Keyword: "disease management"

12 items were found with the keyword "disease management".

  • Improving Patient Decisions about Bariatric Surgery

    New

    PI: Nancy J. Birkmeyer, PhD , Amir A. Ghaferi, MD, MS

    Obesity is increasingly considered among the most important public health problems of our times. Bariatric surgery is arguably the only treatment that has proven effective in producing long-term weight loss for patients with morbid obesity. Bariatric surgery also results in resolution of obesity related co-morbid conditions, improvements in quality of life, and increased survival. There are currently four different bariatric surgical procedures in use: adjustable gastric banding, gastric bypass, sleeve gastrectomy, and duodenal switch. Bariatric surgery is considered a highly preference sensitive medical issue. Existing decision aids in bariatric surgery are limited in that they provide information about the average comparative risks and benefits of the treatment options, but do not provide customized estimates of the risks and benefits of the different procedures for individual patients. As a result of these draw-backs, decision aids are not frequently used in making treatment decisions in bariatric surgery. Our proposal is highly innovative in that our decision support tool integrates data from a large clinical registry with individual patient data to provide patients with real-time, customized, accurate information regarding the risks and benefits of the treatment options to better inform decision making. This tool will be continuously updated to ensure that the data on risks and benefits that it provides are accurate and current. Our tool also provides information about other attributes of the treatment options that bariatric surgery patients and other relevant stakeholders feel are important for patients to consider in deciding whether and what type of bariatric surgery to have. The proposed research promotes shared medical decision making for patients who are considering bariatric surgery for the treatment of morbid obesity. If our intervention proves effective, it will result in improved decision quality and outcomes of care for patients. It may also result in improved efficiency of care to the extent that it serves to augment or guide communication between the patient and physician to promote shared medical decision-making. (09/01/2013 - 08/31/2016)

  • Technologically Enhanced Coaching (TEC): A Program for Improving Diabetes Outcomes

    New

    PI: M. E. Michele Heisler, MD, MPA

    Peer mentoring and support models have been found in two recent VA RCTs to be more effective than usual care, financial incentives, and usual nurse care management to improve glycemic control in high-risk veteran patients with poor glycemic control. While peer supporters and coaches can be trained in effective behavioral approaches to support other veterans’ self-management behaviors, such supporters necessarily lack content expertise to help veterans better share in treatment decisions and goal-setting with their health care providers. Accordingly, in an AHRQ-supported RCT we developed and tested tailored, interactive tools with diabetes and medication information embedded in the tool software that peer coaches and other outreach workers can employ to facilitate discussions with patients. Such tools could enhance the sustainability and effectiveness of coaching programs to better prepare patients to set self-management goals, action plans, and to discuss treatment options with their health care providers. (09/01/2013 - 08/31/2017)

  • iNSider

    PI: Debbie S. Gipson, MD, MS

    The overarching goal of this study is to strengthen our understanding of the patient and physician perspective of nephrotic syndrome, therapy, prognosis, and factors influencing disease management and to use the information generated from stakeholder engagement to inform the creation of a shared-learning online decision support tool. (10/11/2012 - 12/31/2014)

    Related Media:

  • Puff City ED

    PI: Christine L. M. Joseph, PhD, MPH

    The objective of the proposed project is to evaluate the feasibility of initiating Puff City in an urban Emergency Department (ED) setting. This proposal will inform a future randomized trial to test the ability of an ED-initiated version of Puff City to reduce the risk of future exacerbations, symptom frequency, and functional limitations among urban adolescents presenting to the ED with asthma. (08/15/2012 - 05/31/2013)

  • Puff City Clinic

    PI: Mei Lu, PhD

    Asthma continues to be a major public health problem in the US with high economic and social costs. Vulnerable ethnic communities are disproportionately affected by asthma as demonstrated by higher morbidity and mortality for these groups. These disparities are especially true in urban teens. We have completed two school-based, randomized trials of a web-based, computer-tailored asthma management intervention that targets urban teens (Puff City). Results showed reductions in self report of symptoms and activity limitations. Puff City has not yet been evaluated as a clinical tool or one that is initiated in a clinical setting. The current paradigm for conducting such a trial is costly with respect to patient recruitment, intervention delivery, and data collection and management.Electronic initiatives such as remote data capture (RDC) for data collection and utilization of patient electronic medical records (EMR) are revolutionizing the conduct of clinical trials. Comparative effectiveness methods (CEMs), adaptive designs and pragmatic trials, are recommended to enhance trial efficiency and to study real-world effectiveness. The objective of this project is 1) to implement a seamless clinical trial lifecycle through electronic initiatives and ii) to design and conduct a phase II/III randomization trial using both CEMs and EMR-RDC integration to evaluate Puff City in teens in a clinical setting. (08/15/2012 - 05/31/2014)

  • iDECIDE for Ann Arbor and Detroit VAs

    PI: Angela Fagerlin, PhD

    Successful diabetes management is dependent on the patient - provider partnership. However, a full discussion of potential benefits, harms, costs, and burdens associated with each medication option is often too much for a brief clinic visit. This project uses AHRQ-developed consumer guides as inspiration for a tailored program that assists with this decision-making. The current iDECIDE intervention serves as the base of the program, with updates geared toward making it more specific to veterans. (01/01/2012 - 09/30/2012)

  • iDecide/iDecido

    PI: M. E. Michele Heisler, MD, MPA

    Successful diabetes management is dependent on the patient - provider partnership. However, a full discussion of potential benefits, harms, costs, and burdens associated with each medication option is often too much for a brief clinic visit. This project uses AHRQ-developed consumer guides as inspiration for a tailored program that assists with this decision-making. The intervention is delivered on iPads by Community Health Workers in participant homes and is available in both English and Spanish. (09/30/2010 - 09/29/2013)

    Related Media:

  • Narrative Video Library

    PI: Borsika Rabin, PhD, MPH, PharmD

    This project aims to develop an online library of video vignettes that highlight a discussion with a leading researcher or practitioner who describe one problem in the process of dissemination and implementation (D&I) and show viewers how he/she solved the problem. (09/01/2010 - 08/31/2011)

  • THISN

    PI: Victor J. Strecher, PhD, MPH

    THISN (Tailored Health Information in Social Networks) is a collaborative effort with CHCR and CDC's National Center for Public Health Informatics to conceive, design, and develop a prototype application testing the viability of using tailoring technology in a web-based social networking context (e.g., MySpace, Facebook). (09/01/2008 - 08/31/2009)

  • Tools for Being a Helpful Peer Partner - DVD

    PI: M. E. Michele Heisler, MD, MPA

    This DVD is one portion of a larger study (Mobilizing Peer Support for Effective Heart Failure Self-Management) being conducted by Dr. Michele Heisler. The goal of the DVD is to teach people with congestive heart failure how to support each other in managing their illness via phone calls to each other. The DVD describes and models Motivational Interviewing (MI) style communication skills for peer-to-peer communications. The DVD explains the basics of MI style communications and provides numerous examples of peer-to-peer conversations that use MI techniques. (11/01/2006 - 10/30/2007)

    Related Media:

  • Better Health

    PI: Victor J. Strecher, PhD, MPH

    This projects uses longitudinally-tailored print materials and telecounseling interventions and compares their effectiveness, individually and in combination, among individuals with one or more risks, including smoking, poor diet, and sedentary behavior. (04/01/1999 - 12/31/2004)

  • I Can Decide Dashboard

    New

    PI: Lawrence C. An, MD , Sarah T. Hawley, PhD, MPH

    Patients newly diagnosed with breast cancer face a series of complex decisions regarding locoreginal and systemic treatment. Currently many of these decisions do not meet the definition of a high quality decision, defined as one that is both informed (based on an accurate understanding of the treatment risks and benefits) and preference-concordant (consistent with the patient's underlying preferences). I Can Decide evaluates the impact of an innovative decision tool on locoregional and systemic therapy decision making for newly diagnosed breast cancer patients.  The I Can Decide Dashboard links the I Can Decide patient website to a clinic dashboard. Some of the information patients enter on the website will be shared with the clinic. The goal is to improve communication and help patients make informed treatment decisions. (08/31/2017)