title: Improving preclinic preparation for patients with chronic conditions in quito, ecuador: a randomized controlled trial.
abstract: Objectives. As in many settings, patients in community health centers in Ecuador do not complete previsit forms or receive assistance to identify questions and concerns they would like to address in brief clinic visits with physicians. We examined the comparative effectiveness of providing (1) a previsit form to complete; (2) a previsit form along with assistance in completing the form; and (3) usual care. Methods. Parallel, three-arm randomized controlled trial in two health centers serving indigent to low-income communities in Quito, Ecuador, among 199 adult patients who took medications for at least one chronic condition. Outcome measures were self-reported satisfaction with the visit, confidence in asking questions, and extent to which patients' objectives were met. Results. Patients who received assistance in completing a previsit form were more than twice as likely as participants in usual care to report achieving everything they wanted during their visit (AOR 2.2, P = 0.039). There were no differences in any outcomes between the groups who received the previsit form with no assistance and usual care. Conclusions. For high-quality patient-centered primary care, it is important to develop and test innovative and scalable interventions for patients and physicians to make the best use of limited clinic time.
authors.affiliation: University of Michigan Medical School, Ann Arbor, MI 48109, USA.
authors.forename: K
authors.initials: K
authors.lastname: Rodriguez
authors.affiliation: University of Michigan Medical School, Ann Arbor, MI 48109, USA ; Center for Clinical Management Research, Ann Arbor Veterans' Affairs (VA) Healthcare System, Ann Arbor, MI 48109, USA.
authors.forename: E
authors.initials: E
authors.lastname: Kaselitz
authors.affiliation: University of Michigan Medical School, Ann Arbor, MI 48109, USA.
authors.forename: J
authors.initials: J
authors.lastname: Wong
authors.affiliation: University of Michigan Medical School, Ann Arbor, MI 48109, USA.
authors.forename: S
authors.initials: S
authors.lastname: Ligard
authors.affiliation: University of Michigan Medical School, Ann Arbor, MI 48109, USA.
authors.forename: D
authors.initials: D
authors.lastname: Peck
authors.affiliation: Pontifical Catholic University of Ecuador (PUCE) Medical School, P.O. Box 17012184, Quito, Ecuador.
authors.forename: V
authors.initials: V
authors.lastname: Hugo Mena
authors.affiliation: Pontifical Catholic University of Ecuador (PUCE) Medical School, P.O. Box 17012184, Quito, Ecuador.
authors.forename: F
authors.initials: F
authors.lastname: Gordillo
authors.affiliation: University of Michigan Medical School, Ann Arbor, MI 48109, USA.
authors.forename: D
authors.initials: D
authors.lastname: Serlin
authors.affiliation: University of Michigan Medical School, Ann Arbor, MI 48109, USA ; Center for Clinical Management Research, Ann Arbor Veterans' Affairs (VA) Healthcare System, Ann Arbor, MI 48109, USA ; Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA ; Michigan Center for Diabetes Translational Research (MCDTR), University of Michigan, Ann Arbor VA, Ann Arbor, MI 48109, USA.
authors.forename: M
authors.initials: M
authors.lastname: Heisler