Improving patient function: a randomized trial of functional disability screening.

Area of Science:

• Clinical Practice Improvement
• Patient Outcomes Research
• Health Services Research

Background:

• Assessing patient functional status is crucial for effective medical care.
• Physician utilization of patient-reported outcomes can guide therapeutic decisions.
• The impact of functional status questionnaires on clinical practice and patient outcomes requires investigation.

Purpose of the Study:

• To evaluate the effectiveness of a functional status questionnaire in improving patient outcomes.
• To determine if physicians in community practices can utilize such a tool to enhance patient care.

Main Methods:

• A prospective randomized trial was conducted in community internal medicine practices.
• 76 internists and 510 patients with functional disabilities were enrolled.
• Experimental group physicians received training and functional status reports; control group received no intervention. Patients were assessed over one year.

Main Results:

• 43% of experimental physicians reported using the questionnaire to alter therapy; 95% found it useful.
• No significant differences were observed in medication use, healthcare utilization, or health behaviors between groups.
• Patient functional status and overall health outcomes did not differ significantly between experimental and control groups.

Conclusions:

• A brief educational session and regular functional status feedback were insufficient to improve patient outcomes.
• More robust interventions are necessary to facilitate the integration of functional status assessment into routine clinical practice.
• Office-based internists require enhanced support to effectively leverage patient functional status data for improved patient health.