title: A tool to strengthen the older patient-companion partnership in primary care: results from a pilot study.
abstract: OBJECTIVE
  To determine the acceptability of a pre-consultation checklist for older adults who attend medical visits with an unpaid companion and to evaluate its effects on visit communication.
  
  
  METHODS
  Randomized controlled pilot study.
  
  
  METHODS
  Academic geriatrics ambulatory clinic.
  
  
  METHODS
  Thirty-two individuals aged 65 and older and their unpaid companions.
  
  
  METHODS
  A self-administered checklist was compared with usual care. The checklist was designed to elicit and align patient and companion perspectives regarding health concerns to discuss with the doctor and stimulate discussion about the companion's role in the visit.
  
  
  METHODS
  
  
  
  METHODS
  ratio of patient-centered communication, coded from visit audiotapes.
  
  
  RESULTS
  checklist acceptability; visit duration; patient-companion verbal activity; patient- and physician-reported perspectives of the visit.
  
  
  RESULTS
  All intervention patients and companions (n = 17) completed the checklist, and all participants (n = 32 dyads) completed the study. Patients and companions stated that the checklist was easy to complete (88%) and useful (91%), and they uniformly (100%) recommended it to other patients. Communication was significantly more patient-centered in intervention group visits (ratio of 1.22 vs 0.71; P = .03). Visit duration (35.0 and 30.6 minutes; P = .34) and percentage of total verbal activity contributed by patients and companions (58.2% and 56.3% of visit statements; P = .50) were comparable in the intervention and control groups, respectively. Physicians were more likely to indicate that intervention companions "helped them provide good care to the patient" (94% vs 60%; P = .02). Intervention patients were more likely to indicate that they "better understood their doctor's advice and explanations" because their companion was present (82% vs 47%; P = .03).
  
  
  CONCLUSIONS
  A checklist to elicit and align perspectives of older adults and their companions resulted in enhanced patient-centered medical visit communication.
authors.affiliation: Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Division of Geriatric Medicine and Gerontology and Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Wolff
authors.forename: Debra L
authors.initials: DL
authors.lastname: Roter
authors.forename: Jeremy
authors.initials: J
authors.lastname: Barron
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Boyd
authors.forename: Bruce
authors.initials: B
authors.lastname: Leff
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Finucane
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Gallo
authors.forename: Peter V
authors.initials: PV
authors.lastname: Rabins
authors.forename: David L
authors.initials: DL
authors.lastname: Roth
authors.forename: Laura N
authors.initials: LN
authors.lastname: Gitlin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D005190:Family; D005260:Female; D033062:Friends; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration*; D011368:Professional-Family Relations; D012017:Referral and Consultation / Q000458:organization & administration
keywords: family caregiver; patient-provider communication; physician office; primary health care