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Jaggumantri, Venkata Narendra Sravan

University of British Columbia

Determining tangible outcomes that reflect the personal goals and priorities of individual patients regarding their treatment’s effects are currently not part of the treatment evaluation in clinical practice. My doctoral research addressed one overarching question: how can clinicians provide an effective person-centered approach to clinical care that identifies what matters most to the individual patient and the expected level of change that is considered meaningful? In this dissertation, I present a new strategy to evaluate treatment effectiveness at a personal level: the Personally Meaningful Outcomes – Assessment Process (PMO-AP). PMO-AP is administered in four successive stages using an interview-based format, which includes generation of personally meaningful outcomes (PMOs) with clear indicators and a modified goal attainment scaling corresponding to the different levels of meaningful changes in PMOs expected by each individual patient described a-priori in collaboration with the clinician using a modified goal attainment scaling process. At each stage of PMO-AP from identification of PMOs to why a particular score is selected for a PMO at a follow-up visit, there is a dialogue between the clinician and the patient, which provides context and rationale for the information collected. I conducted a study with 50 participants to evaluate the test-retest reliability, validity, and ability of PMO-AP to generate information in the context of personalized medicine. The results showed that the PMO-AP is a reliable process that generates valid PMOs and meets the characteristics of a truly personalized assessment. I evaluated the feasibility of using PMO-AP in clinical practice through focus groups with staff from three separate clinics serving diverse types of patients. All participants found the PMO-AP compatible with their current clinical practice and indicated their willingness to use it in clinical practice with certain clinic-specific modifications after training. PMO-AP has the potential to be relevant for all chronic conditions as a patient-centered system that promotes trust and partnership between the patient and clinician.

Text

2024-01-02

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/87008

Experimental Medicine

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/