Implementation outcomes of a patient decision-aid in a diverse population with systemic lupus erythematosus in 15 US rheumatology clinics

作者：Jasvinder A. Singh, Larry R. Hearld, Seth A. Eisen, Winn Chatham, Sonali Narain, Narender Annapureddy, Diane L Kamen, Kimberly Trotter, Vikas Majithia, Cathy Lee Ching, Zineb Aouhab, Swamy Venuturupalli, Daniel J. Wallace, Rosalind Ramsey‐Goldman, Alfred H.J. Kim, Maureen McMahon, S. Sam Lim, Kalpana Bhairavarasu, Alexa Meara, Kenneth Kalunian, Mark Beasley, Winn Chatham, Jasvinder A. Singh, Sonali Narain, Narender Annapureddy, Diane L Kamen, Charleston, Kimberly Trotter, Vikas Majithia, Cathy Lee Ching, Jackson, Zineb Aouhab, Swamy Venuturupalli, Rosalind Ramsey‐Goldman, Alfred H.J. Kim, Maureen McMahon, S Sam Lim, Kalpana Bhairavarasu, Alexa Meara, Kenneth Kalunian · 发表于：Lara D. Veeken · 年份：2025 · DOI：10.1093/rheumatology/keaf205 · 被引用次数：4 · 研究领域：Mental Health and Patient Involvement、Patient-Provider Communication in Healthcare、Diabetes Management and Education

OBJECTIVE: The objective of this study was to examine the clinical outcomes during the implementation of a self-administered patient decision-aid (PtDA) for lupus. METHODS: We provided an effective computerized lupus PtDA in 15 rheumatology outpatient clinics 2019-2024 (including the COVID pandemic). We undertook Organizational Readiness to Implement Change Surveys (ORICs) and Team Learning and Psychological Safety Surveys (TLPSSs) at baseline. The primary study outcome objective measure, percent penetration/reach, was defined as the number of patients who viewed the lupus PtDA at the end of the study, divided by the total number of eligible patients (times 100). We used validated clinical personnel surveys to examine the perceived lupus PtDA appropriateness, acceptability, feasibility, success, and permanence, at 4 months, 12 months and 24 months post-PtDA implementation. RESULTS: Among the sites, the clinical personnels' (n = 184) baseline ORIC commitment and efficacy scores (a 0-5 scale, higher = better) ranged from 3.5 to 4.2, and 3.4 to 4.4, respectively; the TLPSS scores (a 0-7 scale, higher = better) were 3.9-5.5 for internal learning, 3.7-5.6 for external learning, and 4.3-5.5 for psychological safety. The penetration (primary outcome) among 15 geographically diverse US rheumatology clinics ranged from 3% to 44%. We found that the total number of providers in the clinic was positively associated with higher penetration. Clinical personnel-perceived lupus PtDA outcomes...