Patient-Clinician Communication Interventions Across Multiple Primary Care Sites: A Cluster Randomized Clinical Trial

Area of Science:

• Health Services Research
• Patient Engagement
• Clinical Communication

Background:

• Improving patient-clinician communication is crucial for effective healthcare.
• Limited head-to-head comparisons exist for different communication enhancement strategies.

Purpose of the Study:

• To compare the effectiveness of clinician coaching (mobile app vs. in-person) against reminder posters for shared decision-making.
• To assess if mobile app coaching is non-inferior to in-person coaching.

Main Methods:

• A 3-arm cluster randomized clinical trial involving 21 primary care clinics.
• Interventions included in-person coaching, mobile app coaching, and reminder posters (AskShareKnow).
• Primary outcome measured patient perceptions of communication and shared decision-making (CollaboRATE).

Main Results:

• No significant differences were found in the primary outcome (CollaboRATE scores) across the three intervention groups.
• Patients receiving in-person coaching were more likely to recommend their clinician.
• Patients in the mobile app group reported lower confidence in managing their health after 3 months compared to in-person coaching.

Conclusions:

• The study found no significant evidence that clinician coaching (mobile or in-person) improved patient engagement more than reminder posters.
• Some secondary outcomes suggested potential benefits of in-person coaching.
• Alternative measures for patient engagement may be necessary.