Using a structured, patient‐centred, educational exchange to facilitate a shared conversation about stroke prevention medications

Abstract

Objective The aim of this study was to investigate the feasibility of a structured patient‐centred educational exchange to facilitate a shared conversation about stroke prevention medications. Methods Participants (18 years or older) with a principal diagnosis of stroke or transient ischaemic attack were purposively sampled from the stroke unit of a 780‐bed teaching hospital in Australia and consented to participate in the study. A patient‐centred educational exchange was conducted face to face at the bedside before discharge and by telephone post discharge. The structure of these sessions was adapted from academic detailing, an educational strategy, which includes identifying experience, listening to the needs of the audience, and tailoring messages to influence behaviour. To facilitate sharing of needs, three questionnaires, validated as research tools, were used to identify participants' experience, perceptions, and beliefs. The identified perceptions were used to personalize educational messages. The outcomes of the study were to provide descriptions of patients' perceptions necessities and concerns about their condition and medications, provide examples of personalized responses to these, evaluate acceptability by patients, and determine the time taken to share the information. Results Sixteen participants completed both the bedside session (average duration 27 minutes) and the telephone follow‐up (average duration 23 minutes). The strongest patient concern identified was having another stroke. Personalized responses included emphasizing long‐term treatment in response to the perception that stroke will last for a short time, reinforcement of necessity for medications, and further exploration of concerns. Conclusion The questionnaires engaged the participants, allowing them to share perceptions and beliefs, facilitating a patient‐centred educational exchange in a timely manner.

Strategies Australian Hospitals Utilize to Incorporate Patient Feedback in the Delivery and Measurement of Person-Centered Care: A Scoping Review

“…Feedback during the intervention phase related to either creating collaborative partnerships or utilizing feedback to refine the next iteration of the strategy. The final four studies actioned feedback only during the intervention phase (Ayton et al, 2017; Coombes et al, 2020; Girgis et al, 2017; Issac et al, 2018), utilizing an existing documented tool or health clinician developed program as the PCC strategy. Three of these studies (Coombes et al, 2020; Girgis et al, 2017; Issac et al, 2018) collected feedback for the direct purpose of cycling that information back into the PCC strategy itself to further individualize care, while Ayton et al (2017) expanded patient reported outcome measures.…”

“…The vignettes provided a basis for collaborative clinician/patient workshops where potential organizational and educational strategies were generated to address local health literacy needs (Jessup et al, 2018). From a patient education perspective, Coombes et al (2020) trialed a patient-centered educational exchange (PC 3 EE) program, where patient feedback to questionnaires focused the education delivered by staff to the personalized needs of the patient following a stroke or transient ischemic attack.…”

“Lessons Learned” Preventing Recurrent Ischemic Strokes through Secondary Prevention Programs: A Systematic Review

“…Despite Ticaa’dom’s high one-on-one provider–client time, it was not more effective than the standard of care [ 37 ]. Telemedicine Guided Education [ 62 ], StrokeCoach [ 63 ], CEOPS [ 64 ] and a Structured Patient-Centered Educational Exchange [ 65 ] are all examples of ongoing research that utilize telephone follow-ups, which will potentially offer further insight into the efficacy of lower resource-intensive strategies.…”

Editorial introduction: Decision making, reasoning, context, and perspective

“…[18][19][20] The edition concludes with a number of papers proposing innovative methods for implementing and evaluating the impact of PCC and SDM. [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Again, the core concepts of PCC and SDM are explored across a very diverse set of contexts. It would of course be misleading to present this edition as the "conclusion" of the debate commenced in our previous thematic issue on this subject.…”

“…The edition concludes with a number of papers proposing innovative methods for implementing and evaluating the impact of PCC and SDM . Again, the core concepts of PCC and SDM are explored across a very diverse set of contexts.…”