Prevalence of and Factors Associated With Patient Nondisclosure of Medically Relevant Information to Clinicians

Levy, Andrea; Scherer, Aaron M.; Zikmund‐Fisher, Brian J.; Larkin, Knoll; Barnes, Geoffrey D.; Fagerlin, Angela

doi:10.1001/jamanetworkopen.2018.5293

Cited by 120 publications

(128 citation statements)

References 10 publications

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“…Failure of the patient to disclose medically relevant information to clinicians can also impair care or even lead to harm. 11 Uncomfortable conversations may often be avoided, and patients may not be honest with their physicians. In fact, 60% to 80% of people in a recent study reported that they had withheld or lied to their health care provider about medically relevant information.…”

mentioning

confidence: 99%

Centers for Disease Control and Prevention Recommendations for Hepatitis C Testing: The Need to Adopt Universal Screening in an Appalachian Emergency Department

Wojcik

Sharon

Davis

et al. 2020

Academic Emergency Medicine

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Background The Centers for Disease Control and Prevention recommends screening baby boomers and high‐risk patients for hepatitis C virus (HCV); however, the incidence of HCV is rapidly increasing among younger populations, and screening is limited by access to care and risk factor assessment. The purpose of this study was to evaluate characteristics of HCV antibody‐positive (Ab+) and ribonucleic acid (RNA)‐confirmed‐positive patients identified via two screening models in an Appalachian emergency department (ED). Methods This was a retrospective cohort study of patients who screened HCV Ab+ in the ED from January 1 to October 31, 2018. Data were extracted, and comparative analyses were conducted between the risk‐based and the universal screening models. Results Overall, 444 patients screened HCV Ab+, with a median age of 39 years. From January to May 2018, the risk factor model identified 126 HCV Ab+ patients out of 3,014 screened (4%), whereas from June to October 2018, the universal model identified 318 HCV Ab+ patients out of 5,407 screened (6%; p < 0.001). A consistently large proportion of diagnoses were new (71%). There was no statistically significant decrease between the RNA‐confirmed‐positive patients during the risk factor model (76, 60%) and universal model (186, 58%) time periods (p = 0.72). The models had high rates of reported intravenous drug use, and the universal screening adoption was modest at 33%. Conclusion This study was the first to present characteristics of HCV Ab+ and RNA‐confirmed‐positive patients identified during the transition to a universal screening model in an Appalachian ED. Most diagnoses were new regardless of screening model, but more patients screened HCV Ab+, and a similar proportion were RNA‐confirmed‐positive, under the universal model. Given that adoption of universal screening was modest, and risk factors remained similar, future research should investigate how to more effectively implement a universal screening model on a wider scale to identify early infections.

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confidence: 99%

Centers for Disease Control and Prevention Recommendations for Hepatitis C Testing: The Need to Adopt Universal Screening in an Appalachian Emergency Department

Wojcik

Sharon

Davis

et al. 2020

Academic Emergency Medicine

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“…Patients commonly withhold medically relevant information from their physicians, a pattern that likely hinders the quality of care. 34 Patient activation or engagement is associated with positive clinical and healthcare utilization outcomes. 35 Patient-mediated implementation interventions showed a positive impact on patient knowledge, decision making, communication, and behavior.…”

Section: Social Influencesmentioning

confidence: 99%

Using Implementation Science to Promote the Use of the G8 Screening Tool in Geriatric Oncology

Gulasingam

Haq

Johnson

et al. 2019

J American Geriatrics Society

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OBJECTIVES Evidence supports the integration of geriatric assessment in the care of older adults with cancer. The G8 screening tool is a validated instrument to target a geriatric assessment. Use of the G8 tool in clinical practice, however, is suboptimal. We systematically analyzed the barriers and facilitators to G8 tool use in oncology clinics and selected interventions tailored to the local context to enhance its uptake. DESIGN This qualitative study used semistructured interviews and site observations. SETTING St. Michael's Hospital, Toronto, Canada. PARTICIPANTS Ten participants including G8 tool adopters and stakeholders at St. Michael's Hospital were interviewed. MEASUREMENTS An interview guide based on the Theoretical Domains Framework (TDF) was developed to identify beliefs about G8 tool use. Barriers and facilitators to G8 tool use were mapped to the TDF domains and corresponding intervention functions from the Capability, Opportunity, Motivation, and Behavior model. Evidence‐based implementation strategies were selected from two databases. RESULTS Key TDF domains influencing G8 tool use behavior were social/professional role, goals, beliefs about consequences, and social influences. The behavior change domains were mapped to four mechanisms of change: persuasion (conduct local consensus discussions), modeling (identify and prepare a champion), education (distribute educational materials), and enablement (use materials to prepare patients to be active participants in understanding the evidence behind the G8 tool and answering questions accurately). CONCLUSION This study identified barriers to G8 tool use. Local consensus discussions, identifying and preparing a champion, using educational materials, and preparing patients to be active participants may be implementation strategies to improve G8 tool use. J Am Geriatr Soc 67:898–904, 2019.

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“…A recent study has shown the level of non-disclosure of medically relevant information to healthcare professionals [3]. Using data from several online surveys, people were asked if they ever withheld information from healthcare professionals and why.…”

Section: Non-disclosure Of Medically Relevant Informationmentioning

confidence: 99%

News and Views: Update on technologies, medicines and treatments

O’Neill

2019

Diabet. Med.

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Prevalence of and Factors Associated With Patient Nondisclosure of Medically Relevant Information to Clinicians

Cited by 120 publications

References 10 publications

Centers for Disease Control and Prevention Recommendations for Hepatitis C Testing: The Need to Adopt Universal Screening in an Appalachian Emergency Department

Centers for Disease Control and Prevention Recommendations for Hepatitis C Testing: The Need to Adopt Universal Screening in an Appalachian Emergency Department

Using Implementation Science to Promote the Use of the G8 Screening Tool in Geriatric Oncology

News and Views: Update on technologies, medicines and treatments

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