The Effect of a Consultation Dashboard on Patient Activation and Shared Decision Making
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- St. Antonius Hospital
- Enrollment
- 150
- Locations
- 2
- Primary Endpoint
- Patient Activation Measure
Study Overview
Brief Summary
The goal of this clinical pre-post study is to evaluate the effect of using a CKD dashboard, which visualizes individual patient data in patients with Chronic Kidney Disease stage 3b-4, and is used to structure the conversation during patient-clinician health visits. The main question[s] it aims to answer are: • what is the effect of the dashboard on patient activation levels (or outcomes related to patient activation)? • What is the effect of the dashboard on the conversation during health visits, including Shared Decision Making (SDM), Motivational interviewing (MI) and conversation topics? Participants will receive three surveys and have two routine care follow up consultations with their clinician audio recorded. Researchers will compare the same patients before and after implementation as well as compare them with patients in another hospital where no dashboard is (yet) implemented to see if patient activation levels (and related outcomes) increase, and whether there is an increase in SDM, MI and a difference in conversation topics.
Detailed Description
Research questions/objectives:
In this study we aim to better understand how patient activation can be improved on the consultation level. We hypothesize PROMs, the level of SDM and visualization of information (through dashboarding) are important mediators in this process and we which to explore their intertwined relations. The Santeon collaborative is currently developing a consultation dashboard that targets these mediators and aims to increase patient activation. The dashboard visualizes treatment goals and corresponding PROMs and clinical data of the individual patient (n=1) and will be used during consultations by healthcare professionals (HCPs) in their interaction with CKD patients in stage 3-4. With the dashboard, PROMs will also be newly implemented. In this study we thrive to study whether the use of the dashboard relates to an increase of patient activation through the mentioned mediators.
The primary objective is to study the effect of the CKD consultation dashboard on patient activation in CKD management
Secondary objectives:
Assess how decision making is performed in 'all types of' decisions of CKD consultations and explore what the effects are of the CKD consultation dashboard on the level of shared decision making in these decisions.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Other
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients will be eligible for participations if they meet all the following criteria:
- •Patients with Chronic Kidney Disease in stages G3b until G4 due to all causes
- •Patients are treated for chronic kidney disease in the participating hospitals
- •≥ 18 years of age
- •Be able to understand Dutch language in speech and writing or have someone assist them in understanding Dutch language.
- •Able to provide informed consent
Exclusion Criteria
- •Patients with dementia or severe cognitive impairment are excluded from this study.
Arms & Interventions
CKD dashboard + Routine CKD care
Filled out PROMs before consultation and discussed the CKD consultation dashboard together with their clinician in the (already scheduled) routine care follow up consultation.
Intervention: CKD dashboard (Other)
Routine CKD care
In the period of the study PROMs and the dashboard are not yet implemented for this group of patients.
Outcomes
Primary Outcomes
Patient Activation Measure
Time Frame: Change from baseline (pre-implementation dashboard) to one year after implementation of the dashboard.
Patient activation relates to patients having the knowledge, skills and confidence to take an active role in managing their condition. A widely used and validated measure for these aspects of patient activation is the Patient Activation Measure. The PAM contains four levels of activation indicating an increased level of patient activation per level: 1) believing that your role is important; 2) having confidence and knowledge to take action; 3) taking action; 4) staying on course in disease management under stress. Total scores range from 0-100; higher scores indicate higher patient activation.
Patient Activation Measure
Time Frame: Change from baseline (pre-implementation dashboard) to the following consultation more than 3 months later (post-implementation dashboard)
Patient activation relates to patients having the knowledge, skills and confidence to take an active role in managing their condition. A widely used and validated measure for these aspects of patient activation is the Patient Activation Measure. The PAM contains four levels of activation indicating an increased level of patient activation per level: 1) believing that your role is important; 2) having confidence and knowledge to take action; 3) taking action; 4) staying on course in disease management under stress. Total scores range from 0-100; higher scores indicate higher patient activation.
Secondary Outcomes
- Control Preferences Scale (CPS)(Change from baseline (pre-implementation dashboard) to the following consultation more than 3 months later (post-implementation dashboard))
- Shared Decision Making, measured with 4SDM scale(Change from baseline (pre-implementation dashboard) to the following consultation more than 3 months later (post-implementation dashboard))
- Perceived Efficacy of the Patient in Patient-clinician Interactions' (PEPPI).(Change from baseline (pre-implementation dashboard) to the following consultation more than 3 months later (post-implementation dashboard))
- Perceived Efficacy of the Patient in Patient-clinician Interactions' (PEPPI)(Change from baseline (pre-implementation dashboard) to one year after implementation of the dashboard.)
- Disease insight(Change from baseline (pre-implementation dashboard) to one year after implementation of the dashboard.)
- Medication Adherence Report Scale (MARS)(Change from baseline (pre-implementation dashboard) to one year after implementation of the dashboard.)
- Motivational Interviewing(Change from baseline (pre-implementation dashboard) to the following consultation more than 3 months later (post-implementation dashboard))
- Clinical (long term) outcome: Kidney function (eGFR)(Change from baseline (pre-implementation dashboard) to one year after implementation of the dashboard.)
- Revised Patient Perception of Patient-Centeredness (PPPC-R)(Change from baseline (pre-implementation dashboard) to one year after implementation of the dashboard.)
- Satisfaction with information(After more than 3 months and after one year, only for intervention arm after implementation of the dashboard)
- Medication Adherence Report Scale (MARS)(Change from baseline (pre-implementation dashboard) to the following consultation more than 3 months later (post-implementation dashboard))
- Revised Patient Perception of Patient-Centeredness (PPPC-R)(Change from baseline (pre-implementation dashboard) to the following consultation more than 3 months later (post-implementation dashboard))
- Disease insight(Change from baseline (pre-implementation dashboard) to the following consultation more than 3 months later (post-implementation dashboard))
- Clinical (long term) outcome: Kidney function (eGFR)(Change from baseline (pre-implementation dashboard) to the following consultation more than 3 months later (post-implementation dashboard))
Investigators
Dr. WJW Bos
Professor, MD
St. Antonius Hospital