miércoles, 14 de enero de 2015

AHRQ-Funded Studies Find Primary Care Health Risk Assessment Tool Lacks Patients’ Support and Increases Visit Times

Two AHRQ-funded studies that examined the use of a health risk assessment tool in primary care found that the tool may be able to identify behavioral and psychological health risks and lead to improved counseling and behavioral change, and that assessments could be implemented in routine care. However, the studies also found that patients were generally unwilling to discuss their risk factors and that counseling by clinicians would require an additional 28 minutes per patient visit as well as additional staff time. The first study measured patients’ readiness for behavior change to improve their health, desire to discuss their health risks and perceived importance of 13 health risk factors identified in the assessment, known as the My Own Health Report. The second study evaluated whether primary care practices could implement My Own Health Report, typically electronically, as part of providing routine care. The study and abstract titled “Frequency and Prioritization of Patient Health Risks from a Structured Health Risk Assessment,” and the study and abstract titled “Adoption, Reach, Implementation and Maintenance of a Behavioral and Mental Health Assessment in Primary Care” appeared in the November/December 2014 issue of the Annals of Family Medicine.

Frequency and prioritization of patient health risks from a structu... - PubMed - NCBI

2014 Nov-Dec;12(6):505-13. doi: 10.1370/afm.1717.

Frequency and prioritization of patient health risks from a structured health risk assessment.

Phillips SM1, Glasgow RE2, Bello G2, Ory MG2, Glenn BA2, Sheinfeld-Gorin SN2, Sabo RT2, Heurtin-Roberts S2, Johnson SB2, Krist AH2; MOHR Study Group.

Author information

Abstract

PURPOSE:

To describe the frequency and patient-reported readiness to change, desire to discuss, and perceived importance of 13 health risk factors in a diverse range of primary care practices.

METHODS:

Patients (n = 1,707) in 9 primary care practices in the My Own Health Report (MOHR) trial reported general, behavioral, and psychosocial risk factors (body mass index [BMI], health status, diet, physical activity, sleep, drug use, stress, anxiety or worry, and depression). We classified responses as "at risk" or "healthy" for each factor, and patients indicated their readiness to change and/or desire to discuss identified risk factors with providers. Patients also selected 1 of the factors they were ready to change as most important. We then calculated frequencies within and across these factors and examined variation by patient characteristics and across practices.

RESULTS:

On average, patients had 5.8 (SD = 2.12; range, 0-13) unhealthy behaviors and mental health risk factors. About 55% of patients had more than 6 risk factors. On average, patients wanted to change 1.2 and discuss 0.7 risks. The most common risks were inadequate fruit/vegetable consumption (84.5%) and overweight/obesity (79.6%). Patients were most ready to change BMI (33.3%) and depression (30.7%), and most wanted to discuss depression (41.9%) and anxiety or worry (35.2%). Overall, patients rated health status as most important.

CONCLUSIONS:

Implementing routine comprehensive health risk assessments in primary care will likely identify a high number of behavioral and psychosocial health risks. By soliciting patient priorities, providers and patients can better manage counseling and behavior change.