Content Development Team: 2013-2013 Activity

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2013 Winter Medical Editor's Meeting: Sherri Frank Mazzotta,

2013 Winter Medical Editor's Meeting: Sherri Frank Mazzotta,

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  • Patient Perspectives team involved in producing the Foundation’s DAs (HD, maternity, ACC) but also a lot of other projects. Want to highlight two of those. Patient Centered Outcomes Research Institute (PCORI)Brigham and Women’s developing a decision aid – print/online with risk calculator incorporatedDesign: Well underwayDA will be pilot tested with patients, physicians, pharmacists in Year 1DA to be refined/disseminated in Year 2Focus groups on: first-time filling a prescription for anti-hypertensive medication. FG - Helping to guide content, how to integrate tools into providers’ practices.Nurses, secretaries will play a role in helping patients identify their top concerns (for providers)FG – idenfityingbarriers to medication adherence: denial (invisible condition), understanding goals of treatment,Understanding how to measure success, how can lifestyle changes help?, and costs (co-pays, generics)Foundation to continue participating through Year 2: - Pilot testing of DA - Evaluation - Refining the design - Writing manuscripts for possible publication (3 abstracts submitted to Academy Health meeting in June) - disseminating results
  • Focus groups on: first-time filling a prescription for anti-hypertensive medication. FG - Helping to guide content, how to integrate tools into providers’ practices.Nurses, secretaries will play a role in helping patients identify their top concerns (for providers)FG – idenfityingbarriers to medication adherence: denial (invisible condition), understanding goals of treatment,Understanding how to measure success, how can lifestyle changes help?, and costs (co-pays, generics)Foundation to continue participating through Year 2: - Pilot testing of DA - Evaluation - Refining the design - Writing manuscripts for possible publication (3 abstracts submitted to Academy Health meeting in June) - disseminating results
  • Collaboration began with Michael and Pam meeting with members of the Methodology CommitteeMichael presented “SDM: Using Comparative Effectiveness Research to Help Patients Make Better Decisions”- Pam showed video clips from IMDF’s “Transforming the Patient Experience” and “SDM: How it Looks”** We have offered to compile video clips (from patient/provider clips we already have) for PCORI Contract not yet signed.
  • IMDF / Medical Editors reviewed Australian guidelines to ensure recommendations based on high-quality evidence.
  • Adaptation ConsiderationsThese important differences between countries need to be considered when adapting SDM program content (from Angela’s report on “Adapting Decisions Aids for Use in Other Countries”)1. Disease prevalence, prognosis, selection of studies, approaches to outcome measurement, and interpretation of evidence on treatment effects2. Information patients need to know and will understand3. Management of specific conditions4. Views about best practice, as seen in clinical guidelines5. Availability of treatments6. Surgical skills and experience Healthcare organization and care pathways (affects strategies for implementing SDM)Shared understanding of SDM principles and practice
  • First steps….For adaptations in any countries, not just AustraliaGlobal core product: - Consensus on the broad outlines of the clinical content should be secured before starting work on the adaptation - Ask local advisors to review fully referenced evidence document that should be created for each programme, having regard to local clinical guidelines and internationally recognised sources such as the Cochrane Library.International experts as clinical advisors: - Could act as local clinical leads for evidence review - Could assist with adaptations - Act as general advisors on researching and developing approaches to shared decision making in their countriesNeedimplementation strategy that: - emphasizes patient-centered care - support for preference-sensitive conditions - support for chronic disease self management
  • John Wong on Task Force for 2 yearsUncontroversial way to explore SDM

Transcript

  • 1. Content Development Team:2012 - 2013 ActivitySherri Frank MazzottaDirector of Content Development and ProductionJanuary 2013
  • 2. Program Updates• Carotid Endarterectomy• Prostate Cancer HormoneTherapy• Breast Reconstruction• Breast Cancer Surgery• Chronic Low Back Pain• Osteoporosis• Heart Failure• Metastatic Breast Cancer2
  • 3. Program Updates, continued• Medical Care During Serious Illness• Living with Coronary Heart Disease• Abnormal Uterine Bleeding• Uterine Fibroids• Growing Older, Staying Well3
  • 4. New Programs• Anxiety• PeripheralArtery DiseaseProgram in remake• TreatmentChoices for Coronary HeartDisease4
  • 5. California HealthCare Foundation• California HealthCare Foundation’s “GeographicVariation Series”• Examines the rates at which 16 elective treatmentsand one screening test are delivered in differentcommunities in California• PSA testing; treatments for prostate cancer,breast cancer, low back pain, neck pain• Foundation: Review and/or drafting of “Close ups”reports5
  • 6. Patient Perspectives TeamI. Collaboration with Brigham and Women’s Hospital,Division of Pharmacoepidemiology, 2-year PCORI grant:“Developing andTesting a Decision SupportToolfor Primary Medication Adherence”• Foundation team:- PamelaWescott: Project Consultant; Co-facilitated 8 focus groups- Diana Stilwell: Project Consultant- Michael Barry: Advisory Board member6
  • 7. “Developing and Testing a Decision SupportTool for Primary Medication Adherence”Year 1• Focus groups – inform content development:- Identify knowledge, values, preferences of patients,physicians, pharmacists- Identify barriers to adherence- Provide insights: Integrating tool into practice• Decision aid design - underway• Pilot testingYear 2• Refine decision aid design• Disseminate results (publications, etc)7
  • 8. Patient Perspectives TeamII. Collaboration with PCORI on MethodologyStandards• Proposal for Foundation to provide 12patient/provider video clips to illustrate PCORI’sMethodology Standards report• Clips will be juxtaposed with research stories• PamelaWescott, Ellen Reifler overseeing work onclips; involved in weekly calls with PCORI• Contract has not yet been signed8
  • 9. Australian Adaptations• Bupa Health Dialog Australiashared decision making initiative• Adapt decision aid program bookletsfor the Australian healthcare market• Collaborate with the Foundation andits Medical Editors on review of adaptedcontent9
  • 10. Booklets Adapted for Use in Australia• Living with Coronary Heart Disease• Heart DiseaseTesting• Treatment Choices for Coronary Heart Disease• Heart Failure• Treatment Choices for Hip Osteoarthritis• Treatment Choices for Knee Osteoarthritis• Torn Meniscus• Early-Stage Knee Osteoarthritis10
  • 11. 11
  • 12. Team for Australian Adaptations• University of New South Wales:- Review content to ensure alignment with Australianguidelines• Bupa Health Dialog Australia ClinicalTeam:- Localize grammar/spelling, units of measure, terminology(medications, procedures, etc.), product names- Coordinate review by local clinical specialists• Foundation / Medical Editors:- Review/approve proposed revisions- Review Australian guidelines , other supporting citations12
  • 13. Challenges – Australia and Beyond• Efficient adaptation process that includes local experts• Aligning clinical content with country-specific guidelines• Ensuring local clinical buy-in from key endorsing bodies(e.g., Australian Disease Management Association, RoyalAustralian College of General Practitioners)• Implementation strategy• Provider outreach, education and training• Ongoing review and updating of adapted programs13
  • 14. First steps…• Explore feasibility of creating “global” coreproduct that would require less localization forvarious countries• Add international clinical experts to our MedicalEditor teams14
  • 15. American College of CardiologyMedication Decision Aids• New collaboration!• ACC Shared Decision MakingTask Force• Topics:- Statins for primary prevention- Anticoagulation options for atrial fibrillation• For ACC members and patients• On ACC website portals September 201315
  • 16. Medication Decision Aid Features• Foundation to produce• Short production schedule (less than a year)• Web-based educational content (~ 2,000 words)• “Content Specification Documents” –New, shorter format for evidence review• Patient focus groups• Provider survey viaACC16
  • 17. Medication Decision Aid Features• Introductory video by cardiologist• Interactive risk calculators• Clinician’sGuides17
  • 18. Foundation / ACC TeamSteering Committee: Foundation• JohnWong – Medical Editor, Chair of Steering Committee• Colin Nelson – Senior Research Associate• Margaret Lynch –Research Associate• Diana Stilwell – Chief Production Officer• Sherri Frank Mazzotta – Director CD/Production18
  • 19. Foundation / ACC TeamSteering Committee: ACC• Bill Lewis – MetroHealth, Cleveland, OH• MinnowWalsh – St.Vincent Heart Center of Indiana,Indianapolis, IN• JoAnne Foody – Brigham andWomen’s Hospital,Boston, MA• Katherine Doermann Byrd – ACC staff liaison• Lea Binder – ACC staff liaison19