The impact of a patient web communication intervention on reaching treatment suggested guidelines for chronic diseases: A randomized controlled trial.

OBJECTIVE

Examine the impact of a PACE (Prepare, Ask, Check, Express) inspired web-based communication intervention alone or combined with a workshop on reaching treatment goals for patients suffering from chronic diseases (CDs), compared to usual care.

METHODS

Three arm single-blind RCT in community primary care (PC) practices. PC practitioners (n=18) had a CD patient caseload, and practicing >5 years. Patients >40 years old, English speaking, computer literate, not reaching treatment goals for hypertension, type II diabetes, and/or dyslipidemia.

INTERVENTIONS

(1) web-intervention and (2) web intervention and nurse facilitated workshop and (3) usual care.

OUTCOME

Proportion of patients meeting all treatment suggested guidelines for the diagnoses they were enrolled for.

RESULTS

Patients (n=322) were randomized, and of these 221 returned for follow up. Patients in the web group were 1.42 times more likely to meet targets compared to usual care [95% CI: 1.00-2.00], a statistical difference not seen in the combined group. Sensitivity analyses were performed to mitigate bias due to loss to follow up.

CONCLUSIONS

Training patients in communication skills using a website positively affects reaching treatment goals for hypertensive, diabetic and dyslipidemic patients.

PRACTICE IMPLICATIONS

Web communication interventions are an effective tool that can be used in primary care.