Shared Decision‐Making During Virtual Care Regarding Rheumatologic and Chronic Conditions: Qualitative Study of Benefits, Pitfalls, and Optimization
Objective Virtual care (VC) is an accepted modality of care delivery, and shared decision‐making (SDM) benefits patients with rheumatologic and chronic conditions (RCCs). Unfortunately, research suggests reduced quality of SDM during VC. This study explores the benefits and shortcomings of SDM regar...
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Published in | ACR open rheumatology Vol. 6; no. 1; pp. 32 - 42 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Boston, USA
Wiley Periodicals, Inc
01.01.2024
John Wiley & Sons, Inc Wiley |
Subjects | |
Online Access | Get full text |
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Summary: | Objective
Virtual care (VC) is an accepted modality of care delivery, and shared decision‐making (SDM) benefits patients with rheumatologic and chronic conditions (RCCs). Unfortunately, research suggests reduced quality of SDM during VC. This study explores the benefits and shortcomings of SDM regarding RCCs during VC with suggestions for optimally using VC during SDM.
Methods
Following Stiggelbout's framework for SDM, we conducted focus groups of patients with RCCs and providers to understand their experiences with SDM during VC, probing for facilitating and challenging factors. We conducted content analysis of the transcripts, defining themes, and inductively reasoned to identify relationships among themes. We summarized the facilitators, barriers, and opportunities for improving SDM during VC that participants proposed.
Results
Virtual SDM shares several similarities with in‐person practice, as both draw upon trusting patient‐provider relationships, following the same general steps, and relying on effective communication. VC presents solutions for known barriers to in‐person SDM, expanding time for making decisions and access to care. Technology and virtual health systems introduce new barriers to SDM, and participants list opportunities for overcoming these concerns.
Conclusion
VC is a tool that can enhance and even support superior SDM compared with in‐person visits when implemented successfully, a condition requiring the development of nuanced skills to correctly identify when and how to best use VC for SDM as well as technology and health care structures that integrate SDM into VC. Therefore, patients, providers, insurance carriers, and policy makers all contribute to the success of SDM among RCCs during VC. |
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Bibliography: | Emma Nolan‐Thomas, MA: University of Michigan College of Literature, Science, and the Arts, Ann Arbor Elizabeth A. Baker, PhD, MPH: St. Louis University College for Public Health and Social Justice, St. Louis, Missouri. Tiffany Westrich‐Robertson, BS: AiArthritis (International Foundation for Autoimmune and Autoinflammatory Arthritis), St. Louis, Missouri https://onlinelibrary.wiley.com/doi/10.1002/acr2.11633 Lisa Zickuhr, MD, MHPE, Janice L. Hanson, PhD, EdS, MH: Washington University in St. Louis School of Medicine, St. Louis, Missouri . 1 Funded by the Rheumatology Research Foundation Clinician Scholar Educator award (grant CSE212223). 2 3 4 5 Catherine McCarthy, MD, PhD: Washington University in St. Louis School of Medicine and John J. Cochran Veterans Hospital, St. Louis, Missouri Additional supplementary information cited in this article can be found online in the Supporting Information section Author disclosures are available at http://onlinelibrary.wiley.com/doi/10.1002/acr2.11633 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 1Lisa Zickuhr, MD, MHPE, Janice L. Hanson, PhD, EdS, MH: Washington University in St. Louis School of Medicine, St. Louis, Missouri; 2Catherine McCarthy, MD, PhD: Washington University in St. Louis School of Medicine and John J. Cochran Veterans Hospital, St. Louis, Missouri; 3Emma Nolan‐Thomas, MA: University of Michigan College of Literature, Science, and the Arts, Ann Arbor; 4Tiffany Westrich‐Robertson, BS: AiArthritis (International Foundation for Autoimmune and Autoinflammatory Arthritis), St. Louis, Missouri; 5Elizabeth A. Baker, PhD, MPH: St. Louis University College for Public Health and Social Justice, St. Louis, Missouri. Additional supplementary information cited in this article can be found online in the Supporting Information section (http://onlinelibrary.wiley.com/doi/10.1002/acr2.11633). Author disclosures are available at https://onlinelibrary.wiley.com/doi/10.1002/acr2.11633. |
ISSN: | 2578-5745 2578-5745 |
DOI: | 10.1002/acr2.11633 |