Abstract
Background. In primary care, many consultations address symptom-based complaints. Recovery
from these complaints seldom exceeds placebo effects. Patient participation, because of its supposed
effects on trust and patient expectancies, is assumed to benefit patients’ recovery. While the
idea is theoretically promising, it is still unclear what the effects of increased patient participation
are on patient outcomes.
Aim. To review the effects of controlled intervention studies aiming to improve patient participation
in face-to-face primary care consultations on patient-oriented and/or disease-oriented
outcomes.
Methods. This study is a systematic review. A systematic search was undertaken for randomized
controlled trials designed to measure the effects of interventions that aimed to improve adult
patients’ participation in primary care visits. The CINAHL, Cochrane, EMBASE, PsycINFO and
PubMed databases were searched.
Results. Seven different trials fulfilled the inclusion criteria. Three of the studies were related to
symptom-based complaints. Five studies measured patient-oriented outcomes, the primary outcome
of interest for this review. All studies suffered from substantial bias. Studies varied widely
in their aims, types of complaints/diseases, strength of the interventions and their outcomes. The
effects on patient-oriented outcomes and disease-oriented outcomes were ambiguous.
Conclusion. Little research has been performed on health outcomes of interventions aiming to
increase patient participation in general practice visits among patients suffering from symptombased
complaints. The results still are non-conclusive. The quality of the trials has been weak, possibly
due to the complexity of the concept. This weak quality may explain the lack of conclusive
results. Proposals for future research designs are offered.
from these complaints seldom exceeds placebo effects. Patient participation, because of its supposed
effects on trust and patient expectancies, is assumed to benefit patients’ recovery. While the
idea is theoretically promising, it is still unclear what the effects of increased patient participation
are on patient outcomes.
Aim. To review the effects of controlled intervention studies aiming to improve patient participation
in face-to-face primary care consultations on patient-oriented and/or disease-oriented
outcomes.
Methods. This study is a systematic review. A systematic search was undertaken for randomized
controlled trials designed to measure the effects of interventions that aimed to improve adult
patients’ participation in primary care visits. The CINAHL, Cochrane, EMBASE, PsycINFO and
PubMed databases were searched.
Results. Seven different trials fulfilled the inclusion criteria. Three of the studies were related to
symptom-based complaints. Five studies measured patient-oriented outcomes, the primary outcome
of interest for this review. All studies suffered from substantial bias. Studies varied widely
in their aims, types of complaints/diseases, strength of the interventions and their outcomes. The
effects on patient-oriented outcomes and disease-oriented outcomes were ambiguous.
Conclusion. Little research has been performed on health outcomes of interventions aiming to
increase patient participation in general practice visits among patients suffering from symptombased
complaints. The results still are non-conclusive. The quality of the trials has been weak, possibly
due to the complexity of the concept. This weak quality may explain the lack of conclusive
results. Proposals for future research designs are offered.
| Original language | English |
|---|---|
| Pages (from-to) | 365-378 |
| Number of pages | 14 |
| Journal | Family Practice |
| Volume | 30 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 29 Apr 2013 |
Keywords
- Patient participation, patient-oriented outcomes, primary health care, shared decision-