The Power of Communication: Empowering and Engaging Patients as Partners in Managing Care Decisions

The Power of Communication:  Empowering and Engaging Patients
as Partners in Managing Care Decisions

Friday, September 19, 2014
12 – 1:00 pm ET
Click here to register.

Sponsored by Merck Foundation

While there are many paths to better health, something as simple as a conversation can lead to improved patient outcomes. The Alliance to Reduce Disparities in Diabetes health care delivery sites have piloted new ways to improve patient outcomes using shared-decision making, culturally-relevant interventions and other techniques to better communicate with patients and empower them to be an active participant in their care. These techniques can lead to measurable improvements in health outcomes and enhanced efficiency in healthcare delivery.

Webinar participants will hear from leaders from these sites and other health policy experts to learn about ways to:

• Integrate non-clinical team members into the care team to facilitate patient communication
• Involve patients in determining their treatment plans
• Increase understanding and trust between patients and providers through culturally-tailored interventions

The webinar will also feature a panel discussion to explore the implications of better communications for the health care team and wider delivery system, health care financing, and patient satisfaction.

Panelists will include:

• Kavita Patel, MD, MPH, Managing Director, Clinical Transformation and Delivery, Engelberg Center for Health Care Reform, The Brookings Institution (Moderator)
• Erin P. Kane, MD, Family Physician, Baylor Community Care
• Monica Peek, MD, MPH, Assistant Professor, Section of General Internal Medicine; Associate Director, Chicago Center for Diabetes Translation Research, University of Chicago 
• Megan Lewis, PhD, Director, Patient & Family Engagement Research Program, Center for Communication Science, RTI International

To register for the webinar, click here.
 

About the Alliance to Reduce Disparities in Diabetes

The Alliance to Reduce Disparities in Diabetes, a national program launched and supported by Merck Foundation, works to improve health care delivery among those populations most at risk for diabetes – African-American, Hispanic/Latino and Native American adults. The five health care delivery sites that comprise the Alliance to Reduce Disparities in Diabetes have implemented multifaceted evidence-based approaches designed to eliminate gaps produced by inequity and lack of targeted attention to those adults and their families who are most likely to be severely burdened by diabetes. For more information about the Alliance and its sites, click here.   

Switching Antipsychotics May Reduce Metabolic Risks

NIMH-funded study examines whether switching to a different antipsychotic can reduce side effects while maintaining effectiveness

Patients experiencing cardiovascular or metabolic side effects while taking an antipsychotic medication may fare better if they switch to a different medication provided they are closely monitored, according to an NIMH-funded study. The study was published online ahead of print July 18, 2011, in the American Journal of Psychiatry.

Antipsychotic medications can effectively treat psychotic symptoms among people with schizophrenia or related disorders. However, the medications, especially some of those that are most commonly used, are associated with serious metabolic side effects that can lead to heart disease or diabetes. Even when patients do experience these side effects, doctors are often reluctant to change a patient’s medication regimen if the patient’s psychotic symptoms are controlled by the existing medication.

“Treating the symptoms of schizophrenia is a delicate balancing act between risks and benefits,” said National Institute of Mental Health Director Thomas R. Insel, M.D. “The possible benefits of switching medications to reduce metabolic risks must be carefully weighed against the potential risk of symptom relapse or medication failure.”

Scott Stroup, M.D., of Columbia University and colleagues aimed to determine if a medication switch could be made safely and without sacrificing clinical stability. For the Comparison of Antipsychotics for Metabolic Problems (CAMP) study, they enrolled 215 patients from 27 clinical sites whose psychotic symptoms were stabilized on one of three frequently used antipsychotics (olanzapine, quetiapine or risperidone) but were experiencing serious metabolic side effects such as weight gain and high cholesterol levels. Half of the patients were assigned to stay on their current medication, while the other half were switched to aripiprazole, another antipsychotic that is generally associated with fewer metabolic risks. All of the participants received a behavioral intervention that included a diet and exercise program designed to reduce the risk of cardiovascular disease.

After 24 weeks, the researchers found that those who switched to aripiprazole had improved cholesterol levels and other metabolic factors, and lost more weight (average of 8 lbs) than those who stayed on their original medication (average of 1.5 lbs). Those who switched also did not experience any more illness relapses or worsening of psychotic symptoms compared to those who stayed on their original medication. However, those who switched to aripiprazole were more likely to discontinue the new medication compared to those who stayed on their original medication. Almost 44 percent of those who switched discontinued the aripiprazole compared to 24.5 percent of those who were assigned to stay on their current medication.

The authors suggest that the high discontinuation rate for switchers may have been related to the fact that the study was open label, meaning both the patient and the clinician knew what drug the patient was taking. Some patients who were switched may have felt uncomfortable changing from a medication they knew worked for them, and therefore stopped the new medication. In addition, because clinicians were encouraged to closely monitor and intervene before a patient experienced severe problems, many may have discontinued aripiprazole when the clinician first determined that the patient was having difficulties, but before full-blown treatment failure occurred.

“For patients whose symptoms are stabilized but who are overweight or experiencing other metabolic problems, clinicians may want to consider switching to a medication that is less likely to cause metabolic problems. However, because switching is not always successful, clinicians must monitor patients carefully to avoid illness exacerbation,” said Dr. Stroup. “If switching medications is not an option, then adding a medication like metformin or a statin could help reduce cardiovascular risks while maintaining symptom stability,” he concluded. He also noted that the study’s behavioral intervention that focused on improved diet and exercise habits benefited even those who did not switch medications.

Reference

Stroup TS, McEvoy JP, Ring KD, Hamer RH, LaVange LM, Swartz MS, Rosenheck RA, Perkins DO, Nussbaum AM, Lieberman JA. Comparison of antipsychotics for metabolic problems (CAMP):a randomized trial examining the effectiveness of switching from olanzapine, quetiapine, or risperidone to aripiprazole to reduce metabolic risk. American Journal of Psychiatry. Online ahead of print July 18, 2011.

Shared Decision Making in Mental Health

“In July 2007, a meeting of approximately 50 experts and stakeholders in SDM and mental health was convened in Washington, DC by CMHS. Participants included researchers and SDM providers in general and mental health care, policymakers, and mental health consumers. The meeting provided an opportunity for participants to exchange perspectives on SDM, inform one another of the state of the science and practice of SDM in general and mental health care, and develop recommendations for advancing SDM within the U.S. mental health care field. Participants shared their experiences as consumers and providers of mental health care and offered insights and perspectives on a variety of aspects of SDM.

This report is intended to provide a general overview of SDM and the available research on its effects in both general and mental health care. It includes recommendations from the participants of the SDM meeting.”

To obtain a copy of the publication please visit SAMHSA Publications .

Reposted at darkestcloset.bloggerspot.com