Evaluating Patient Information Prescriptions

Evaluating Patient Information Prescriptions in Different Service Environments

Research shows that patient satisfaction with medical care correlates strongly with how satisfied they are with the ease of getting information from their providers regarding their medical condition. Although the Internet is a wonderful source of information for patients, research has shown that, unmediated, it comprises a potential quagmire of information poorly matched to users needs. Providers typically do not have enough time to fulfill all of their patients' information needs. One strategy to meeting the patient's information needs is to introduce librarians trained and experienced in consumer health information services into the relationship between the patient and the provider. One recently described tactic is for providers to provide information the way they of provide treatment-through an information prescription (IRx) filled by a librarian. The librarian fills the prescription by offering information services tailored to the needs of individual patients. At Johns Hopkins, we have piloted such a tactic, and in this project, extend and evaluate it. The research hypothesis is that provision of an IRx will improve patient satisfaction, provider knowledge and attitudes regarding patient information needs, and the efficiencies of care.

Study Overview

• Status: Completed
• Conditions: Breast Neoplasms; Premature Birth
• Intervention / Treatment: Behavioral: Information Services (IRx)

Detailed Description

The goal of this research is to evaluate IRx, to provide enough data so care organizations can decide whether to implement this in their own environment.

To that end, our specific aims are:

1. To evaluate the impact of IRx on patients. We are performing a randomized clinical trial, comparing IRx with standard provision of information. The primary outcome is patient satisfaction.
2. To evaluate the impact of IRx on providers. As part of the trial, provider perceptions and behavior will be assessed.
3. To evaluate the impact of IRx on the health-care system. As part of the trial, costs entailed and resources utilized will be assessed.
4. To evaluate how IRx generalizes across service environments. The trial will be performed in two environments: adult breast cancer and neonatal intensive care.

At the heart of this proposal are the randomized clinical trials. In each, patients in both intervention and control groups will receive standard clinical care in their clinic visits. Patients randomized to the intervention group will receive information services from a specially trained librarian; patients in the control groups will receive routine, current information provision. For Aim 1, immediately after their clinic visits and four weeks later, all participants will report their satisfaction on a survey that include measures of patient-provider communication. For Aim 2, participating providers are surveyed for their perceptions of information needs being met and about patient-provider interaction. For Aim 3, costs of care and costs of providing the IRx environment will be tabulated.

• Study Type: Interventional
• Enrollment (Actual): 299
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • Maryland
    • Baltimore, Maryland, United States, 21205
      • Johns Hopkins School of Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Breast Cancer: any new patient seen in Johns Hopkins medical oncology for Breast Cancer
• Neonatal Intensive care:Biological mothers (or consenting guardians) of premature infants born and admitted or transferred in to Johns Hopkins Hospital or Bayview Medical Center neonatal intensive care units.

Exclusion Criteria:

• Breast Cancer: None
• Neonatal Intensive Care: Parents with infants whose SNAP mortality >= 80%(J Pediatr. 2001 Jan;138(1):92-100)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Patient Satisfaction	4 years

Secondary Outcome Measures

Outcome Measure	Time Frame
provider perceptions and behavior will be assessed;costs entailed and resources utilized will be assessed;how the intervention (information services) generalizes across service environments	4 years

Collaborators and Investigators

• Sponsor: Johns Hopkins University
• Collaborators: National Institutes of Health (NIH); National Library of Medicine (NLM)
• Investigators: Principal Investigator: Nancy K Oliver, MLS, Johns Hopkins School of Medicine; Study Director: Kathleen B Oliver, MLS, MPH, Johns Hopkins School of Medicine

Study record dates

Study Major Dates

• Study Start: September 1, 2004
• Primary Completion (Actual): April 1, 2008
• Study Completion (Actual): September 1, 2009

Study Registration Dates

• First Submitted: July 19, 2006
• First Submitted That Met QC Criteria: July 19, 2006
• First Posted (Estimate): July 21, 2006

Study Record Updates

• Last Update Posted (Actual): October 23, 2018
• Last Update Submitted That Met QC Criteria: October 19, 2018
• Last Verified: October 1, 2018

More Information

Terms related to this study

• Keywords: Randomized Controlled Trials; Costs and Cost Analysis; Breast Neoplasms; Internet; Premature Birth; Patient Satisfaction; Information Services; Medical Records Systems, Computerized; Health Personnel; Librarians
• Additional Relevant MeSH Terms: Skin Diseases; Neoplasms; Neoplasms by Site; Breast Diseases; Pregnancy Complications; Obstetric Labor Complications; Obstetric Labor, Premature; Breast Neoplasms; Premature Birth
• Other Study ID Numbers: JHU 04-09-03-01; 1R01LM008143 (U.S. NIH Grant/Contract)