Please use this identifier to cite or link to this item: https://doi.org/10.1186/1471-2296-14-111
Title: Patient and primary care provider experience using a family health history collection, risk stratification, and clinical decision support tool: A type 2 hybrid controlled implementation-effectiveness trial
Authors: Wu, R.R 
Orlando, L.A
Himmel, T.L
Buchanan, A.H
Powell, K.P
Hauser, E.R
Agbaje, A.B
Henrich, V.C
Ginsburg, G.S
Keywords: aged
anamnesis
article
breast tumor
clinical trial
colorectal tumor
computer assisted diagnosis
decision support system
early diagnosis
familial cancer
family
female
genetic predisposition
genetics
health personnel attitude
human
male
methodology
middle aged
neoplasm
ovary tumor
patient attitude
primary health care
risk assessment
thrombosis
Aged
Attitude of Health Personnel
Breast Neoplasms
Colorectal Neoplasms
Decision Support Systems, Clinical
Diagnosis, Computer-Assisted
Early Detection of Cancer
Family
Female
Genetic Predisposition to Disease
Humans
Male
Medical History Taking
Middle Aged
Neoplasms
Neoplastic Syndromes, Hereditary
Ovarian Neoplasms
Patient Acceptance of Health Care
Primary Health Care
Risk Assessment
Thrombosis
Issue Date: 2013
Citation: Wu, R.R, Orlando, L.A, Himmel, T.L, Buchanan, A.H, Powell, K.P, Hauser, E.R, Agbaje, A.B, Henrich, V.C, Ginsburg, G.S (2013). Patient and primary care provider experience using a family health history collection, risk stratification, and clinical decision support tool: A type 2 hybrid controlled implementation-effectiveness trial. BMC Family Practice 14 : 111. ScholarBank@NUS Repository. https://doi.org/10.1186/1471-2296-14-111
Rights: Attribution 4.0 International
Abstract: Background: Family health history (FHH) is the single strongest predictor of disease risk and yet is significantly underutilized in primary care. We developed a patient facing FHH collection tool, MeTree©, that uses risk stratification to generate clinical decision support for breast cancer, colorectal cancer, ovarian cancer, hereditary cancer syndromes, and thrombosis. Here we present data on the experience of patients and providers after integration of MeTree© into 2 primary care practices. Methods. This was a Type 2 hybrid controlled implementation-effectiveness study in 3 community-based primary care clinics in Greensboro, NC. All non-adopted adult English speaking patients with upcoming routine appointments were invited. Patients were recruited from December 2009 to the present and followed for one year. Ease of integration of MeTree© into clinical practice at the two intervention clinics was evaluated through patient surveys after their appointment and at 3 months post-visit, and physician surveys 3 months after tool integration. Results: Total enrollment =1,184. Average time to complete MeTree© = 27 minutes. Patients found MeTree©: easy to use (93%), easy to understand (97%), useful (98%), raised awareness of disease risk (85%), and changed how they think about their health (86%). Of the 26% (N = 311) asking for assistance to complete the tool, age (65 sd 9.4 vs. 57 sd 11.8, p-value < 0.00) and large pedigree size (24.4 sd 9.81 vs. 22.2 sd 8.30, p-value < 0.00) were the only significant factors; 77% of those requiring assistance were over the age of 60. Providers (N = 14) found MeTree©: improved their practice (86%), improved their understanding of FHH (64%), made practice easier (79%), and worthy of recommending to their peers (93%). Conclusions: Our study shows that MeTree © has broad acceptance and support from both patients and providers and can be implemented without disruption to workflow. © 2013 Wu et al.; licensee BioMed Central Ltd.
Source Title: BMC Family Practice
URI: https://scholarbank.nus.edu.sg/handle/10635/181560
ISSN: 14712296
DOI: 10.1186/1471-2296-14-111
Rights: Attribution 4.0 International
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