Clinical trials of patient education for chronic conditions: A comparative meta-analysis of intervention types

Mullen, Patricia Dolan; Green, Lawrence W.; Persinger, Gary S.

doi:10.1016/0091-7435(85)90070-2

Cited by 276 publications

(114 citation statements)

References 49 publications

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“…Our finding that individual nutritionist visits were more strongly associated with improved outcomes than were group diabetes classes differs from most other studies (12,13). Most studies that have compared group with individual diabetes education strategies have found equivalent outcomes, with some finding improved short-term intermediate outcomes for group participants (13).…”

Section: Associations With Educational Visits Of Any Typecontrasting

confidence: 56%

Nutritionist Visits, Diabetes Classes, and Hospitalization Rates and Charges

Thatcher²,

et al. 2008

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OBJECTIVE—We evaluated the association of different types of educational visits for diabetic patients of the eight Philadelphia Health Care Centers (PHCCs) (public safety-net primary care clinics), with hospital admission rates and charges reported to the Pennsylvania Health Care Cost Containment Council. RESEARCH DESIGN AND METHODS—The study population included 18,404 patients who had a PHCC visit with a diabetes diagnosis recorded between 1 March 1993 and 31 December 2001 and had at least 1 month follow-up time. RESULTS—A total of 31,657 hospitalizations were recorded for 7,839 (42.6%) patients in the cohort. After adjustment for demographic variables, baseline comorbid conditions, hospitalizations before the diabetes diagnosis, and number of other primary care visits, having had any type of educational visit was associated with 9.18 (95% CI 5.02–13.33) fewer hospitalizations per 100 person-years and $11,571 ($6,377 to $16,765) less in hospital charges per person. Each nutritionist visit was associated with 4.70 (2.23–7.16) fewer hospitalizations per 100 person-years and a $6,503 ($3,421 to $9,586) reduction in total hospital charges. CONCLUSIONS—Any type of educational visit was associated with lower hospitalization rates and charges. Nutritionist visits were more strongly associated with reduced hospitalizations than diabetes classes. Each nutritionist visit was associated with a substantial reduction in hospital charges, suggesting that providing these services in the primary care setting may be highly cost-effective for the health care system.

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Section: Associations With Educational Visits Of Any Typecontrasting

confidence: 56%

Nutritionist Visits, Diabetes Classes, and Hospitalization Rates and Charges

Thatcher²,

et al. 2008

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“…Written information alone is not sufficient to increase patient compliance in medication used in longterm therapy. In a meta-analysis of artides written between 1961 and 1984 on intervention strategies, written interventions, except for patient package inserts, were shown to produce increased knowledge and decreased medication utilization errors (60). The studies on patient package inserts resulted in an average effect size value near zero for both knowledge and medication utilization errors (60).…”

Section: Educationd Strategiesmentioning

confidence: 99%

“…In a meta-analysis of combinations of intervention strategies, one-to-one counselling, group education, and written and/or audiovisual interventions, except patient package inserts, increased knowledge and decreased medication utilization errors (60). Robinson and coworkers (62) found that when written information was combined with verbal reinforcement, compliance was significantly higher than when written information was used alone.…”

Section: Educationd Strategiesmentioning

confidence: 99%

Patient compliance-an overview

Morris¹,

Schulz²

1992

Journal of Clinical Pharmacy and Therapeutics

273

162

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SUMMARYThis article reviews the major topic areas of compliance research. Much of the research in the area has focused on measurement, extent, and determinants of non-compliance. Research on the effectiveness of educational and behavioural strategies to improve compliance suggests the need to combine them. While some authors have attempted to model compliance or medication-taking behaviours, these models cannot be applied widely.After decades of compliance research, very little consistent information is available, except that people do not take their medications as prescribed. The methodological rigour of compliance studies may partially contribute to this situation. Methodological flaws have included design features and study execution. In addition, researchers have proceeded with studies without regard to a theoretical framework.Many have argued that much of the existing compliance literature also lacks conceptual rigour. Although we know that people do not take their medications consistently, we do not know specifically why they have done so. One reason for this lack of understanding is that compliance research has been dominated by the perspective of the health professional. To better understand medicationtaking behaviour, researchers need to examine the patient's perspective. Consequently, future research needs to investigate a patient's decisionmaking process and the reasons for those decisions.

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“…This finding suggests that the use of EMR is feasible in busy primary care clinics and does not negatively affect or substitute oral counseling for medication indications and side effects as has been suggested by a much earlier finding in a metaanalysis. 54 Our study was conducted in a practicebased primary care network with both private and public clinics; therefore, our study findings may be more easily translated into clinical practice. This exploratory study provides some understanding of how medication counseling received by primary care patients is affected by EMR and how counseling may affect medication outcomes.…”

Section: Discussionmentioning

confidence: 99%

Cross-Sectional Comparison of Electronic and Paper Medical Records on Medication Counseling in Primary Care Clinics: A Southern Primary-care Urban Research Network (SPUR-Net) Study

Kuo

Mullen

McQueen

et al. 2007

The Journal of the American Board of Family Medicine

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Introduction: This study compared the frequency of oral counseling and written information by primary care physicians at paper medical record (PMR) clinics and electronic medical record (EMR) clinics, and assessed relationships between medication counseling and medication outcomes (knowledge, questions, reported adherence and side effects, and medication fill).Methods: A cross-sectional study with two convenience samples of English-speaking adult patients receiving >1 prescription at the primary care index visit was conducted in two PMR clinics, with 184 (48% response) patients seen by one of 22 physicians, and in two EMR clinics, with 249 (37% response) patients seen by one of 25 physicians. Data were from medical record reviews of the index visit and 2-week post-visit telephone interviews.Results

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Clinical trials of patient education for chronic conditions: A comparative meta-analysis of intervention types

Cited by 276 publications

References 49 publications

Nutritionist Visits, Diabetes Classes, and Hospitalization Rates and Charges

Nutritionist Visits, Diabetes Classes, and Hospitalization Rates and Charges

Patient compliance-an overview

Cross-Sectional Comparison of Electronic and Paper Medical Records on Medication Counseling in Primary Care Clinics: A Southern Primary-care Urban Research Network (SPUR-Net) Study

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