Improving Patient and Caregiver Engagement by Sharing Annotated Audio-recorded Clinic Visits
- Conditions
- Multimorbidity
- Interventions
- Other: AudioOther: Annotated Audio
- Registration Number
- NCT04827381
- Lead Sponsor
- Dartmouth-Hitchcock Medical Center
- Brief Summary
In this project, the investigators will conduct a three-arm patient-randomized pilot trial in older adults with multimorbidity in ambulatory care settings to determine the feasibility, usability, and acceptability of an audio-based PHL developed with older adults and caregivers, HealthPAL.
- Detailed Description
Providing digital recordings of clinical visits to patients has emerged as a new strategy to promote patient and family engagement in care. With advances in natural language processing, an opportunity exists to maximize the value of visit recordings for patients by automatically annotate key visit information (e.g., medications, tests \& imaging) with linkages to trustworthy online resources. These resources can be curated in an audio-based personal health library (PHL). In this project, the investigators will conduct a three-arm patient-randomized pilot trial in older adults with multimorbidity in ambulatory care settings to determine the feasibility, usability, and acceptability of an audio-based PHL developed with older adults and caregivers, HealthPAL. Participants in the intervention arms will receive access to an audio-based PHL with either 1) a clinic visit recording where key information is annotated and hyperlinks to trustworthy health information are provided (HealthPAL), 2) a clinic visit recording without annotations or hyperlinks, or 3) the third group of participants will receive usual care (control) with no recordings. Usability metrics and satisfaction will be assessed at two weeks. Preliminary data on the impact of HealthPAL on patient ability to seek, find and use health information with high confidence and patient activation, as well caregiver preparedness will also be gathered.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 45
- (1) ≥ 65 years
- (2) with multimorbidity
- (3) plan on receiving ongoing care at the clinic for the subsequent month
- (4) access to internet.
The investigators will only include patients of clinicians (MDs, NPs) who (1) are based at the study clinic; (2) who treat adult patients.
- (1) who have a six-item screener (SIS) of cognitive function score ≤ 4 and/or for those with a defined caregiver, whose proxy has not provided consent for the patient's participation
- (2) with schizophrenia, or other psychotic disorders, substance-abuse disorders, and with uncorrectable vision or hearing impairment
- (3) who reside in nursing homes, long-term care, skilled nursing, or hospice.
The investigators will exclude clinicians who (1) are trainees, e.g., medical students or residents; or (2) commonly audio or video record clinic visits for patient's personal use.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Audio Audio In addition to usual care, patients will also be given access to an audio-based PHL, HealthPal to listen to outside of the clinic. HealthPAL will allow participants to replay the audio recording of their clinic visit (no annotations or hyperlinks). Access to their HealthPAL can also be shared with a caregiver. Annotated Audio Annotated Audio In addition to usual care, patients will be given access to an annotated audio-based PHL, HealthPal to listen to outside of the clinic. HealthPAL will allow participants to replay the audio recording of their clinic visit which will be annotated with key information discussed (e.g., medications). The recording will also contain hyperlinks related to annotations, that will direct participants to the online health information resource at Medline Plus. Access to their HealthPAL can also be shared with a caregiver.
- Primary Outcome Measures
Name Time Method Participant retention (Feasibility) Two weeks from baseline The proportion of included participants completing the two-week (T1) follow up assessment.
Listening rates (Acceptability) Two weeks from baseline The proportion of patients who listen to their recordings.
System Usability Scale (SUS) Two weeks from baseline 10-item PROM. A score ≥68 points (0-100) indicates above average usability
Acceptability of Intervention Measure (AIM) Two weeks from baseline Four-item PROM assessing acceptability of intervention. Higher score indicates higher acceptability of the intervention.
Intervention Appropriateness Measure (IAM) Two weeks from baseline Four-item PROM assessing feasibility of intervention. Higher score indicates greater appropriateness of the intervention.
Feasibility of Intervention Measure (FIM) Two weeks from baseline Four-item PROM assessing feasibility of intervention. Higher score indicates higher feasibility of the intervention.
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Dartmouth-Hitchcock Medical Center
🇺🇸Manchester, New Hampshire, United States