Document Detail


Counseling women with early pregnancy failure: utilizing evidence, preserving preference.
MedLine Citation:
PMID:  21093193     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVES: To apply principles of shared decision-making to EPF management counseling. To present a patient treatment priority checklist developed from review of available literature on patient priorities for EPF management.
METHODS: Review of evidence for patient preferences; personal, emotional, physical and clinical factors that may influence patient priorities for EPF management; and the clinical factors, resources, and provider bias that may influence current practice.
RESULTS: Women have strong and diverse preferences for EPF management and report higher satisfaction when treated according to these preferences. However, estimates of actual treatment patterns suggest that current practice does not reflect the evidence for safety and acceptability of all options, or patient preferences. Multiple practice barriers and biases exist that may be influencing provider counseling about options for EPF management.
CONCLUSION: Choosing management for EPF is a preference-sensitive decision. A patient-centered approach to EPF management should incorporate counseling about all treatment options.
PRACTICE IMPLICATIONS: Providers can integrate a counseling model into EPF management practice that utilizes principles of shared decision-making and an organized method for eliciting patient preferences, priorities, and concerns about treatment options.
Authors:
Robin R Wallace; Suzan Goodman; Lori R Freedman; Vanessa K Dalton; Lisa H Harris
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.     Date:  2010-11-18
Journal Detail:
Title:  Patient education and counseling     Volume:  81     ISSN:  1873-5134     ISO Abbreviation:  Patient Educ Couns     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8406280     Medline TA:  Patient Educ Couns     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  454-61     Citation Subset:  N    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
University of California, San Francisco, Department of Family and Community Medicine, 1001 Potrero Avenue, Ward 6D, San Francisco, CA 94110, USA. wallacer@fcm.ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
Grant Support
ID/Acronym/Agency:
1 K08 JS015491//PHS HHS

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