OBJECTIVE: To improve functional status among primary care patients. INTERVENTION: 1) Computer-generated feedback to physicians about the patient's functional status, the patient's self-reported "chief complaint," and problem-specific resource and management suggestions; and 2) two brief interactive educational sessions for physicians. DESIGN: Randomized controlled trial. SETTING:University primary care clinic. PARTICIPANTS: All 73 internal medicine house officers and 557 of their new primary care patients. MEASURES: 1) Change in patient functional status from enrollment until six months later, using the Functional Status Questionnaire (FSQ); 2) management plans and additional information about functional status abstracted from the medical record; and 3) physician attitude about whether internists should address functional status problems. RESULTS:Emotional well-being scores improved significantly for the patients of the experimental group physicians compared with those of the control group physicians (p < 0.03). Limitations in social activities indicated as "due to health" decreased among the elderly (> or = 70 years of age) individuals in the experimental group compared with the control group (p < 0.03). The experimental group physicians diagnosed more symptoms of stress or anxiety than did the control group physicians (p < 0.001) and took more actions recommended by the feedback form (p < 0.02). CONCLUSIONS: Computer-generated feedback of functional status screening results accompanied by resource and management suggestions can increase physician diagnoses of impaired emotional well-being, can influence physician management of functional status problems, and can assist physicians in improving emotional well-being and social functioning among their patients.
RCT Entities:
OBJECTIVE: To improve functional status among primary care patients. INTERVENTION: 1) Computer-generated feedback to physicians about the patient's functional status, the patient's self-reported "chief complaint," and problem-specific resource and management suggestions; and 2) two brief interactive educational sessions for physicians. DESIGN: Randomized controlled trial. SETTING: University primary care clinic. PARTICIPANTS: All 73 internal medicine house officers and 557 of their new primary care patients. MEASURES: 1) Change in patient functional status from enrollment until six months later, using the Functional Status Questionnaire (FSQ); 2) management plans and additional information about functional status abstracted from the medical record; and 3) physician attitude about whether internists should address functional status problems. RESULTS: Emotional well-being scores improved significantly for the patients of the experimental group physicians compared with those of the control group physicians (p < 0.03). Limitations in social activities indicated as "due to health" decreased among the elderly (> or = 70 years of age) individuals in the experimental group compared with the control group (p < 0.03). The experimental group physicians diagnosed more symptoms of stress or anxiety than did the control group physicians (p < 0.001) and took more actions recommended by the feedback form (p < 0.02). CONCLUSIONS: Computer-generated feedback of functional status screening results accompanied by resource and management suggestions can increase physician diagnoses of impaired emotional well-being, can influence physician management of functional status problems, and can assist physicians in improving emotional well-being and social functioning among their patients.
Authors: A M Epstein; J A Hall; M Fretwell; M Feldstein; M L DeCiantis; J Tognetti; C Cutler; M Constantine; R Besdine; J Rowe Journal: JAMA Date: 1990-01-26 Impact factor: 56.272
Authors: A M Jette; A R Davies; P D Cleary; D R Calkins; L V Rubenstein; A Fink; J Kosecoff; R T Young; R H Brook; T L Delbanco Journal: J Gen Intern Med Date: 1986 May-Jun Impact factor: 5.128
Authors: A L Stewart; S Greenfield; R D Hays; K Wells; W H Rogers; S D Berry; E A McGlynn; J E Ware Journal: JAMA Date: 1989-08-18 Impact factor: 56.272
Authors: D R Calkins; L V Rubenstein; P D Cleary; A R Davies; A M Jette; A Fink; J Kosecoff; R T Young; R H Brook; T L Delbanco Journal: J Gen Intern Med Date: 1994-10 Impact factor: 5.128
Authors: Simon J Griffin; Ann-Louise Kinmonth; Marijcke W M Veltman; Susan Gillard; Julie Grant; Moira Stewart Journal: Ann Fam Med Date: 2004 Nov-Dec Impact factor: 5.166
Authors: Lisa V Rubenstein; Lisa S Meredith; Louise E Parker; Nancy P Gordon; Scot C Hickey; Carole Oken; Martin L Lee Journal: J Gen Intern Med Date: 2006-07-07 Impact factor: 5.128
Authors: Chuan-Fen Liu; Lisa V Rubenstein; JoAnn E Kirchner; John C Fortney; Mark W Perkins; Scott K Ober; Jeffrey M Pyne; Edmund F Chaney Journal: Health Serv Res Date: 2009-02 Impact factor: 3.402