@article{b5a6efa3d244481fab064a90a74b2dc1,
title = "Changing conversations in primary care for patients living with chronic conditions: Pilot and feasibility study of the ICAN Discussion Aid",
abstract = "Purpose To pilot test the impact of the ICAN Discussion Aid on clinical encounters. Methods A pre-post study involving 11 clinicians and 100 patients was conducted at two primary care clinics within a single health system in the Midwest. The study examined clinicians' perceptions about ICAN feasibility, patients' and clinicians' perceptions about encounter success, videographic differences in encounter topics, and medication adherence 6 months after an ICAN encounter. Results 39/40 control encounters and 45/60 ICAN encounters yielded usable data. Clinicians reported ICAN use was feasible. In ICAN encounters, patients discussed diet, being active and taking medications more. Clinicians scored themselves poorer regarding visit success than their patients scored them; this effect was more pronounced in ICAN encounters. ICAN did not improve 6-month medication adherence or lengthen visits. Conclusion This pilot study suggests that using ICAN in primary care is feasible, efficient and capable of modifying conversations. With lessons learned in this pilot, we are conducting a randomised trial of ICAN versus usual care in diverse clinical settings. Trial registration number NCT02390570.",
keywords = "chronic disease, healthcare communication, minimally disruptive medicine, multimorbidity, patient-centred care",
author = "Boehmer, {Kasey R.} and Dobler, {Claudia C.} and Anjali Thota and Megan Branda and Rachel Giblon and Emma Behnken and Paige Organick and Allen, {Summer V.} and Kevin Shaw and Montori, {Victor M.}",
note = "Funding Information: 1Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA 2Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA 3Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA 4Department of Family Medicine, Mayo Clinic, Rochester, Minnesota, USA Contributors KRB was responsible for study design, overall study execution, analysis and the draft manuscript. CCD and AT conducted videographic analysis and provided critical revisions for the manuscript. MB and RG conducted statistical analysis, created tables and drafted the statistical sections of the manuscript. EB was responsible for the study coordination of the study and data collection procedures. PO assisted with data cleaning procedures, drafting of the manuscript and critical revisions to the manuscript. SVA served as clinical champion for the study and provided critical revisions to the manuscript. KS provided revisions to the manuscript and data visualisation. VMM assisted KRB with study design and oversight of the project. Funding This research was supported in part by an internal award from the Mayo Clinic Robert and Arlene Kogod Center for Aging. Competing interests None declared. Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2019",
month = sep,
day = "1",
doi = "10.1136/bmjopen-2019-029105",
language = "English (US)",
volume = "9",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "9",
}