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Published on: August 1, 2019
Feasibility and potential effectiveness of a primary care consultation tool: a pilot controlled trial
Simone Postma1, Henk Schers2, Reinier Akkermans2
1Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands Simone.Postma@radboudumc.nl.
Background:
The Primary Care Functioning Consultation Tool (PCFCT) supports the integration of different aspects of health related functioning for patients with multimorbidity in disease management programs.
Aim:
To assess feasibility, satisfaction, and potential effectiveness of the PCFCT on functioning, self-efficacy, illness perceptions, and disease performance indicators in daily general practice.
Design & Setting:
Pilot non-randomized controlled trial in Dutch general practices METHOD: Patients with multimorbidity were allocated to the intervention group (consultations with the practice nurse using the consultation tool) or to the control group (regular consultations). Feasibility was assessed by recruitment, retention, and identified patients at baseline and 3 months. After 3 months, satisfaction of patients and nurses was measured. Potential treatment effects were assessed using the Primary Care Functioning Scale, Self-efficacy Questionnaire, Brief Illness Perception Questionnaire, and disease-related outcomes.
Results:
Sixty-five patients were included (31 intervention, 34 control). Both patients and practice nurses reported high satisfaction and acceptability. Nineteen control patients (59%) and 24 intervention patients (80%) completed all questionnaires at baseline and 3 months. Between-group differences were not statistically significant, however intervention patients showed small exploratory differences towards better functioning, higher self-efficacy, and more adaptive illness perceptions. Missing data ranged from 25% to>90% across disease performance indicators, precluding reliable comparisons.
Conclusion:
The PCFCT is feasible, acceptable, and can be embedded within existing chronic disease management, with the potential to improve patient outcomes.