The SAGE-PAGE trial: do family genograms make a difference?

Area of Science:

• Family Medicine
• Clinical Psychology
• Medical Education

Background:

• Family genograms are promoted for clinical use, but their impact on practice is not well-studied.
• Physician sensitivity to psychosocial issues and the physician-patient relationship are key aspects of care.

Purpose of the Study:

• To investigate the effect of genograms on physicians' sensitivity to psychosocial issues.
• To examine the influence of genograms on the physician-patient relationship and clinical care processes.

Main Methods:

• A randomized clinical trial involving 189 patients and 5 physicians at an academic family practice center.
• Three groups: physician-administered genogram (PAGE), self-administered genogram (SAGE), and no genogram (control).
• A baseline group without genograms was also included for comparison.

Main Results:

• Genograms did not alter physician thinking about clinical problems or patient perceptions of the encounter.
• Neither patient- nor physician-administered genograms improved physician understanding of patients or the importance of psychosocial issues.
• Physicians found genograms more relevant when self-administered, but these encounters were longer and less informative than patient-completed genograms.

Conclusions:

• The study found no significant impact of genograms on clinical practice in this setting.
• The clinical utility of genograms requires further scientific demonstration, especially in routine use or complex cases.
• Future research could explore genogram effectiveness with residents, experts, or in specific difficult cases requiring family assessment.