Changing conversations in primary care for patients living with chronic conditions: pilot and feasibility study of the ICAN Discussion Aid
Purpose To pilot test the impact of the ICAN Discussion Aid on clinical encounters.Methods A pre–post study involving 11 clinicians and 100 patients was conducted at two primary care clinics within a single health system in the Midwest. The study examined clinicians’ perceptions about ICAN feasibili...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2019-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/9/e029105.full |
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| author | Claudia C Dobler Víctor M Montori Kasey R Boehmer Anjali Thota Megan Branda Rachel Giblon Emma Behnken Paige Organick Summer V Allen Kevin Shaw |
| author_facet | Claudia C Dobler Víctor M Montori Kasey R Boehmer Anjali Thota Megan Branda Rachel Giblon Emma Behnken Paige Organick Summer V Allen Kevin Shaw |
| author_sort | Claudia C Dobler |
| collection | DOAJ |
| description | Purpose To pilot test the impact of the ICAN Discussion Aid on clinical encounters.Methods A pre–post study involving 11 clinicians and 100 patients was conducted at two primary care clinics within a single health system in the Midwest. The study examined clinicians’ perceptions about ICAN feasibility, patients’ and clinicians’ perceptions about encounter success, videographic differences in encounter topics, and medication adherence 6 months after an ICAN encounter.Results 39/40 control encounters and 45/60 ICAN encounters yielded usable data. Clinicians reported ICAN use was feasible. In ICAN encounters, patients discussed diet, being active and taking medications more. Clinicians scored themselves poorer regarding visit success than their patients scored them; this effect was more pronounced in ICAN encounters. ICAN did not improve 6-month medication adherence or lengthen visits.Conclusion This pilot study suggests that using ICAN in primary care is feasible, efficient and capable of modifying conversations. With lessons learned in this pilot, we are conducting a randomised trial of ICAN versus usual care in diverse clinical settings.Trial registration number NCT02390570. |
| format | Article |
| id | doaj-art-dc7a781307104fcda7dbc5fb1c2cf90c |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-dc7a781307104fcda7dbc5fb1c2cf90c2025-08-20T02:06:46ZengBMJ Publishing GroupBMJ Open2044-60552019-09-019910.1136/bmjopen-2019-029105Changing conversations in primary care for patients living with chronic conditions: pilot and feasibility study of the ICAN Discussion AidClaudia C Dobler0Víctor M Montori1Kasey R Boehmer2Anjali Thota3Megan Branda4Rachel Giblon5Emma Behnken6Paige Organick7Summer V Allen8Kevin Shaw9Department of Respiratory Medicine, Liverpool Hospital, Sydney, New South Wales, Australia1Knowledge and Evaluation Research, Mayo Clinic, Rochester, Minnesota, USA1 Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA1 Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA3 Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA2Mayo Clinic, Health Sciences Research, Rochester, MN, United States of AmericaKnowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA1 Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA1 Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA1 Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USAPurpose To pilot test the impact of the ICAN Discussion Aid on clinical encounters.Methods A pre–post study involving 11 clinicians and 100 patients was conducted at two primary care clinics within a single health system in the Midwest. The study examined clinicians’ perceptions about ICAN feasibility, patients’ and clinicians’ perceptions about encounter success, videographic differences in encounter topics, and medication adherence 6 months after an ICAN encounter.Results 39/40 control encounters and 45/60 ICAN encounters yielded usable data. Clinicians reported ICAN use was feasible. In ICAN encounters, patients discussed diet, being active and taking medications more. Clinicians scored themselves poorer regarding visit success than their patients scored them; this effect was more pronounced in ICAN encounters. ICAN did not improve 6-month medication adherence or lengthen visits.Conclusion This pilot study suggests that using ICAN in primary care is feasible, efficient and capable of modifying conversations. With lessons learned in this pilot, we are conducting a randomised trial of ICAN versus usual care in diverse clinical settings.Trial registration number NCT02390570.https://bmjopen.bmj.com/content/9/9/e029105.full |
| spellingShingle | Claudia C Dobler Víctor M Montori Kasey R Boehmer Anjali Thota Megan Branda Rachel Giblon Emma Behnken Paige Organick Summer V Allen Kevin Shaw Changing conversations in primary care for patients living with chronic conditions: pilot and feasibility study of the ICAN Discussion Aid BMJ Open |
| title | Changing conversations in primary care for patients living with chronic conditions: pilot and feasibility study of the ICAN Discussion Aid |
| title_full | Changing conversations in primary care for patients living with chronic conditions: pilot and feasibility study of the ICAN Discussion Aid |
| title_fullStr | Changing conversations in primary care for patients living with chronic conditions: pilot and feasibility study of the ICAN Discussion Aid |
| title_full_unstemmed | Changing conversations in primary care for patients living with chronic conditions: pilot and feasibility study of the ICAN Discussion Aid |
| title_short | Changing conversations in primary care for patients living with chronic conditions: pilot and feasibility study of the ICAN Discussion Aid |
| title_sort | changing conversations in primary care for patients living with chronic conditions pilot and feasibility study of the ican discussion aid |
| url | https://bmjopen.bmj.com/content/9/9/e029105.full |
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