None listed
Conditions
Brief summary
Doctors’ lack of emphasis on patient agendas, and patients being passive in consultations can lead to a negative impact on patient outcomes. This study aims to determine the effectiveness of using VISIT (Values in Shared Interactions Tool) to help patients communicate their concerns to facilitate value-based consultations, versus regular primary care consultations, on patient & physician satisfaction, agenda items & length of consultation. A single-site cluster randomized trial study design will be used & will take place in University of Malaya Medical Centre. It will involve n=30 Year 3 & 4 family medicine trainees in the Department of Primary Care Medicine & n=272 clinic patients (n=136 in each arm) who are on follow-up visits with those doctors for long-term chronic conditions. Doctors will be split into control and intervention groups and the latter will be trained on the use of VISIT. An added qualitative component will involve audio-recording of n=10 consultations in each arm and interviewing intervention group doctors on the use of VISIT and control group doctors on managing patient agendas.
Interventions
VISIT Consultation Arm
VISIT is a website whereby patients can input their health concerns or agenda that they want to discuss with their doctors before their appointments, so as to enable the doctors to review the agenda prior to the consultation.
The purpose of conducting this intervention is to determine the effect of using this tool in consultations on patient and physician satisfaction, agenda items and length of consultation, compared to regular consultations.
Materials included for the in
VISIT Consultation Arm VISIT is a website whereby patients can input their health concerns or agenda that they want to discuss with their doctors before their appointments, so as to enable the doctors to review the agenda prior to the consultation. The purpose of conducting this intervention is to determine the effect of using this tool in consultations on patient and physician satisfaction, agenda items and length of consultation, compared to regular consultations. Materials included for the intervention are the VISIT website itself, which patients can access through their own accounts on the hospital website and via the electronic medical record (EMR) for the doctors involved. We will also be giving out participant information sheets for the patients and doctors involved, and have them sign a consent form should they agree to participate. Materials for pre-test data collection include a patient demographic data sheet, and the Mobile Device Proficiency Questionnaire-16 (MDPQ-16). For post-test, a single item "My doctor discussed the issues that were important to me", as well as the Healthcare Provider-Patient Communication Instrument (HCP-PC). As for the doctors, we will be giving a form to record the duration of each consultation and the number of agenda discussed. Whilst patients are waiting for their appointment, they will be approached to participate in the study. Once they have been informed of the study, agree to participate and give written consent, patients will have to fill in their demographic details and the MDPQ-16. After that, they will need to access the VISIT tool on their own devices to input the health concerns that they want to discuss with the doctor, for approximately 5-10 minutes. Once they have done that, they continue to wait to see the doctor. After the consultation has ended, they will need to fill in the HCP-PC instrument before their participation ends. As for the doctors, the patients' agenda can be accessed via the EMR prior to seeing the patients. Doctors are expected to discuss these agenda and at the end of the consultation, record the duration of the consultation and the number of agenda items discussed. About 10 consultations in this arm will be audio-recorded, to explore how the use of VISIT affects the process of aligning the doctor and patient agendas. The patient intervention and data collection will be carried out by a research assistant who is trained on the use of the VISIT tool and familiar with the data collection process. As the intervention is an online tool, it will be delivered virtually and individually to each patient's mobile device and each doctor's EMR screen. Patients will only need to access the tool once during one of their scheduled appointments throughout their participation in the study. Whereas, doctors will need to participate for 1.5 to 2 months, until the required number of patients have been reached (approximately 10 patients per doctor). The intervention will be conducted at the outpatient clinic at the University of Malaya Medical Centre, Malaysia.
Sponsors
Lee Yew Kong
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
For doctors, we will be recruiting Year 3 and Year 4 family medicine trainees in the clinic. For patients, those who are on follow-up visits for long-term chronic conditions, such as diabetes, hypertension and high cholesterol, and have smartphones with web browsers and mobile data at the time of the study. We are selecting patients with chronic conditions as they are more likely to fall into a routine during follow-up consultations and may have certain concerns overlooked by the doctors. As the study is looking to see the effect of the website on addressing these concerns, we feel this population is appropriate for the study.
Exclusion criteria
Doctors who are not Year 3 and Year 4 family medicine trainees at the clinic, and patients who do not have a follow-up for a chronic condition (i.e; walk-in patients).
Outcome results
None listed