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A survey of primary care patients’ readiness to engage in the de-adoption practices recommended by Choosing Wisely Canada
BACKGROUND: Strategies such as Choosing Wisely have been established to identify the overuse of interventions considered as low-value. Reduction of low-value practices will require patients to understand why certain interventions are no longer recommended. The objective of this study was to determin...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4902938/ https://www.ncbi.nlm.nih.gov/pubmed/27286651 http://dx.doi.org/10.1186/s13104-016-2103-6 |
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author | Silverstein, William Lass, Elliot Born, Karen Morinville, Anne Levinson, Wendy Tannenbaum, Cara |
author_facet | Silverstein, William Lass, Elliot Born, Karen Morinville, Anne Levinson, Wendy Tannenbaum, Cara |
author_sort | Silverstein, William |
collection | PubMed |
description | BACKGROUND: Strategies such as Choosing Wisely have been established to identify the overuse of interventions considered as low-value. Reduction of low-value practices will require patients to understand why certain interventions are no longer recommended. The objective of this study was to determine whether older adults accept the rationale for and perceive themselves ready to de-adopt annual electrocardiogram testing, imaging for low back pain, the use of antibiotics for sinusitis, the use of sedative-hypnotics for insomnia, and the use of antipsychotics to treat behavioural symptoms of dementia. METHODS: A self-administered iPad survey was distributed to consecutive patients aged 50 years and older, presenting to three primary care outpatient practices in Ontario, Canada. Data from patients who were able and willing to complete the survey while waiting to see their physician were included. The survey queried knowledge, attitudes and behaviours around the targeted low-value interventions, before and after exposure to a Choosing Wisely Canada patient educational brochure on one of these five topics. A subset of patients agreed to participate in a semi-structured interview after their clinic visit. RESULTS: Three-hundred and forty-four patients (mean age 63, range 50–88, 59 % female) read the materials and completed the survey. Forty-eight percent (95 % CI 43–53 %) intended to discuss the information with a healthcare provider. Forty-five percent (95 % CI 40–51 %) expressed a desire to change current low-value practices. Approximately two-thirds of those who indicated they would not change future behaviours explained that it was because they were already espousing the Choosing Wisely values. After reading the Choosing Wisely brochures, knowledge improved independent of age, sex and education in 48 % (95 % CI 38–57 %) of participants about electrocardiogram testing, in 74 % (95 % CI 65–82 %) about use of antipsychotics, in 66 % (95 % CI 52–78 %) about use of antibiotics for sinusitis, in 60 % (95 % CI 46–72 %) about imaging for low back pain, and in 40 % (95 % CI 26–55 %) about sedative-hypnotic use in the elderly. CONCLUSIONS: The majority of primary care patients seem ready to de-adopt low-value practices. Provision of education in clinic waiting rooms can help improve knowledge around unnecessary care. |
format | Online Article Text |
id | pubmed-4902938 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-49029382016-06-12 A survey of primary care patients’ readiness to engage in the de-adoption practices recommended by Choosing Wisely Canada Silverstein, William Lass, Elliot Born, Karen Morinville, Anne Levinson, Wendy Tannenbaum, Cara BMC Res Notes Research Article BACKGROUND: Strategies such as Choosing Wisely have been established to identify the overuse of interventions considered as low-value. Reduction of low-value practices will require patients to understand why certain interventions are no longer recommended. The objective of this study was to determine whether older adults accept the rationale for and perceive themselves ready to de-adopt annual electrocardiogram testing, imaging for low back pain, the use of antibiotics for sinusitis, the use of sedative-hypnotics for insomnia, and the use of antipsychotics to treat behavioural symptoms of dementia. METHODS: A self-administered iPad survey was distributed to consecutive patients aged 50 years and older, presenting to three primary care outpatient practices in Ontario, Canada. Data from patients who were able and willing to complete the survey while waiting to see their physician were included. The survey queried knowledge, attitudes and behaviours around the targeted low-value interventions, before and after exposure to a Choosing Wisely Canada patient educational brochure on one of these five topics. A subset of patients agreed to participate in a semi-structured interview after their clinic visit. RESULTS: Three-hundred and forty-four patients (mean age 63, range 50–88, 59 % female) read the materials and completed the survey. Forty-eight percent (95 % CI 43–53 %) intended to discuss the information with a healthcare provider. Forty-five percent (95 % CI 40–51 %) expressed a desire to change current low-value practices. Approximately two-thirds of those who indicated they would not change future behaviours explained that it was because they were already espousing the Choosing Wisely values. After reading the Choosing Wisely brochures, knowledge improved independent of age, sex and education in 48 % (95 % CI 38–57 %) of participants about electrocardiogram testing, in 74 % (95 % CI 65–82 %) about use of antipsychotics, in 66 % (95 % CI 52–78 %) about use of antibiotics for sinusitis, in 60 % (95 % CI 46–72 %) about imaging for low back pain, and in 40 % (95 % CI 26–55 %) about sedative-hypnotic use in the elderly. CONCLUSIONS: The majority of primary care patients seem ready to de-adopt low-value practices. Provision of education in clinic waiting rooms can help improve knowledge around unnecessary care. BioMed Central 2016-06-10 /pmc/articles/PMC4902938/ /pubmed/27286651 http://dx.doi.org/10.1186/s13104-016-2103-6 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Silverstein, William Lass, Elliot Born, Karen Morinville, Anne Levinson, Wendy Tannenbaum, Cara A survey of primary care patients’ readiness to engage in the de-adoption practices recommended by Choosing Wisely Canada |
title | A survey of primary care patients’ readiness to engage in the de-adoption practices recommended by Choosing Wisely Canada |
title_full | A survey of primary care patients’ readiness to engage in the de-adoption practices recommended by Choosing Wisely Canada |
title_fullStr | A survey of primary care patients’ readiness to engage in the de-adoption practices recommended by Choosing Wisely Canada |
title_full_unstemmed | A survey of primary care patients’ readiness to engage in the de-adoption practices recommended by Choosing Wisely Canada |
title_short | A survey of primary care patients’ readiness to engage in the de-adoption practices recommended by Choosing Wisely Canada |
title_sort | survey of primary care patients’ readiness to engage in the de-adoption practices recommended by choosing wisely canada |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4902938/ https://www.ncbi.nlm.nih.gov/pubmed/27286651 http://dx.doi.org/10.1186/s13104-016-2103-6 |
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