Journal article
Assessing Anticoagulation Management and Shared Decision-Making Documentation From Providers Participating in the SUPPORT-AF II Study
The Journal of continuing education in the health professions, Vol.40(2), pp.76-80
2020
DOI: 10.1097/CEH.0000000000000293
PMID: 32404775
Abstract
Background: A previously tested intervention featured educational outreach with modified academic detailing (AD) to increase anticoagulation use in patients with atrial fibrillation. Currently, this study compares providers receiving and not receiving AD in terms of inclusion of AD educational topics and shared decision-making elements in documentation. Methods: Physicians reviewed themes discussed with providers during AD and evaluated charts for evidence of shared decision-making. Frequencies of documentation of individual items for providers receiving AD versus non-AD providers were compared. To understand baseline documentation practices of AD providers, encounters of AD providers before their AD participation were randomly selected. Results: There were 113 eligible encounters in the four months after AD-36 from AD providers and 77 from non-AD providers. Thirty-five encounters were identified from AD providers before participating in the intervention. Providers infrequently documented many reviewed items (% documenting): anticoagulation mentioned (44%), multiple options for anticoagulation (5%), CHA(2)DS(2)-VASc score (11%), bleeding risk factors (2%). Compared with non-AD providers, AD providers had statistically significant higher percentages for the following items: mention of anticoagulation (64% versus 35%), stroke risk (11% versus 0%), anticoagulation benefits (8% versus 0%), and patient involvement (17% versus 0%). There was no improvement, however, for AD providers compared with baseline documentation percentages. Discussion: Providers infrequently documented important items in anticoagulation management and shared decision-making. AD participation did not improve documentation. Improving adoption of AD educational items may require more prolonged interaction with providers. Improving shared decision-making may require an intervention more focused on it and its documentation.
Details
- Title: Subtitle
- Assessing Anticoagulation Management and Shared Decision-Making Documentation From Providers Participating in the SUPPORT-AF II Study
- Creators
- Laboni Hoque - Mayo ClinicAzraa Amroze - University of Massachusetts SystemVinit Gilvaz - University of Massachusetts SystemSonu Abraham - University of Massachusetts SystemAmos Lal - University of Massachusetts SystemAjay Mishra - University of Massachusetts SystemSybil Crawford - University of Massachusetts SystemKathleen Mazor - University of Massachusetts SystemDavid D. McManus - University of Massachusetts SystemAlok Kapoor - University of Massachusetts System
- Resource Type
- Journal article
- Publication Details
- The Journal of continuing education in the health professions, Vol.40(2), pp.76-80
- DOI
- 10.1097/CEH.0000000000000293
- PMID
- 32404775
- NLM abbreviation
- J Contin Educ Health Prof
- ISSN
- 0894-1912
- eISSN
- 1554-558X
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 5
- Grant note
- R01HL137794-01A1; R01HL126911-03 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA Bristol Myers Squibb; Bristol-Myers Squibb Pfizer Biotronik 28358345 / Bristol Myers Squibb; Bristol-Myers Squibb R01HL137794 / National Heart Lung and Blood Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) Boeringher Inghelheim Philips Healthcare
- Language
- English
- Date published
- 2020
- Academic Unit
- Internal Medicine
- Record Identifier
- 9985237503702771
Metrics
1 Record Views