Comparing Healthcare Visit Recording and Open Notes to Improve Chronic iLlness Care Experience in Older Adults
Comparing Healthcare Visit Recording and Open Notes to Improve the Chronic Illness Care Experience for Older Adults (The CHRONICLE Trial)
Dartmouth-Hitchcock Medical Center
1,200 participants
Jan 24, 2024
INTERVENTIONAL
Conditions
Summary
CHRONICLE is a randomized trial assessing the comparative effectiveness of providing written visit information via the patient portal (NOTES) versus NOTES plus visit audio recording (AUDIO) to older adult patients with chronic diseases on quality of life and other outcomes. During the trial, the team will also invite caregivers identified by patients to join the project.
Eligibility
Inclusion Criteria11
- PATIENTS:
- ≥ 65 years;
- With multimorbidity (diabetes or hypertension plus one of the following: arthritis (osteoarthritis and rheumatoid arthritis), asthma, atrial fibrillation, Alzheimer's disease and related dementia (not severe), cancer, chronic obstructive pulmonary disease, depression, heart disease, heart failure, hyperlipidemia, osteoporosis, kidney disease and stroke. Patients with diabetes plus hypertension are eligible.
- Have had two or more clinic visits in the previous 12 months;
- Plan on receiving ongoing care at the clinic with the enrolled clinician for the subsequent 6 months;
- Do not have vision or hearing problems that cannot be corrected; and
- Have not recorded a clinic visit for personal use in the past 6 months
- Agree to their identified role as a caregiver;
- Speak English or Spanish;
- Have capacity to consent to research participation; and
- ≥ 18 years.
Exclusion Criteria13
- With no capacity to consent to the project;
- With schizophrenia and other psychotic disorders, current substance-use disorders, uncorrected hearing or visual impairment;
- Living in skilled nursing homes or hospice, because they engage less in self-management;
- With cognitive impairment as identified by a score of ≤3 on the six-item screener (SIS)
- Lacking internet access;
- Who do not speak English or Spanish;
- Who (i) do not have access to a personal email, (ii) do not have an email address shared with a family member or patient-identified caregiver, and/or (iii) are not interested in creating a personal email as this would prevent them from engaging with the intervention(s); and
- Who do not wish to create a patient portal account, if they do not already have one as this would prevent them from engaging with the intervention(s).
- CAREGIVERS:
- No capacity to consent to the project;
- Living in skilled nursing homes or hospice;
- Lacking internet access; or
- Do not speak English or Spanish
Interventions
The intervention will include: (1) a brief training on using the patient portal to access written visit information with assistance in setting up patient portal accounts where necessary (including strategies to share notes with a caregiver), (2) post-visit reminders to use the patient portal to access written visit information.
The intervention will include: (1) audio recording all visits with the study clinician for six months, (2) training on how to record visits and access visit recordings, and (3) post-visit reminders listen to the visit recordings.
Locations(3)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT05955339