Pubmed: occupational therapy

Pubmed: occupational therapy

  • : Montreal Accord on Patient-Reported Outcomes Use Series - Paper 4: Patient Reported Outcomes (PRO) Can Inform Clinical Decision-Making in Chronic Care. - pubmed: "occupational therap...
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    Montreal Accord on Patient-Reported Outcomes Use Series - Paper 4: Patient Reported Outcomes (PRO) Can Inform Clinical Decision-Making in Chronic Care.

    J Clin Epidemiol. 2017 Apr 19;:

    Authors: Bingham CO, Noonan V, Auger C, Feldman D, Ahmed S, Bartlett SJ

    Abstract
    BACKGROUND: Providing patient-centered healthcare requires that patient needs, preferences, and valued outcomes are more fully integrated into all decisions. Patient reported outcome measures (PROs) provide unique information from the patient perspective on overall health, symptoms, burden, and treatment response.
    OBJECTIVE: We sought to describe applications of PROs in clinical settings and considerations for implementation from the perspectives of PRO researchers, clinicians, administrators, policy makers, and patients attending a multidisciplinary meeting.
    DISCUSSION: Clinical applications of PROs include individual level use for medical decision-making and aggregate use for comparative effectiveness research, program evaluation, quality improvement, and performance assessments. Considerations of feasibility on work flow impact and patient burden, display of results, and administration frequency are important. PROs with strong psychometric properties, actionable thresholds, and interpretable results should be selected. We provide current exemplars of PRO use in various clinical applications, initial lessons learned, and highlight conceptual, logistical, and consequential considerations of PRO data collection. A research agenda is proposed to address critical knowledge gaps. In conclusion, PROs can be used in clinical settings to support patient-centered care. This requires an assessment of feasibility in the intended setting of use, measurement considerations, and process measures to optimize integration and use.

    PMID: 28433678 [PubMed - as supplied by publisher]

  • : Montreal Accord on Patient-Reported Outcomes Use Series- Paper 8: Patient Reported Outcomes (PRO) in Electronic Health Records Can Inform Clinical and Policy Decisions. - pubmed: "occupational therap...
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    Montreal Accord on Patient-Reported Outcomes Use Series- Paper 8: Patient Reported Outcomes (PRO) in Electronic Health Records Can Inform Clinical and Policy Decisions.

    J Clin Epidemiol. 2017 Apr 19;:

    Authors: Ahmed S, Ware P, Gardner W, Witter J, Bingham CO, Khairy D, Bartlett SJ

    Abstract
    BACKGROUND: Given that the goal of healthcare systems is to improve and maintain the health of the populations they serve, the indicators of performance must include outcomes that are meaningful to patients. The growth of health technologies provides an unprecedented opportunity to integrate the patient voice into clinical care by linking electronic health records (EHR) to patient-reported outcome (PRO) data collection. However, PRO data must be relevant, meaningful, and actionable for those who will have to invest the time and effort to collect it.
    OBJECTIVE: In this paper, we highlight opportunities to integrate PRO data collection into EHRs. We consider how stakeholder perspectives should influence the selection of PROs and ways to enhance engagement in and commitment to PRO implementation. We propose a research and policy agenda to address unanswered questions and facilitate the widespread adoption of PRO data collection into EHRs.
    DISCUSSION: Building a learning healthcare system that gathers PRO data in ways that can inform individual patient care, quality improvement, and comparative effectiveness research has the potential to accelerate the application of new evidence and knowledge to patient care.

    PMID: 28433675 [PubMed - as supplied by publisher]

  • : Montreal Accord on Patient-Reported Outcomes Use Series - Paper 6: Creating National Initiatives to Support Patient Reported Outcomes (PRO) Development and Use-the PROMIS Example. - pubmed: "occupational therap...
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    Montreal Accord on Patient-Reported Outcomes Use Series - Paper 6: Creating National Initiatives to Support Patient Reported Outcomes (PRO) Development and Use-the PROMIS Example.

    J Clin Epidemiol. 2017 Apr 19;:

    Authors: Bartlett SJ, Witter J, Cella D, Ahmed S

    Abstract
    BACKGROUND: PRO data are beneficial to a range of stakeholders including patients, clinicians, researchers, national funding and regulatory agencies, health system administrators, and policymakers.
    OBJECTIVE: Because stakeholders represent diverse groups and needs, it is challenging to reach consensus on how to advance PRO development and harmonize data across settings to enable use for multiple secondary purposes. Collaborative national networks can facilitate the sharing of expertise, resources and necessary infrastructure; create development, use, and reporting standards; optimize formats to efficiently store and transfer data; and disseminate tools and information for widespread uptake.
    DISCUSSION: In the United States, the National Institutes of Health's Patient Reported Outcomes Measurement System (PROMIS) offers an example of how collaborators can work across distances to form essential partnerships, create a common vision, and leverage technology to accelerate the development and testing of universal PROs that are broadly applicable across health conditions and settings.

    PMID: 28433674 [PubMed - as supplied by publisher]

  • : Montreal Accord on Patient-Reported Outcomes Use Series - Paper 2: Terminology Proposed to Measure What Matters in Health. - pubmed: "occupational therap...
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    Montreal Accord on Patient-Reported Outcomes Use Series - Paper 2: Terminology Proposed to Measure What Matters in Health.

    J Clin Epidemiol. 2017 Apr 19;:

    Authors: Mayo NE, Figueiredo S, Ahmed S, Bartlett S

    Abstract
    BACKGROUND: We outline different health outcomes and describe how multiple perspectives can be harnessed to optimize accuracy of key data collected about patients with chronic conditions. The terms health status, health-related quality of life, and quality of life are often used interchangeably without recognizing that they have different meanings, as are the terms used to refer to the different components of function. While the advantages and limitations of existing frameworks and perspectives are largely understood, greater precision is needed when using health outcome terminology and identifying optimal sources of information.
    OBJECTIVE: A refinement of the current taxonomy is proposed to distinguish between patient reported outcomes (PROs) and self-report outcomes (SROs) and expand the concept of clinically reported outcomes (ClinROs) to include those assessed by performance (PerfOs) and emerging technologies (TechOs).
    DISCUSSION: Health outcomes yield important information that can be used to improve the lives of many people. Now is the time to "talk the talk" as part of larger coordinated efforts within and across countries to identify and measure what matters most in health.

    PMID: 28433673 [PubMed - as supplied by publisher]

  • : Montreal Accord on Patient-Reported Outcomes Use Series Paper 1: Introduction. - pubmed: "occupational therap...
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    Montreal Accord on Patient-Reported Outcomes Use Series Paper 1: Introduction.

    J Clin Epidemiol. 2017 Apr 19;:

    Authors: Bartlett SJ, Ahmed S

    Abstract
    BACKGROUND: Patient-centered healthcare, where we design and deliver care to address the needs and preferences of patients, represents an important paradigm shift. Patient reported outcomes (PROs) are critical to capture the patient voice, understand how illness and treatments affect people, and establish how well services and treatments address what matters most to patients.
    OBJECTIVE: Originally developed for use in research, PROs are now used to monitor individuals and populations, manage care, evaluate services and providers, and inform policy. However, moving PROs beyond research settings incurs considerable methodological, organizational, technological, and ethical considerations. National collaborative networks of researchers, clinicians, patients, and other stakeholders can address these challenges by coordinating development, creating standards for use, sharing costs and delivery platforms, and improving widespread uptake of core sets of measures to better inform healthcare decisions and improve outcomes.
    DISCUSSION: We introduce eight papers from researchers, clinicians, patients and decision-makers who participated in deliberations around creating a national network to accelerate the application and harmonized use of PROs in Canada. They offer a snap shot of the strategies pioneers and innovative thinkers are using to integrate the patient voice into comprehensive care, research, and health policy planning of chronic diseases.

    PMID: 28433672 [PubMed - as supplied by publisher]

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