Pacific Northwest University of Health Sciences, College of Osteopathic Medicine, Yakima, WA, USA.
Family Health Care of Ellensburg, Ellensburg, WA, USA.
BMC Fam Pract. 2019 Jul 8;20(1):97. doi: 10.1186/s12875-019-0972-1.
Shared medical appointments (SMAs), or group visits, are a healthcare delivery method with the potential to improve chronic disease management and preventive care. In this review, we sought to better understand opportunities, barriers, and limitations to SMAs based on patient experience in the primary care context.
An experienced biomedical librarian conducted literature searches of PubMed, Cochrane Library, PsycINFO, CINAHL, Web of Science, ClinicalTrials.gov , and SSRN for peer-reviewed publications published 1997 or after. We searched grey literature, nonempirical reports, social science publications, and citations from published systematic reviews. The search yielded 1359 papers, including qualitative, quantitative, and mixed method studies. Categorization of the extracted data informed a thematic synthesis. We did not perform a formal meta-analysis.
Screening and quality assessment yielded 13 quantitative controlled trials, 11 qualitative papers, and two mixed methods studies that met inclusion criteria. We identified three consistent models of care: cooperative health care clinic (five articles), shared medical appointment / group visit (10 articles) and group prenatal care / CenteringPregnancy® (11 articles).
SMAs in a variety of formats are increasingly employed in primary care settings, with no singular gold standard. Accepting and implementing this nontraditional approach by both patients and clinicians can yield measurable improvements in patient trust, patient perception of quality of care and quality of life, and relevant biophysical measurements of clinical parameters. Further refinement of this healthcare delivery model will be best driven by standardizing measures of patient satisfaction and clinical outcomes.
共设医疗预约（SMAs）或小组就诊是一种具有改善慢性病管理和预防保健潜力的医疗服务提供方式。在本次综述中，我们旨在根据初级保健背景下患者的体验，更好地了解 SMA 的机会、障碍和局限性。
一位经验丰富的生物医学图书管理员对 PubMed、Cochrane 图书馆、PsycINFO、CINAHL、Web of Science、ClinicalTrials.gov 和 SSRN 进行了文献检索，以查找 1997 年或之后发表的同行评审出版物。我们还检索了灰色文献、非实证报告、社会科学出版物以及已发表系统综述的参考文献。搜索共生成 1359 篇论文，包括定性、定量和混合方法研究。提取数据的分类为主题综合提供了信息。我们未进行正式的荟萃分析。
筛选和质量评估共纳入 13 项定量对照试验、11 篇定性论文和 2 项混合方法研究。我们确定了三种一致的护理模式：合作医疗诊所（5 篇文章）、共设医疗预约/小组就诊（10 篇文章）和小组产前护理/生育中心（11 篇文章）。
各种形式的 SMA 越来越多地应用于初级保健环境中，没有单一的黄金标准。患者和临床医生接受并实施这种非传统方法，可以在患者信任、患者对护理质量和生活质量的感知以及临床参数的相关生理测量方面取得可衡量的改善。进一步完善这种医疗服务模式将最好通过标准化患者满意度和临床结果的衡量标准来实现。
