A Feasibility Study to Improve Older Patient and Physician Communication

Participatory and patient-centered interactions between older patients and their physicians directly and positively impact important patient outcomes, such as health status and the use of health care services. Patient activation and other related interventions have been demonstrated to enhance these interactions, but are time consuming and do not replicate to primary care settings where much older adults receive their care. This study will determine the feasibility of implementing the Electronic Enhancement of Health Assessments in Clinical Encounters (ENHANCE) system in primary care settings to improve physician communication. A sample of 60 patients presenting for routine care, who are 50 years of age and older with a self-identified serious chronic illness (e.g., congestive heart failure, chronic lung disease) will be identified and recruited into a feasibility study. Patients will be recruited from four primary care practices, which participate in a primary care research network, and will be selected from counties in central North Carolina over a 9-month period. All practices will receive the intervention (i.e., ENHANCE), consisting of a touchpad personal computer and software that will gather and report patient health-related quality of life at the time of the encounter. Patient encounters will be audio-taped and analyzed using the Roter Interaction Analysis System (RIAS). The evaluation of the intervention will be guided by the RE-AIM framework, using semi-structured interviews of physician and staff members, analyses of RIAS codes, and direct observation of practice sites during the study.

Principal Investigator: Timothy P. Daaleman, D.O., M.P.H.

Primary Funding Source: NIA

Total Project Period: 08/15/09 – 0 7/31/12