A consultation leaflet to improve an older patient's involvement in general practice care: a randomized trial.
OBJECTIVE
To evaluate the effects of a programme to enhance the involvement of older patients in their consultations in general practice.


METHODS
Cluster randomized trial, in which data was collected from different cohorts.


METHODS
Twenty-five general practices in the south-east part of the Netherlands and their patients aged 70 years and over.


METHODS
Patients in the intervention group received a leaflet to help them prepare for the consultation. General practitioners (GPs) received an outreach visit to optimize older patients' involvement when visiting their GP. Patients in the control group received usual care.


METHODS
Questionnaires measuring involvement (COMRADE), enablement (Patient Enablement Index) and satisfaction with their care (EUROPEP).


RESULTS
Pre-intervention 315 patients and post-intervention 263 patients were included. Subjects were satisfied with their involvement and the GP's behaviour during the consultation. No differences in effect as a result of the leaflet on involvement, enablement or satisfaction were found between the intervention and the control group. Of 318 patients who received the leaflet and visited their GP in the intervention period, 47 patients used the leaflet. These users were more accustomed to prepare themselves for consultations. Users reported more psychological problems than non-users.


CONCLUSIONS
No relevant effects of the implementation programme on involvement, enablement or satisfaction were found. Other strategies are needed to enhance involvement of older patients in their care. Alternatively, older patients may perceive themselves sufficiently involved.
Wetzels
Raymond
R
Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre, The Netherlands. r.wetzels@kwazo.umcn.nl
Wensing
Michel
M
van Weel
Chris
C
Grol
Richard
R
D000368:Aged; D000369:Aged, 80 and over; D016000:Cluster Analysis; D015331:Cohort Studies; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation; D012017:Referral and Consultation; D011795:Surveys and Questionnaires