Using a Triple Aim Approach to Implement "Less-is-More Together" and Smarter Medicine Strategies in an Interprofessional Outpatient Setting: Protocol for an Observational Study.

Détails

ID Serval
serval:BIB_2102F9575419
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Using a Triple Aim Approach to Implement "Less-is-More Together" and Smarter Medicine Strategies in an Interprofessional Outpatient Setting: Protocol for an Observational Study.
Périodique
JMIR research protocols
Auteur⸱e⸱s
Lehky Hagen M., Julen R., Buchs P.A., Kaufmann A.L., Gaspoz J.M., Verloo H.
ISSN
1929-0748 (Print)
ISSN-L
1929-0748
Statut éditorial
Publié
Date de publication
18/07/2019
Peer-reviewed
Oui
Volume
8
Numéro
7
Pages
e13896
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Increased awareness of the world's problematic growing health care expenditure and health care shortages requires sustainable use of available resources. To promote cultural changes in medical mindsets, societies representing medical specialties have developed new Choosing Wisely strategies. The Valais Medical Society and the Valais Pharmacy Association have developed an interprofessional collaboration project entitled "Less-is-more Together-PPI" to analyze and optimize change management practices focusing on the prescription and deprescription of proton pump inhibitors (PPIs).
This study aims to enhance interprofessional collaboration between physicians, pharmacists, and patients to optimize PPI use, avoid unnecessary treatments and improve therapeutic adherence to indicated therapies, and to analyze hindrances and facilitators to implementing interprofessional Less-is-more strategies in the field.
Home-dwelling adults domiciled in Valais and prescribed PPIs in the last 6 months will be invited to participate in this observational study. The studied subpopulation will be constituted of consenting patients whose physicians and pharmacists also voluntarily agree to participate. The process of collecting, pooling, transmitting, evaluating, and protecting data has been validated by the Human Research Ethics Committee of the Canton Vaud.
The Primary Triple Aim outcome measures will be (1) population health: patient's assessment of their own health, functional status, and disease burden using a monthly questionnaire for 6 months; Behavioral/physiological factors will be investigated using a final questionnaire at 6 months, (2) experience of care: assessment using a final questionnaire for participating patients, pharmacists and physicians, and an analysis of negative/positive experiences via 6 follow-up questionnaires, and (3) Per capita cost: participants' fluctuating or decreasing PPI intake (number of pills/dosage) and an analysis of participants' different categories following their medical prescription, in relation to possible bias effects on the overall drug intake of the population studied. Secondary outcomes will be participation rates; patient, physician, and pharmacist follow-up; and evaluations of participants' experiences and their perceived benefits, as well as whether the interprofessional process can be improved.
This project seeks a deeper understanding of how Less-is-more and smarter-medicine strategies are perceived by patients and health care providers in their daily lives in a very specific context. It will reveal some of the hindrances to and facilitators for efficient cultural change toward a more sustainable health care system. The results will be useful to optimize and scale up further Choosing Wisely approaches.
DERR1-10.2196/13896.
Mots-clé
deprescription, evidence-based medicine, family physicians, pharmacists, polypharmacy, prescription
Pubmed
Open Access
Oui
Création de la notice
04/08/2019 15:11
Dernière modification de la notice
20/08/2019 12:57
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