Interventions for improving older patients' involvement in primary care episodes

Area of Science:

• Geriatric Medicine
• Health Services Research
• Patient Engagement

Background:

• Growing patient expectation for involvement in medical care.
• Evidence shows active patient participation improves health outcomes.
• Unclear if these benefits extend to the elderly population.

Purpose of the Study:

• To assess interventions enhancing older patients' (>=65 years) involvement in primary medical care.
• Evaluate the impact of patient engagement strategies on geriatric healthcare interactions.

Main Methods:

• Systematic review of randomized and quasi-randomized controlled trials.
• Searched multiple databases (Cochrane, MEDLINE, EMBASE, PsycINFO, etc.) up to June 2004.
• Independent data extraction and quality assessment; narrative synthesis due to inability to perform meta-analysis.

Main Results:

• Three studies with 433 patients were included; overall study quality was low with moderate to high risk of bias.
• Pre-visit interventions (booklets, sessions) increased patient questioning and self-reported active behavior.
• Some positive impact on satisfaction with interpersonal care, but no significant changes in consultation length or overall satisfaction.

Conclusions:

• Limited evidence suggests some positive effects of specific interventions for older patients' involvement in primary care.
• Widespread recommendation is not possible due to insufficient evidence; further research is needed.
• Face-to-face coaching, potentially with written materials, may be beneficial, especially for older patients who desire involvement but lack skills.