Involving Family to Improve Communication in Primary Care
| Status: | Completed |
|---|---|
| Conditions: | Cognitive Studies, Cognitive Studies |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 65 - Any |
| Updated: | 1/2/2019 |
| Start Date: | August 2016 |
| End Date: | August 2017 |
Involving Family to Improve Primary Care Visits for Cognitively Impaired Patients
This study evaluates an agenda-setting checklist for patients with cognitive impairment and
their family companions that is completed in the waiting room in advance of a primary care
visit. The study team will conduct a two-group randomized trial to examine feasibility of the
protocol and to compare medical communication (from visit audiotapes) during visits of
patient-companion dyads who complete the checklist (n=50) with patient-companion dyads who
receive usual care (n=50)
their family companions that is completed in the waiting room in advance of a primary care
visit. The study team will conduct a two-group randomized trial to examine feasibility of the
protocol and to compare medical communication (from visit audiotapes) during visits of
patient-companion dyads who complete the checklist (n=50) with patient-companion dyads who
receive usual care (n=50)
The study team has established proof of concept for a paper-pencil checklist to be used by
older patients and their companions in the waiting room prior to medical visits. The
checklist is designed to elicit and align patient and companion perspectives regarding
patient health issues to discuss with the doctor, and to stimulate discussion about the
companion's role in the visit. The premise for the checklist is that companions are typically
motivated to support patients during medical visits, but that they often lack knowledge of
the patient's health concerns and preferences for communication assistance.
The study team will conduct a two group pilot randomized trial of up to 100 (50 per group)
patients ages 65+ with cognitive impairment and their unpaid companion to test the effects of
the refined checklist for medical communication. Each patient-companion dyad will be
randomized to the intervention (to receive the checklist) or to a control protocol. The study
will evaluate the feasibility of delivering the study protocol to patients with cognitive
impairment and their companions in primary care, and to generate preliminary evidence
regarding the effect of the checklist on medical communication. For these reasons, the
control group protocol will comprise usual care which is in this case existing clinical
practice. Patients (when feasible), companions, and doctors in both intervention and control
groups will complete in-person post-visit surveys immediately after the visit. Patients (when
feasible) and companions will separately complete follow-up surveys by telephone two weeks
after the doctor visit conducted by a research staff member.
older patients and their companions in the waiting room prior to medical visits. The
checklist is designed to elicit and align patient and companion perspectives regarding
patient health issues to discuss with the doctor, and to stimulate discussion about the
companion's role in the visit. The premise for the checklist is that companions are typically
motivated to support patients during medical visits, but that they often lack knowledge of
the patient's health concerns and preferences for communication assistance.
The study team will conduct a two group pilot randomized trial of up to 100 (50 per group)
patients ages 65+ with cognitive impairment and their unpaid companion to test the effects of
the refined checklist for medical communication. Each patient-companion dyad will be
randomized to the intervention (to receive the checklist) or to a control protocol. The study
will evaluate the feasibility of delivering the study protocol to patients with cognitive
impairment and their companions in primary care, and to generate preliminary evidence
regarding the effect of the checklist on medical communication. For these reasons, the
control group protocol will comprise usual care which is in this case existing clinical
practice. Patients (when feasible), companions, and doctors in both intervention and control
groups will complete in-person post-visit surveys immediately after the visit. Patients (when
feasible) and companions will separately complete follow-up surveys by telephone two weeks
after the doctor visit conducted by a research staff member.
Inclusion Criteria:
- Older adults: 65 years or older, established patient of participating primary care
provider, regularly attend medical visits with one or more family member or unpaid
friend "companion(s)", agree to allow companion to be contacted and participate in the
study, authorize disclosure of Protected Health Information (PHI) in their electronic
health record, able to provide informed consent or have a legally authorized
representative
- Companion: family member (spouse, adult child, parent, adult sibling) or unpaid friend
who accompanies older adult participant to medical visits.
- Primary care provider: practicing physician, nurse practitioner or physician assistant
at a participating primary care practice.
Exclusion Criteria:
- Older adults: younger than 65 years, no evidence of cognitive impairment, do not
attend medical visits with family member or unpaid friend.
- Companion: paid non-family member who accompanies patient to visits
We found this trial at
3
sites
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