CME slideshow (PACE)
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CME slideshow: PACE Noreen M. Clark Center for Managing Chronic Disease University of Michigan
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CME slideshow (PACE)
- 23. Summary
Notas del editor
- First, a little background....... Clinician communication and patient education is central to a patient’s compliance with the clinician’s recommendations.
- * Studies have shown that physicians think they can predict who will comply, but studies show that they cannot. * Assume that every patient is at risk for noncompliance and needs help to adhere to the long-term treatment plan
- Here are the objectives for the next few slides.
- Research in psychology has demonstrated that this model can be used to predict and explain health behavior, and that action is strongly related to the four beliefs presented. When the clinician focuses communications on these points, patients have been shown to follow therapeutic advice more closely. * A recent study showed that parents who believed more strongly that their children with asthma were vulnerable were more likely to seek care from a general pediatrician during any acute episode and keep their children home from school regardless of the actual severity of the episode Reference:
- * These susceptibility beliefs are sometimes the main concern when patients come to see the clinicians, and advice from the clinician can help dispel them.
- Families need to learn to use objective indicators of asthma’s seriousness. These can include frequency and severity of symptoms, peak flow monitoring, etc. The physician can provide criteria as listed in the asthma action plan so the family can gain a better perspective on the severity of disease.
- The benefits of the therapy can be explicitly tied to the patient’s personal goals, e.g. to play basketball, to sleep through the night, etc. In this way the “costs” of following the therapeutic plan are reduced and the physician’s recommendations are seen as a way to reach one’s personal goals.
- You have probably experienced this yourselves, for example when learning a new sport or a musical instrument For example, many families go immediately to the emergency department even for mild asthma episodes instead of beginning appropriate treatment at home Explicit efforts to build patient confidence for self management are central to asthma control
- Families are often reluctant to bring up their beliefs or concerns; it is important to identify them so they can be dealt with and they do not act as “background noise” distracting the patient from hearing what the clinician is communicating
- Now let’s review the purpose of each strategy shown in the videotape. Let me emphasize these have been evaluated as part of a clinical trial with pediatricians. References: