Evidence Based Health Care Quality Help: Patient Communication Samples

Patient-centered Resources:
Samples

newest 05/27/09: Drug Facts Boxes: Examples

Important
Not all clinical recommendations from other sources have been reviewed for validity and ours may or may not be uptodate, so selections below should be viewed as representing examples of approaches and formats for communications, etc. Feel free to contact us for details. Read our Health Care Information Source Cautions at Notices.

Contents

Delfini Rx Messaging Scripts™: Messaging scripts are targeted treatment messaging & decision support tools for specific clinical topics. This tool, and accompanying template, can help you construct your own
Patient Decision-Aid: Delfini Patient Decision Aid for Menopause (sample only, no guarantee that this is complete or up-to-date)
Patient Information Checklist example: Chronic Kidney Disease Guideline Patient Information. Read more information about the Kaiser Permanente Nephrology Guideline Project here.
newest Drug Facts Boxes: Examples
Patient Flowcharts: This is for illustration of examples only — we have not evaluated this content
Delfini Irritable Bowel Syndrome (IBS) Guideline: guideline resource kit sample of an"explicit" evidence-based clinical practice guideline, information and decision aids and patient information
Acute Bronchitis: Visual aids for patients and shown to help reduce antibiotic use for viral infections
Cardiovascular Risk Calculators: Great tool for doctors and patients
Diagnostic Test Calculator: We all have trouble understanding diagnostic testing measures of functions — odds, probabilities, and all that. Here's a calculator that communicates the outcomes in natural language. Useful for clinicians and patients
Consumer Drug Reviews: From the Oregon Evidence-based Practice Center: Delfini Review of NSAIDS and Cox2 Inhibitors — Ways to convey evidence-based information to patients

Let us see your examples: Submission Criteria & Other Information [PDF]

Delfini Patient Information and Decision Aid for Menopause (sample only — not complete or up-to-date)
If you are a subscriber, look at BestTreatments as well for information on more treatment options and other information!

Here's a link to an example of a Patient Decision-Aid we created to illustrate how one might communicate around menopause issues — be patient for loading (or you might want to just print it out)— this is a big one:

Decision Aid — Menopause [PDF]

Read Patient Decision Aids: Potential value of patient decision aids »

Drug Facts Boxes: Examples
05/27/09

In a recent study published in the Annals of Internal Medicine, authors Schwartz et al., conducted two randomized, controlled trials between October 2006 and April 2007 with the objective of determining whether providing consumers with a drug facts box—a table quantifying outcomes with and without the drug— improves knowledge and affects judgments about prescription medications.[1]

There are limitations in these trials, including a response rate of less than 50 percent, and like most literature in the area of patient communications, the strength of the evidence is weak.

We think it is useful, however, to see their format for providing information to patients as it is our opinion that this kind of format and information may be effective with patients, helping them to make decisions based on their own values and preferences.

The full text of the article can be accessed here by copying the following into an internet search engine: http://www.annals.org/cgi/content/full/150/8/516
Article includes appendices of the test cases, examples of the fact sheets and the patient surveys.
To access, copy the following into an internet search engine: http://www.annals.org/cgi/content/full/0000605-200904210-00106/DC1

Specifically, the authors recommend information in the following areas:

What is this drug for?
Who might consider taking it?
Who should NOT take it?
Recommended testing
Other things to consider doing

They also provide a Study Findings Box that provides nicely quantified information in easy to understand terms.

Lastly, they provide information about how long the drug has been in use with approval dates and a caution that, “Studies show that most serious side effects or recalls of new drugs happen during their first 5 years of approval.”

The authors have done a very nice job. Our main recommendation would be to add references to the fact sheet itself for full transparency.

A reminder that Delfini has some examples for providing evidence-based information to clinicians and patients at http://www.delfini.org/page_SamePage_RxMessagingScripts.htm

[1] Schwartz LM, Woloshin S, Welch HG. Using a drug facts box to communicate drug benefits and harms: two randomized trials.
Ann Intern Med. 2009 Apr 21;150(8):516-27. Epub 2009 Feb 16. PMID: 19221371 »

Patient Flow Charts (samples only — we have not evaluated this content)
Here are examples of patient flow charts — another way to effectively present information and choices to patients.

http://familydoctor.org/flowcharts/537.html

Acute Bronchitis
Here's a link to an example of how to display Patient Information that we like (see the Campaign Poster at the bottom of the link):

Example from:
Decreasing antibiotic use in ambulatory practice: impact of a multidimensional intervention on the treatment of uncomplicated acute bronchitis in adults

Gonzales R, Steiner JF, Lum A, Barrett PH Jr. Division of General Internal Medicine, Department of Medicine, University of Colorado Health Sciences Center, Denver 80262, USA. Ralph.Gonzales@uchsc.edu. JAMA 1999 Apr 28;281(16):1512-9

http://www.uchsc.edu/uh/gim/educate/bronchitis.html

Cardiovascular Risk Calculators
Tools that can provide instant evidence-based answers are very much needed by clinicians. Tools that can provide customized information to patients are more likely to be used by patients.

Here's an example of an electronic risk calculator done by our friends of the New Zealand Guidelines Group in the New Zealand Health Ministry.

http://www.racp.edu.au/bp/resources/EBM_cardio.pdf

Delfini Review of Oregon Evidence-based Practice Center Consumer Drug Reviews:
About NSAIDS and Cox2 Inhibitors (as of 8/2002)
General Information for Consumers: Evidence-based Medicine & Oregon Evidence-based Practice Center Drug Reviews

We reviewed consumer drug information developed by the Oregon Evidence-based practice center. This patient-centered piece is an example of evidence-based writing for consumers. Note: the information in this piece is based on Cox2 Inhibitors as a drug class. New Cox 2 Inhibitors may become available after the time of this writing (8/2002) which may be categorically different.

Decision Aid - About NSAIDS and Cox2 Inhibitors [PDF]