REPLAY: The Effect of Clinic Visit Audio Recordings for Self-management in Older Adults
Study Details
Study Description
Brief Summary
The objective of this study is to conduct a multisite trial evaluating the impact of adding an audio recording of clinic visits (AUDIO) to usual care in older adults with multimorbidity, including diabetes, compared to After Visit Summary (AVS) alone (Usual Care; UC).
Condition or Disease | Intervention/Treatment | Phase |
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N/A |
Detailed Description
The objective of this study is to conduct a multisite trial evaluating the impact of adding an audio recording of clinic visits (AUDIO) to usual care in older adults with multimorbidity, including diabetes, compared to AVS alone (Usual Care; UC). The specific aims are: Aim 1 Conduct a three-site trial in primary care where older patients with multimorbidity including diabetes (n=336) will be randomized to receive an audio recording as well as AVS (AUDIO) versus AVS alone (UC) for all scheduled clinic visits over 12 months; patients will be assessed at baseline, 1 week, 6 months and 12 months. Applicants hypothesize (Main Effect) that: compared to those receiving UC, patients randomized to also receive audio recordings (AUDIO) of clinic visits will report a greater self-management ability (Primary Outcome), with improved quality of life, medication adherence, and satisfaction (Secondary Outcomes) at 12 months.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Active Comparator: Audio Researchers will audio record both in-person and telehealth visits of participants in the intervention group. |
Other: Clinic visit audio recordings for self-management in older adults
The intervention is audio-recordings of primary care clinic visits that are shared with participating patients. All scheduled visits with study clinicians will be recorded and shared with patients randomized to the intervention group (AUDIO) for 12 months.
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Placebo Comparator: Usual care Participants will receive Usual Care |
Other: Usual Care
The Usual Care arm participants will receive After Visit Summaries (AVS) per the standard delivery at each institution
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Outcome Measures
Primary Outcome Measures
- Patient Activation Measure-Short Form [Patient activation at 12-months from enrollment]
The Patient Activation Measure-Short Form is a 13-item patient reported measure. Scores range from 0 (low activation) to 100 (high activation).
Secondary Outcome Measures
- Adherence to Refills and Medications-D (ARMS-D) [Adherence at 12-months from enrollment]
Eleven-item measure of medication adherence in diabetes. Two domains: i) Medication taking; and ii) medication refill.
- Global PROMIS 10 [Global PROMIS 10 at 12 month from enrollment]
Global PROMIS (Patient-Reported Outcome Measurement Information System) is a 10-item patient reported measure with two domains: mental and physical health. Domain scores range from 4 to 20, with higher scores representing better health.
- Patient Satisfaction Questionnaire-18 [Patient satisfaction at 12-months from enrollment]
Patient Satisfaction Questionnaire-18 (PSQ-18) is a patient reported measure of satisfaction. It assesses seven sub-scales of satisfaction with care with scores ranging from 1 - 5 for each. We will use the two-item domain assessing general satisfaction.
Eligibility Criteria
Criteria
Patients participants:
Inclusion Criteria:
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Patients who are (1) ≥ 65 years;
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Patients with multimorbidity (i.e. patient has diabetes and one or more chronic conditions including: arthritis, asthma, atrial fibrillation, cancer, chronic obstructive pulmonary disease, heart disease, depression, heart failure, hypertension, osteoporosis, kidney disease and stroke);
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Have had two or more clinic visits with their enrolled provider in the previous 12 months; plan on receiving ongoing care at the clinic for the subsequent 12 months;
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Do not have any vision or hearing problems that cannot be corrected.
Exclusion Criteria:
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Without capacity to consent to the project;
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With schizophrenia and other psychotic disorders, substance-use disorders, uncorrectable hearing or visual impairment or a six item screener (SIS) cognitive function score ≤ 4;
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Living in skilled nursing homes or hospice;
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Patients who have audio- recorded a clinic visit for their personal use in the previous six months;
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Patients who do not speak English or Spanish;
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Patients who lack internet access;
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Patients who (a) do not have access to a personal email, (b) do not have an email address shared with a family member or patient-identified caregiver, and (c) are not interested in creating an email account between the time they are first contacted by the study team to the time that the study team requires an email address to initiate the online recording software registration.
Clinician participants:
Inclusion criteria:
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Are based at the study clinic;
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Who treat adult patients.
Exclusion criteria:
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Are trainees, e.g., fellows, medical students or residents;
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Commonly audio or video record clinic visits for patient's personal use.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Dartmouth-Hitchcook Manchester | Manchester | New Hampshire | United States | 03104 |
2 | Vanderbit University Medical Center | Nashville | Tennessee | United States | 37232 |
3 | University of Texas Medical Branch | Galveston | Texas | United States | 77555 |
Sponsors and Collaborators
- Dartmouth-Hitchcock Medical Center
- Vanderbilt University Medical Center
- The University of Texas Medical Branch, Galveston
- National Institute on Aging (NIA)
- National Institutes of Health (NIH)
Investigators
- Principal Investigator: Paul J Barr, PhD, Dartmouth College
- Principal Investigator: Kerri L Cavanaugh, MD, Vanderbilit University Medical Center
- Principal Investigator: Meredith C Masel, PhD, University Texas Medical Branch
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- STUDY02001844
- 1R01AG074959-01A1