Shared decision making and patient reported outcomes among adults with atherosclerotic cardiovascular disease, medical expenditure panel survey 2006–2015
Importance: Shared decision-making (SDM), one of the pillars of patient centered care is strongly encouraged and has been incorporated into the management of atherosclerotic cardiovascular disease (ASCVD) but the expansion of its use has been limited Objective: To determine the association of SDM on...
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2021
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oai:doaj.org-article:0850df208b894c338d433a80c9c8015b2021-11-24T04:34:54ZShared decision making and patient reported outcomes among adults with atherosclerotic cardiovascular disease, medical expenditure panel survey 2006–20152666-667710.1016/j.ajpc.2021.100281https://doaj.org/article/0850df208b894c338d433a80c9c8015b2021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2666667721001367https://doaj.org/toc/2666-6677Importance: Shared decision-making (SDM), one of the pillars of patient centered care is strongly encouraged and has been incorporated into the management of atherosclerotic cardiovascular disease (ASCVD) but the expansion of its use has been limited Objective: To determine the association of SDM on patient-reported health status, measures of quality of care, healthcare resource utilization, and healthcare spending among US adults with ASCVD Method: This is a retrospective cohort study in an ambulatory setting, utilizing the Medical Expenditure Panel Survey (MEPS) 2006–2015. Analysis completed in December 2020. Participants included were adults 18 years and over with a diagnosis of ASCVD. We used the average weighted response to self-administered questionnaire evaluating shared-decision-making process as the exposure variable in the regression model. Outcome measures included inpatient hospitalizations, Emergency Department (ED) visits, statin and aspirin use, self-perception of health, and healthcare expenditure Results: When compared with individuals reporting poor SDM, those with optimal SDM were more likely to report statin and aspirin use [statin use, Odds Ratio (OR) 1.26 (95% CI, 1.09–1.46)], [aspirin use, 1.25 (1.07–1.45)], more likely to have a positive perception of their health and healthcare related quality of life, and were less likely to visit the ED [OR for ≥ 2 ED visits: 0.81 (0.67–0.99)]. There was no difference between groups in annual total or out of pocket healthcare expenditure Conclusion: This study suggests that effective SDM is associated with better utilization of healthcare resources and patient reported health outcomes. We hope these results could provide useful evidence for expanding the use of SDM in patient-centered care among individuals with ASCVDVictor OkunrintemiJavier Valero-ElizondoNeil J. StoneRon BlanksteinMichael J. BlahaMartha GulatiSalim S. ViraniWilliam A. ZoghbiErin D. MichosKhurram NasirElsevierarticleDiseases of the circulatory (Cardiovascular) systemRC666-701Public aspects of medicineRA1-1270ENAmerican Journal of Preventive Cardiology, Vol 8, Iss , Pp 100281- (2021) |
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Diseases of the circulatory (Cardiovascular) system RC666-701 Public aspects of medicine RA1-1270 |
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Diseases of the circulatory (Cardiovascular) system RC666-701 Public aspects of medicine RA1-1270 Victor Okunrintemi Javier Valero-Elizondo Neil J. Stone Ron Blankstein Michael J. Blaha Martha Gulati Salim S. Virani William A. Zoghbi Erin D. Michos Khurram Nasir Shared decision making and patient reported outcomes among adults with atherosclerotic cardiovascular disease, medical expenditure panel survey 2006–2015 |
description |
Importance: Shared decision-making (SDM), one of the pillars of patient centered care is strongly encouraged and has been incorporated into the management of atherosclerotic cardiovascular disease (ASCVD) but the expansion of its use has been limited Objective: To determine the association of SDM on patient-reported health status, measures of quality of care, healthcare resource utilization, and healthcare spending among US adults with ASCVD Method: This is a retrospective cohort study in an ambulatory setting, utilizing the Medical Expenditure Panel Survey (MEPS) 2006–2015. Analysis completed in December 2020. Participants included were adults 18 years and over with a diagnosis of ASCVD. We used the average weighted response to self-administered questionnaire evaluating shared-decision-making process as the exposure variable in the regression model. Outcome measures included inpatient hospitalizations, Emergency Department (ED) visits, statin and aspirin use, self-perception of health, and healthcare expenditure Results: When compared with individuals reporting poor SDM, those with optimal SDM were more likely to report statin and aspirin use [statin use, Odds Ratio (OR) 1.26 (95% CI, 1.09–1.46)], [aspirin use, 1.25 (1.07–1.45)], more likely to have a positive perception of their health and healthcare related quality of life, and were less likely to visit the ED [OR for ≥ 2 ED visits: 0.81 (0.67–0.99)]. There was no difference between groups in annual total or out of pocket healthcare expenditure Conclusion: This study suggests that effective SDM is associated with better utilization of healthcare resources and patient reported health outcomes. We hope these results could provide useful evidence for expanding the use of SDM in patient-centered care among individuals with ASCVD |
format |
article |
author |
Victor Okunrintemi Javier Valero-Elizondo Neil J. Stone Ron Blankstein Michael J. Blaha Martha Gulati Salim S. Virani William A. Zoghbi Erin D. Michos Khurram Nasir |
author_facet |
Victor Okunrintemi Javier Valero-Elizondo Neil J. Stone Ron Blankstein Michael J. Blaha Martha Gulati Salim S. Virani William A. Zoghbi Erin D. Michos Khurram Nasir |
author_sort |
Victor Okunrintemi |
title |
Shared decision making and patient reported outcomes among adults with atherosclerotic cardiovascular disease, medical expenditure panel survey 2006–2015 |
title_short |
Shared decision making and patient reported outcomes among adults with atherosclerotic cardiovascular disease, medical expenditure panel survey 2006–2015 |
title_full |
Shared decision making and patient reported outcomes among adults with atherosclerotic cardiovascular disease, medical expenditure panel survey 2006–2015 |
title_fullStr |
Shared decision making and patient reported outcomes among adults with atherosclerotic cardiovascular disease, medical expenditure panel survey 2006–2015 |
title_full_unstemmed |
Shared decision making and patient reported outcomes among adults with atherosclerotic cardiovascular disease, medical expenditure panel survey 2006–2015 |
title_sort |
shared decision making and patient reported outcomes among adults with atherosclerotic cardiovascular disease, medical expenditure panel survey 2006–2015 |
publisher |
Elsevier |
publishDate |
2021 |
url |
https://doaj.org/article/0850df208b894c338d433a80c9c8015b |
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