Patient-oriented Evidence-based Treatment Decision Support System (TreatQuest®) for Lung Cancer

Involving patients in healthcare decisions makes a significant and enduring difference to healthcare outcomes. One challenge for patients is the lack of evidence-based information and tools to support their decision making. Although patients have access to significant information through internet and other sources, it is not personalized for their specific situation. This dissertation attempts to help patients acquire evidence-based information relevant to their own situation, so they can make a more informed decision in co-operation with their physicians. Lung cancer has been selected as a focus for this study because lung cancer presents very complex decision making situation and is the leading cause of cancer deaths in both men and woman in every ethnic group worldwide. The prototype decision support system for lung cancer is called TreatQuest®. This system allows users to create their own profile, access cases similar to their case, and learn about treatment options. The evidences for the treatment were extracted from public data and knowledge gained from guideline. The effectiveness of patient-oriented evidence-based approach was validated by having a group of patient use the system. TreatQuest® is one of the first system developed to support patient\u27s treatment decision process, which represent the most recent trend in delivery of healthcare services. Results from this study show that such a patient-oriented decision support system provides an effective way to help patient receive more personalized information and make informed treatments. In summary, patient-oriented evidence-based decision support systems such as TreatQuest®, can improve the decision quality for patients. Also, such systems can improve health care decisions that are made with the active participation of fully informed patients. Therefore, patient-oriented evidence-based decision support systems can have significant impact on the healthcare industry

Evaluating the QUIT-PRIMO clinical practice ePortal to increase smoker engagement with online cessation interventions: a national hybrid type 2 implementation study

BACKGROUND: Effective web-assisted tobacco interventions (WATIs) have been underutilized by smokers; moreover, despite practice guideline recommendations, clinical teams do not routinely refer smokers to WATIs. Our goal was to test a clinical practice innovation, an ePortal designed to change practice and patient behavior. Our hypotheses were that the integrated system would result in increased smoker referrals, with an automated follow-up system resulting in more smoker registrations and finally augmentations of the WATI would result in more smokers quitting at 6 months. METHODS: Practice ePortal Implementation Trial: Practices (n = 174) were randomized to an online practice ePortal with an e-referral tool to the WATI (e-referred smokers received automated email reminders from the practice) and with practice feedback reports with patient tracking and practice-to-patient secure messaging versus comparison (a paper referral prescription ). Implementation success was measured by the number of smokers referred and smokers registering. Clinical Effectiveness Trial: To estimate the effectiveness of the WATI components on 6-month smoking cessation, registered smokers were randomized into three groups: a state-of-the-art tailored WATI control [control], the WATI enhanced with proactive, pushed tailored email motivational messaging (messaging), and the WATI with messaging further enhanced with personal secure messaging with a tobacco treatment specialist and an online support group (personalized). RESULTS: Practice ePortal Trial results: A total of 4789 smokers were referred. The mean smokers referred per practice was not statistically different by group (ePortal 24.89 (SD 22.29) versus comparison 30.15 (SD 25.45), p = 0.15). The e-referral portal implementation program resulted in nearly triple the rate of smoker registration (31 % of all smokers referred registered online) versus comparison (11 %, p \u3c 0.001). Clinical Effectiveness Trial results: Active smokers randomized to the personalized group had a 6-month cessation rate of 25.2 %, compared with the messaging group (26.7 %) and the control (17 %). Next, when using an inverse probability weighted selection model to account for attrition, those randomized to the two groups that received motivational messaging (messaging or personalized) were more likely to quit than those in the control (p = 0.04). CONCLUSIONS: Among all smokers referred, the e-referral resulted in nearly threefold greater registrants (31 %) than paper (11 %). The practice ePortal smokers received multiple reminders (increasing registration opportunities), and the practices could track patient progress. The result was more smokers registering and, thus, more cessation opportunities. Combining the proactive referral and the WATI resulted in higher rates of smoking cessation. TRIAL REGISTRATION: Web-delivered Provider Intervention for Tobacco Control (QUIT-PRIMO) - a randomized controlled trial: NCT00797628

Lamar Soutter Library Annual Report FY2016

Annual report of the Lamar Soutter Library at the University of Massachusetts Medical School, covering fiscal year July 1, 2015-June 30, 2016.https://escholarship.umassmed.edu/library_annual_reports/1016/thumbnail.jp

AACP Basic Resources for Pharmacy Education

The AACP Basic Resources for Pharmacy Education is produced as a guide for those developing or maintaining the library collections that serve colleges and schools of pharmacy. The goal of the Basic Resources list is to make recommendations of books and other works to be included in pharmacy libraries, but not all titles are required to be purchased. Each pharmacy college has its own mission and its own program(s), and so each college’s library collection must reflect that mission and support the college’s program(s). Excellent library collections are built by knowledgeable librarians and drug information specialists using their professional judgment along with the expertise of the college’s faculty. The Basic Resources list should not be used as a benchmark and is not prescriptive but is instead a starting place for librarians who are building a new collection or maintaining an established one