title: Shared medical appointments improve QOL in neuromuscular patients: a randomized controlled trial.
abstract: OBJECTIVE
  To systematically study the effects of shared medical appointments (SMAs) compared with individual appointments for patients with a chronic neuromuscular disorder and their partners.
  
  
  METHODS
  In this randomized controlled trial with a follow-up of 6 months, we included patients with a chronic neuromuscular disorder and their partners. Participants were randomly allocated to an SMA or an individual outpatient appointment. The primary outcome measure was patients' health-related quality of life (QOL) (36-Item Short Form Health Survey). Secondary outcome measures included self-efficacy, social support, patient and partner satisfaction with the appointment, and time available per patient.
  
  
  RESULTS
  Two hundred seventy-two patients and 149 partners were included. Health-related QOL showed greater improvement in patients who had attended an SMA (mean difference 2.8 points, 95% confidence interval 0.0-5.7, p = 0.05). Secondary outcomes showed small improvements in the control group for satisfaction with the appointment (p = 0.01). Neurologists spent less time per patient during the SMAs: mean 16 minutes (range 11-30) vs. 25 minutes (range 20-30) for individual appointments.
  
  
  CONCLUSIONS
  This study provides evidence that SMAs can improve aspects of QOL of patients with a chronic neuromuscular disorder. This could result in an alternative to individual appointments and improvements in both effectiveness and efficiency. Further research to optimize SMAs and to identify critical success factors seems warranted. These data extend evidence on SMAs for neurologic patients.
  
  
  METHODS
  This study provides Class III evidence that for patients with chronic neuromuscular disorders, SMAs improve QOL as compared with individual medical appointments.
authors.affiliation: From the Department of Neurology (F.M.S., G.D., B.G.M.v.E.) and Department for Health Evidence (J.G., G.J.v.d.W.), Radboud University Medical Centre, Nijmegen; and Departments of Neurology and Neurosurgery (G.D.), University Medical Centre Groningen, University of Groningen, the Netherlands. Femke.Seesing@Radboudumc.nl.
authors.forename: Femke Marie
authors.initials: FM
authors.lastname: Seesing
authors.affiliation: From the Department of Neurology (F.M.S., G.D., B.G.M.v.E.) and Department for Health Evidence (J.G., G.J.v.d.W.), Radboud University Medical Centre, Nijmegen; and Departments of Neurology and Neurosurgery (G.D.), University Medical Centre Groningen, University of Groningen, the Netherlands.
authors.forename: Gea
authors.initials: G
authors.lastname: Drost
authors.affiliation: From the Department of Neurology (F.M.S., G.D., B.G.M.v.E.) and Department for Health Evidence (J.G., G.J.v.d.W.), Radboud University Medical Centre, Nijmegen; and Departments of Neurology and Neurosurgery (G.D.), University Medical Centre Groningen, University of Groningen, the Netherlands.
authors.forename: Johannes
authors.initials: J
authors.lastname: Groenewoud
authors.affiliation: From the Department of Neurology (F.M.S., G.D., B.G.M.v.E.) and Department for Health Evidence (J.G., G.J.v.d.W.), Radboud University Medical Centre, Nijmegen; and Departments of Neurology and Neurosurgery (G.D.), University Medical Centre Groningen, University of Groningen, the Netherlands.
authors.forename: Gert Jan
authors.initials: GJ
authors.lastname: van der Wilt
authors.affiliation: From the Department of Neurology (F.M.S., G.D., B.G.M.v.E.) and Department for Health Evidence (J.G., G.J.v.d.W.), Radboud University Medical Centre, Nijmegen; and Departments of Neurology and Neurosurgery (G.D.), University Medical Centre Groningen, University of Groningen, the Netherlands.
authors.forename: Baziel G M
authors.initials: BG
authors.lastname: van Engelen
mesh_terms: D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006126:Group Processes; D006801:Humans; D008297:Male; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000523:psychology*; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D011788:Quality of Life / Q000523:psychology*; D020377:Self Efficacy; D012944:Social Support; D018454:Spouses / Q000523:psychology; D013997:Time Factors