What can patients do to improve health care?

OBJECTIVE: To give an overview of the value of different interventions for increasing the role of individual patients in improving the quality of care provision. SEARCH strategy: Medline searches and manual searches in medical journals covering the period from 1980 until June 1997. INCLUSION CRITERIA: Studies reporting descriptions and evaluations of seven types of interventions that aim to help integrate the needs and preferences of individual patients into health care provision. DATA EXTRACTION: The following information was extracted: assumptions underlying the interventions; resources needed for development and implementation; and acceptability to clinicians. MAIN RESULTS: Several interventions for increasing patients' roles in health care could be successful in clinical practice, such as feeding forward patient data to clinicians, interactive patient education and feedback to health care providers about patients' evaluations of care. The available research focuses on feedback methods. Insights into the benefits and limitations of the use of the different interventions for improving care are limited. CONCLUSION: The active role that patients' views play in the contact with a care provider is often neglected. Promising interventions for the empowerment of individual patients require further development and evaluation.