Empowering Patients and Improving Communication
Helping women diagnosed with uterine fibroids make informed decisions about treatment options
One of the most effective ways to improve health outcomes and increase people’s satisfaction with care is through better communication and more responsive, patient-centered decision making. This model for care—often called shared decision making—has at its core a strong partnership between health care provider and patient. The Dartmouth Institute is at the forefront of patient engagement and shared decision making research, working to develop tools to improve communication between patients and healthcare providers and strategies for integrating shared decision making into healthcare practice at many levels.
Uterine Fibroids: Better Informing Women about Scope and Effectiveness of Treatment Options
Fibroids, noncancerous growths in the uterus, are particularly common in women age 35-45 and can significantly affect a women’s quality of life, causing problems like pelvic pain, heavy periods, painful intercourse, and difficulty becoming pregnant. There is a wide range of possible treatment options available for women with fibroids which vary significantly in terms of cost, recovery, and impact on fertility, among other factors. With support from the Patient-Centered Outcomes Research Institute (PCORI), Dartmouth Institute researchers are launching a pilot project that could help women with uterine fibroids make more informed decisions about treatment options. The team, led by Dartmouth Institute Professor Glyn Elwyn, MD, PhD,
will incorporate evidence from an earlier PCORI-supported comparative effectiveness study on which treatments for uterine fibroids have the best results into a multi-component shared decision making strategy at Brigham and Women’s Hospital in Boston; Mayo Clinic in Rochester, Minnesota; Montefiore Medical Center, Bronx, New York; Barnes-Jewish Hospital, St. Louis, Missouri; and Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
The strategy to be implemented at the five sites includes four components:
- an assessment of each organization’s readiness for SDM and a tailored strategy to address potential organizational barriers to implementation
- online or in-person training of clinical teams
- implementation of a paper-based text or picture version and/or a web-based interactive Option Grid encounter decision aid
- integration of the new evidence and the SDM approach into existing clinical practice guidelines, where possible
At least five gynecologists at each of the sites will introduce the treatment option tools to patients during the clinical visit. The team also plans to assess whether the process of implementation is sustained or “normalized” to become part of the routine workflow at the five sites.
For more information: www.upfrontproject.org