link tested relationships among the intervention, study phase, intervention by study phase interaction and patient-reported awareness of risks with either prescription or over-the-counter (OTC) NSAIDs. RESULTS: Three hundred and forty-seven patients at baseline and 355 patients at follow-up participated in this study. The intervention [adjusted odds ratio (AOR)=0.74, P=0.248], follow-up study phase (AOR=1.31, P=0.300) and intervention by study phase interaction (AOR=0.98, P=0.942) were not significantly associated with patient-reported awareness of any prescription NSAID risk. Follow-up study phase was associated with increased odds of reporting any OTC NSAID risk awareness (AOR=2.99, P < 0.001), but the patient activation intervention and intervention by study phase interaction were not significantly associated with patient-reported awareness of any OTC NSAID risk (AOR=0.98, P=0.929; AOR=0.87, P=0.693, respectively). CONCLUSIONS: Our point-of-care intervention encouraging shared decision making did not increase NSAID risk awareness.Source
J Eval Clin Pract. 2014 Oct;20(5):638-48. doi: 10.1111/jep.12193. Epub 2014 Jun 11. Link to article on publisher's siteDOI
10.1111/jep.12193Permanent Link to this Item
http://hdl.handle.net/20.500.14038/30420PubMed ID
24916786Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1111/jep.12193