%0 Journal Article
%T Alerting Doctors About Patient Life Challenges: A Randomized Control Trial of a Previsit Inventory of Contextual Factors
%A Alan Schwartz
%A Amy Binns-Calvey
%A Ben Gerber
%A Beverly Gonzalez
%A Brendan Kelly
%A Carol Kostovich
%A Frances M. Weaver
%A Kevin T. Stroupe
%A Lisa Burkhart
%A Naomi Ashley
%A Saul J. Weiner
%A Scott Miskevics
%A Sherri LaVela
%J MDM Policy & Practice
%@ 2381-4683
%D 2019
%R 10.1177/2381468319852334
%X Objective. Effective care attends to relevant patient life context. We tested whether a patient-completed inventory helps providers contextualize care and increases patientsĄŻ perception of patient-centered care (PCC). Method. The inventory listed six red flags (e.g., emergency room visits) and if the patient checked any, prompted for related contextual factors (e.g., transportation difficulties). Patients were randomized to complete the inventory or watch health videos prior to their visit. Patients presented their inventory results to providers during audio-recorded encounters. Audios were coded for physician probing and incorporating context in care plans. Patients completed the Consultation and Relational Empathy (CARE) instrument after the encounter. Results. A total of 272 Veterans were randomized. Adjusting for covariates and clustering within providers, inventory patients rated visits as more patient-centered (44.5; standard error = 1.1) than controls (42.7, standard error = 1.1, P = 0.04, CARE range = 10¨C50). Providers were more likely to probe red flags (odds ratio = 1.54; confidence interval = 1.07¨C2.22; P = 0.02) when receiving the inventory, but not incorporating context into care planning. Conclusion. A previsit inventory of life context increased perceptions of PCC and providersĄŻ likelihood of exploring context but not contextualizing care. Information about patientsĄŻ life challenges is not sufficient to assure that context informs provider decision making even when provided at the point of care by patients themselves
%K contextual error
%K patient-centered care
%K provider behavior
%K randomized trial
%K socioeconomic factors
%U https://journals.sagepub.com/doi/full/10.1177/2381468319852334