The debate over the U.S. Preventive Services Task Force's (USPSTF) final recommendation on PSA testing continued this week. Michael Barry, president of the Informed Medical Decisions Foundation and Mary McNaughton-Collins, medical director, each had an opportunity to speak on NPR radio programs about the USPSTF recommendation this week. They voiced their views on the recommendation -- both from the perspective of the Foundation and as practicing primary care physicians.
In the latest edition of the New England Journal of Medicine (NEJM), authors make a call to action for policymakers to take meaningful steps to implement what the authors call “the sleeper” shared decision making (SDM) provision of the Accountable Care Act (ACA). The authors, Emily Oshima Lee from the Center for American Progress and Dr. Ezekiel J. Emanuel from the University of Pennsylvania, make a compelling argument that the benefits of SDM with the use of decision aids -- improvements in patient knowledge, lower anxiety over the care process, improved health outcomes, reduction in unwarranted variation in care and costs, and greater alignment of care with patients’ values -- should warrant swift action on the provision of ACA (Section 3506) that relates directly to SDM implementation. Lee and Emanuel argue that the current pace of Section 3506 implementation is detrimental to both patients and the health care system as a whole.
Posted in Current News
Tagged ACA, Affordable Care Act, decision aids, health care, health care costs, HHS, NEJM, patient values, practice variation, Section 3506, shared decision making
This article reviews a research study where patients with selected medical conditions and predicted high health care costs were given telephone-based care-management coaching to instruct them about SDM, self-care and behavioral change. This research goes beyond previous care-management studies because it included patients at risk for a preference-sensitive condition decision in the future, and the health coaching included shared decision making and access to patient decision aids. The average monthly medical and pharmacy costs per person in the enhanced-support group were 3.6% lower than those in the usual-support group, largely due to a 10.1% reduction in annual hospital admissions.
Who should decide about screening for prostate cancer: expert panels of clinicians and methodologists, primary care clinicians, specialists, or fully informed patients themselves? The U.S. Preventive Services Task Force recently released a draft recommendation on screening for prostate cancer, designed for primary care physicians and health systems, and has opened if for public comment until November 8, 2011.