NCT04902664

Shared Decision-making on Medical Tests and Care Cascades

A Multi-pronged Intervention to Initiate Shared Decision-making on Medical Tests and Care Cascades in the Primary Care Setting

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 329 (actual)
• Sponsor: Brigham and Women's Hospital · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

The purpose of this randomized controlled trial is to evaluate the impact of patient and provider facing educational materials and peer comparison on medical testing conversations during annual physicals. The investigators hypothesize that education materials and peer comparison will improve conversation quality about medical testing decisions.

Detailed description

Medical tests may show unexpected findings leading to additional tests, treatments, and visits that cost money and take time but may not have benefits. This is a prevalent issue with major consequences for patients and clinicians. Making informed decisions about when to order medical tests may help avoid unnecessary costs and worry. However, doctors don't always have detailed conversations about medical testing and there are patient gaps in knowledge. The investigators hypothesize that education materials and peer comparison to promote conversations about medical tests will improve conversation quality about medical testing decisions. The investigators have developed patient and provider-facing interventions to educate on and promote conversations about the uses and consequences of medical tests, and the investigators will test the impact of this just-in-time educational and peer comparison intervention on the likelihood of patients having productive conversations about medical tests. The effects of the intervention will be assessed using surveys before and after the study. This work has the potential to help patients feel more supported by their healthcare system, empower patients to participate in shared decision-making, and build trust between patients and clinicians.

Conditions

• Health Knowledge, Attitudes, Practice
• Health Care Utilization

Interventions

Type	Name	Description
BEHAVIORAL	Patient education materials	Patients receive a text-message and email with educational materials about medical testing.
BEHAVIORAL	Physician peer-comparison email	Physicians receive an email with feedback on how they compare to their peers in aggregate on test ordering during annual physicals.
BEHAVIORAL	Physician education materials	Physicians receive reference materials on medical test interpretation and incidental findings.
BEHAVIORAL	General visit preparation materials	Patients receive a text-message and email with general visit preparation tips.

Timeline

• Start date: 2021-05-24
• Primary completion: 2022-10-06
• Completion: 2022-10-29
• First posted: 2021-05-26
• Last updated: 2022-11-17

Locations

1 site across 1 country: United States