The feasibility of sharing digital audio-recordings of clinic visits online with older adults in primary care settings: A multisite trial.

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Patient Education and Counseling Pub Date : 2025-02-01 Epub Date: 2024-11-29 DOI:10.1016/j.pec.2024.108574

Paul J Barr, Meredith Masel, Reed W Bratches, Elizabeth Carpenter-Song, A James O'Malley, Martha L Bruce, James S Goodwin, Sunil Kripalani, Susan Tarczewski, Sonya Williams, Isamar Ortiz, Adam Wright, Mukaila A Raji, Hyunouk Hong, Parul M Goyal, Kerri L Cavanaugh

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Abstract

Objective: The objective of this trial was to determine the feasibility, acceptability, and preliminary effectiveness of sharing audio recordings of primary care visits with older adults with multimorbidity.

Methods: We used a two-arm, randomized, controlled, feasibility trial with 3-month follow-up. Patients aged ≥ 65 years-with diabetes and hypertension-were recruited from academic primary care settings in New Hampshire, Tennessee, and Texas. Patients were randomized to receive online access to audio recordings of scheduled visits for three-months or care as usual (after visit summaries). Primary outcomes were acceptability and feasibility assessed using several indicators: acceptabilityrecruitment of 90 patients; recording use; and the Appropriateness of Intervention Measure (AIM; >3), feasibility- retention rate; protocol adherence; and the Feasibility of Intervention Measure (FIM; >3). Interviews were conducted with clinicians (n = 14) and patients (n = 19). Exploratory outcomes included patient activation, satisfaction, adherence, and quality of life.

Results: We met recruitment (n = 91) and retention (98 %) targets and exceeded feasibility (Median FIM 4; IQR 3 - 4) and acceptability (Median AIM 4; IQR 3 - 4) metrics. Fidelity to protocol was high (92 %), and 40 of 45 patients (85 %) accessed their recordings. Interviewees noted the benefits of visit recording, including greater recall, understanding, and family engagement. Recording had little perceived impact on the visit interaction, and concerns about visit recording were minimal. Exploratory outcomes revealed better PROMIS Mental Health Scores for patients receiving Audio compared to Usual Care at 3 months: 51.5 (SD 7.7) vs. 47.7 (SD 9.9), P = 0.04.

Conclusions: Sharing visit recordings online with older adults is feasible and acceptable. A larger trial is needed to determine the impact of sharing recordings on patient health outcomes.

Practice implications: Recording is a highly scalable approach to supporting older adults and their care partners in managing care. Advances in natural language processing may unlock further opportunities for this innovative strategy.

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与初级保健机构的老年人在线共享诊所访问的数字录音的可行性：一项多站点试验。

目的：本试验的目的是确定与患有多种疾病的老年人共享初级保健就诊录音的可行性、可接受性和初步有效性。方法：采用两组随机对照可行性试验，随访3个月。年龄≥65岁的糖尿病和高血压患者从新罕布什尔州、田纳西州和德克萨斯州的学术初级保健机构招募。患者被随机分为两组，一组在线访问三个月的预定访问录音，另一组接受常规护理（访问总结后）。主要结局是通过几个指标评估可接受性和可行性：可接受招募90例患者；记录使用;干预措施的适宜性；3)、可行性——保留率；协议依从性;干预措施的可行性研究> 3)。对临床医生（n = 14）和患者（n = 19）进行了访谈。探索性结果包括患者激活、满意度、依从性和生活质量。结果：我们达到了招募（n = 91）和保留（98%）的目标，并超出了可行性(中位FIM 4；IQR 3 - 4)和可接受性(中位AIM 4；IQR 3 - 4)度量。对方案的忠实度很高（92%），45名患者中有40名（85%）访问了他们的记录。受访者指出了访问记录的好处，包括更好的回忆、理解和家庭参与。记录对访问互动几乎没有感知到的影响，对访问记录的关注最小。探索性结果显示，与常规治疗相比，接受音频治疗的患者在3个月时的PROMIS心理健康评分更高：51.5分（SD 7.7）比47.7分（SD 9.9）， P = 0.04。结论：与老年人在线共享就诊记录是可行且可接受的。需要更大规模的试验来确定共享录音对患者健康结果的影响。实践意义：记录是一种高度可扩展的方法，可支持老年人及其护理伙伴管理护理。自然语言处理的进步可能会为这种创新策略带来更多的机会。

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来源期刊

Patient Education and Counseling 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

11.40%

发文量

384

审稿时长

46 days

期刊介绍： Patient Education and Counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. The journal seeks to explore and elucidate the educational, counseling and communication models in health care. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of organizational issues involved with the delivery of patient education, counseling, health promotion services and training models in improving communication between providers and patients.