Using IT for Patient-Centered Communication and Decision Making about Medications
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DESCRIPTION (provided by applicant): In the ambulatory setting, the process of medication management is truly a meeting between experts: Physicians are patients' primary source of information about prescription medications, while patients have the best perspective on how a treatment plan fits into their own lives. However, prior research has shown that patient-provider communication about medications is inadequate. To improve medication management, this project brings together four vibrant lines of research and development at Northwestern: health communication, health literacy, medication safety, and informatics. The patient-centered information technology interventions in this study are designed to enhance communication and shared decision making about medications, with a focus on increasing patient understanding of essential information and improving the medication management process. This proposal addresses the following specific aims:
Aim 1. Pre-Visit Patient Intervention: Develop and test a multimedia program to help patients understand the importance of both giving and receiving accurate information about medications.
Aim 2. Provider/System Intervention: Use the electronic medical record (EMR) to encourage patient-centered medication management.
Aim 2A. Extend the EMR medication management capability by training nurses to engage in a patient-centered review of current medications immediately before a patient sees the doctor.
Aim 2B. Leverage the EMR by developing a template that physicians can easily access and display on-screen to engage in a patient-centered discussion about new medications under consideration.
Aim 3. Dissemination: Work with our Practice-Based Research Network to disseminate and track the use of effective interventions, and create pathways for facilitating national distribution to other practices.
This study focuses on primary care, integrating interventions that target patients, providers, and the overall practice system. All of the aims involve patients and providers as research partners, not simply research subjects. In other words, intervention development will benefit from ideas and feedback obtained through focus groups and Beta-tests, as well as the input of a patient who will be hired as part of the research team. No other studies have included patients in systematic efforts to redesign the process of reviewing current medications and discussing new medications. If our interventions prove effective in this randomized clinical trial, they can be rapidly adapted and disseminated to practices that use an EMR.
