Outpatient process quality evaluation and the Hawthorne Effect

Leonard, Kenneth L.; Masatu, Melkiory C.

doi:10.1016/j.socscimed.2006.06.003

Cited by 235 publications

(202 citation statements)

References 19 publications

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“…Electronic monitoring may have provided more details, but we did not want to raise awareness of the monitoring process, which may have resulted in a change of behaviour 38 by patients or clinicians. To minimise performance bias, clinicians were not involved in the study apart from their role in referring eligible patients.…”

Section: Discussionmentioning

confidence: 99%

Individualised patient care as an adjunct to standard care for promoting adherence to ocular hypotensive therapy: an exploratory randomised controlled trial

Gray

Fenerty

Harper

et al. 2011

Eye

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Purpose To evaluate the impact of individualised patient care, as an adjunct to standard care, on adherence to ocular hypotensive therapy. Methods A two-arm, single-masked exploratory randomised controlled trial recruited patients newly prescribed ocular hypotensive therapy. The intervention involved an individual assessment of health-care needs and beliefs and a 1-year follow-up period according to need. The primary outcome was refill adherence, measured by collating prescription and dispensing data for 12 months. Secondary outcomes included self-reported adherence, glaucoma knowledge, beliefs about illness and medicines, quality of care, intraocular pressure (IOP) fluctuation, and changes in clinical management assessed at 12 months. The strength of the intervention was measured following withdrawal by reviewing clinical outcomes for a further 12 months. Results In all, 127 patients were recruited (91% response rate). Intervention-arm patients collected significantly more prescriptions than control-arm patients. Self-report adherence was significantly better in the intervention-arm for patients who forgot drops and those who intentionally missed drops. The intervention group demonstrated significantly more glaucoma knowledge, expressed a significantly stronger belief in the necessity of eye drops and believed that they had more personal control over managing their condition. Control-arm patients had more IOP fluctuation and changes in clinical management. However, this finding only reached significance at 24 months. Conclusion Modelling patient care according to health-care needs and beliefs about illness and medicines can have a significant impact on improving adherence to therapy for this patient group, with the potential benefit of improving clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Individualised patient care as an adjunct to standard care for promoting adherence to ocular hypotensive therapy: an exploratory randomised controlled trial

Gray

Fenerty

Harper

et al. 2011

Eye

View full text Add to dashboard Cite

show abstract

“…The final drafts were ratified by a steering group of glaucoma specialists and academics. The time spent observing consultations was crucial for diminishing the 'Hawthorne effect', 27,28 allowing health-care professionals being observed to become more familiar with the researcher's presence and less conscious of the observation process. The observation schedules were checklists of statements concerning glaucoma and its management.…”

Section: Methodsmentioning

confidence: 99%

Preliminary survey of educational support for patients prescribed ocular hypotensive therapy

Gray

Fenerty

Harper

et al. 2010

Eye

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“…5 Leonard and Masatu (2006) and Leonard (2008) use this instrument to measure the quality of care provided by clinicians. Leonard and Masatu (2006) show that it is a reasonable (though not perfect) representation of the quality of care by comparing what patients say the clinician did to what medical staff on a research team observed during the same consultation.…”

Section: Instrumentsmentioning

confidence: 99%

“…Health workers are very likely to change their behavior in such a setting, so the quality of care observed is most likely higher than would have been provided in the absence of the observer (Leonard and Masatu 2006). In addition, direct observation does not control for case mix, meaning that the type of patient may change significantly between health workers and facilities.…”

Section: Strengths and Weaknessesmentioning

confidence: 99%

“…Instruments: Leonard and Masatu (2005) developed an instrument for observing the clinical practices of health workers in Tanzania; this has been used in modified form by Leonard and Masatu (2006) and Maestad, Torsvik, and Aakvik (2010). 11 The first two pages of the four-page instrument are shown in annex 7A, table 7A.7 (part 1 and 2).…”

Section: Strengths and Weaknessesmentioning

confidence: 99%

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