A randomized controlled trial of facilitating information giving to patients with chronic medical conditions: effects on outcomes of care

Learning points from paper

• For patients with chronic diseases, a patient-centered approach 1) increases the patient’s satisfaction  with their physician's care, 2) increases the patient’s interest  in the contents of their medical records and 3) improves the  patient’s overall health status.

Critique of paper

Other comments

Was the inspiration behind the software described in Design of a consumer health record for supporting the patient-centered management of chronic diseases.

Citation and Abstract

J Fam Pract. 1999 May;48(5):356-63. A randomized controlled trial of facilitating information giving to patients with chronic medical conditions: effects on outcomes of care. Maly RC, Bourque LB, Engelhardt RF.

Department of Family Medicine, UCLA School of Medicine, Los Angeles, CA 90095-1683, USA.

BACKGROUND: The purpose of this study was to assess the impact of an intervention to facilitate information giving to patients with chronic medical conditions on outcomes of care.

METHODS: A consecutive sample of 276 eligible patients with chronic medical conditions at a family medicine clinic was randomized to control and experimental interventions. A total of 205 completed the study. Experimental group patients received copies of their medical record progress notes, and they completed question lists for physician review, while control group patients received health education sheets and completed suggestion lists for improving clinic care. Self-reported physical functioning, global health, and patient satisfaction and adherence were measured at enrollment and after the interventions. Visit lengths and patient response to medical record sharing after the interventions were also measured.

RESULTS: After the intervention, experimental group patients reported 3.7% better overall physical functioning than did control patients (mean = 83.6, standard deviation [SD] = 17.6 vs mean = 79.9, SD = 25.3; P = .005 after adjusting for covariates). The experimental group was more satisfied with their physician's care (mean = 31.4, SD = 4.6 vs mean = 31.3, SD = 5.2; P = .045 after adjusting for covariates). They were also more interested in seeing their medical records than were control patients (mean = 12.0, SD = 2.8 vs mean = 11.2, SD = 2.8; P = .002 after adjusting for covariates). Experimental group patients also reported an 8.3% improvement in overall health status (postintervention mean = 3.0, SD = 1.1) compared with their pre-intervention health status (mean = 2.8, SD = 1.0; P =.001). Visit lengths for patients in the experimental group did not differ from those of the control group.

CONCLUSIONS: A simple patient-centered intervention to facilitate information giving in the primary health care of patients with chronic medical conditions can improve self-reported health, physical functioning, and satisfaction with care.

PMID: 10334612 [PubMed - indexed for MEDLINE]

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