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
{"title":"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。","authors":"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","doi":"10.1016/j.pec.2024.108574","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Practice implications: </strong>Recording is a highly scalable approach to supporting older adults and their care partners in managing care. 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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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Practice implications: </strong>Recording is a highly scalable approach to supporting older adults and their care partners in managing care. 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The feasibility of sharing digital audio-recordings of clinic visits online with older adults in primary care settings: A multisite trial.
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.
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.
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