Patient Satisfaction Clinical Trial
Official title:
Effect of Telemedicine on Physician-Patient Communication
The purpose of this study is to determine whether the physical separation between patient and physician required during telemedicine has an affect on physician-patient communication and related outcomes, including patient and physician satisfaction, patient compliance, and patient understanding of medical care.
BACKGROUND/RATIONALE:
The Veterans Administration system supports telemedicine (TM) to provide medical
consultations between patients and physicians via videoconference. At present, little is
known about the impact of such TM consultations on patient-physician communication and
related health outcomes. Analyses of in-person (IP) medical encounters have shown that
effective patient-physician communication is associated with improved health outcomes.
OBJECTIVE(S):
To determine whether the physical separation between patient and physician required during
TM has an affect on patient-physician communication and related outcomes, including patient
and physician satisfaction, patient compliance, and patient understanding of medical care.
METHODS:
In this clinical trial, 238 patients were randomized to receive either consultative care at
the remote site via TM with a consultant physician located the Milwaukee VA (intervention)
OR by an IP consultation with a consultant physician at the Milwaukee VA (control). The same
group of consultant physicians provided both IP and TM consultations.
Patients in both study arms had their medical encounter video recorded. We compared patterns
and quality of patient-physician communication for the TM and IP encounters, using the Roter
Interaction Analysis System. Data on patient and physician satisfaction with the encounter
and patients' understanding of their medical problems were collected at the end of each
medical encounter. Patient compliance (medication refill behavior) was assessed at 90 days
post visit. The frequency of communication behaviors during the TM and IP encounters was
compared using the analysis of a Linear Mixed Model. Comparison of patient satisfaction,
physician satisfaction, patient compliance, and patient knowledge measures between TM and IP
groups were conducted with similar Linear Mixed Models.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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