Grant supports Geisel research

by Lucia McGloin | 10/14/14 6:21pm

More than $3 million from the Patient-Centered Outcomes Research Institute will support Geisel research on the effectiveness of health care delivery strategies. Geisel psychiatry professor Dror Ben-Zeev received $1.88 million to evaluate new smartphone technology for mental health patients, and Rachel Thompson, a health policy and clinical practice professor at The Dartmouth Institute, received $2 million to study new video and paper comparison tools to help women choose contraceptive methods. Thompson will lead the study with Geisel professor Glyn Elwyn.

With smartphone technology, treatments are more widely accessible and affordable, Ben-Zeev said. Mobile technology to address serious mental illnesses has been developed, but little research has measured its effectiveness, he said.

In his research proposal for the institute’s funding, Ben-Zeev wrote that serious mental illness, if not managed well, increases a patient’s risk of homelessness, incarceration, victimization, hospitalization and suicide. Little clinic-based illness management is accessible for patients, he wrote.

Working with patients and providers at Thresholds Psychiatric Rehabilitation Centers in Chicago, Ben-Zeev will give patients phones and data plans, with a pre-uploaded application to help them self-manage their illness, he said. The app provides pre-scheduled prompts that ask patients to input their symptoms, he said. The app then assesses their answers and provides feedback, suggesting, for example, relaxation strategies and questions to re-evaluate and interpret paranoid emotions. The app can share patients’ usage information with Ben-Zeev’s research team on a secure server.

“Patients are not dependent anymore on a clinician’s case load, but can access intervention strategies whenever they like,” Ben-Zeev said.

In her research proposal, Thompson wrote that she hopes to help women make more informed decisions about contraceptive methods. Currently, many women do not use the contraceptive method that best suits their lifestyles, she wrote.

In the U.S., more than half of pregnancies are unintended, Thompson wrote. Thompson aims to help women better communicate their contraceptive needs to clinicians and receive the most appropriate contraception method.

“Nearly half of these unintended pregnancies occur among women who have a contraceptive method but use it either inconsistently or incorrectly,” wrote Thompson, who is in Australia, in an email to The Dartmouth.

Thompson will test two strategies. In one, women will view a brief video in the waiting room that discusses questions patients can ask as they choose a contraceptive method. The second will use a set of paper tools called Option Grids, a single-page tool that helps women and providers compare contraceptive methods to evaluate the patient’s specific needs.

The study will test women of all reproductive ages.

Thompson’s research will survey 3,000 women on how they chose their contraceptive method, which contraceptive device or method they chose and whether it fits their lifestyle and needs. Six months later, the same women will be asked follow-up questions relating to their satisfaction with and use of the contraceptive device.

Women receiving care that integrates the video, Option Grids or both mechanisms will receive a contraceptive method better tailored to their individual needs, Thompson wrote in her proposal.

Interim Geisel dean Duane Compton said that these areas of research will help expand Geisel’s grant portfolio in comparative effectiveness research, which is concerned with “real world” applications.

The institute supports comparative trial research to determine different health care approaches’ effectiveness. Rather than centralize solely on patient symptoms and treatment outcomes, as many clinical medical trials do, the organization focuses on more patient-centered treatment experiences, media relations associate director Christine Stencel said. These can include patient energy levels and ability to go to work, sleep and take care of their families as well as access to treatment.

Selected from a pool of 490 research proposals, Ben-Zeev and Thompson’s research projects were among 46 proposals approved. The 46 projects approved received a total of $102 million, according to an institute press release.

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