The Patient-Centered Outcomes Institute shared results of 5 recent publications summarizing results from their awardees. The studies included research on a decision aid for patients with heart failure, 2 different approaches to treating mental illness, and addressing chronic pain.
The Patient-Centered Outcomes Institute (PCORI) has shared the latest published results of their funded projects.
The institute, which seeks to aid people in making informed healthcare decisions and improve healthcare outcomes by funding useful research, reported results of 5 recent publications summarizing results from their awardees.
1. Decision aid for patients with heart failure
Researchers from the University of Colorado conducted a randomized, stepped-wedge trial from 2015 to 2017 in 6 US left ventricular assist device (LVAD) implanting centers that consisted of 248 patients considered for designation therapy LVAD. The researchers developed a decision aid to help patients who are ineligible for a heart transplant to weigh the pros and cons of a LVAD, which helps patients live longer but comes with significant risks, including infection and stroke.
The study, published in JAMA Internal Medicine, found that patients who utilized the decision aid made more informed choices. Following the use of the decision aid, patients were more likely to not choose an LVAD. The authors concluded that a shared decision-making intervention modestly improved decision quality as measured by patient knowledge and concordance between stated values and patient-reported treatment choice.
2. Treatment options for inflammatory bowel disease
To determine which of 2 drugs to treat Crohn disease (CD) and ulcerative colitis (UC) is better for each condition, researchers from the University of Pennsylvania compared insurance claims from over 13,000 patients with the conditions. The study, published in the American Journal of Gastroenterology, compared corticosteroids and tumor necrosis factor inhibitors (anti-TNF drugs) and found that the long-term risk of death was significantly lower for anti-TNF therapy among patients with CD, but not for patients with UC.
Among patients with CD, anti-TNF treatment also yielded lower rates of significant heart issues and hip fracture. However, the study did not find a difference in association between the 2 treatments and risk of death, heart problems, or broken hips for patients with UC. According to PCORI, the results of the study provide patients and clinicians with the first real guidance on the pros and cons of the 2 common treatments of inflammatory bowel disease, which can help patients made better and more personalized decisions on how to proceed with treatment.
3. Improving care for serious mental illness
Researchers at the University of Pittsburgh Medical Center studied 1200 adults with mental illness receiving mental health care at behavioral health homes and compared 2 approaches to help them stay on top of their care: self-directed healthcare using a variety of online self-management tools and provider-directed care in which patients met with nurses about managing their healthcare.
Following 2 years, patients at both types of clinics reported improved mental health. According to PCORI, the study, which was published in Health Affairs, suggests that this patient population can improve their outcomes using self-management tools or meeting with nurses.
4. Reducing opioid use while reducing chronic pain
Researchers at a health plan in Washington State found that among 1600 patients who received care at clinics with a dose-reduction and risk-monitoring initiative did not experience more pain than those receiving care at clinics with no specific dose-reduction efforts. The study, published in Journal of Pain, is the first to evaluate the effects of a clinical policy initiative that implemented an opioid dose-reduction and risk-monitoring strategy, and its results could provide insight for other health plans trying to combat the opioid epidemic, according to PCORI.
5. Pain education and therapy for people with low incomes
A study, published in Annals of Internal Medicine, found that group sessions that provided either cognitive behavioral therapy or pain education helped people in dealing with chronic pain compared to standard medical therapy. The team of researchers from the University of Alabama focused on 290 patients from western Alabama with low incomes.
Patients who received groups sessions or either type reported lower pain intensity and better physical function than people receiving usual care compared to patients who received medical treatment only.