Improving chronic illness care experience for older adults through visit notes and audio recordings

Comparing Healthcare Visit Recording and Open Notes to Improve the Chronic Illness Care Experience for Older Adults (The CHRONICLE Trial)

This study tests if giving older adults access to their healthcare visit notes and audio recordings can help them better manage chronic conditions like diabetes and hypertension.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 1200 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Dartmouth-Hitchcock Medical Center (other)
• Locations: 3 sites (Manchester, New Hampshire and 2 other locations)
• Trial ID: NCT05955339 on ClinicalTrials.gov

What this trial studies

This trial evaluates the effectiveness of providing older adults with access to their healthcare visit notes and audio recordings to enhance their management of chronic conditions like diabetes and hypertension. Participants aged 65 and older will be randomly assigned to receive either written visit notes or both notes and audio recordings of their visits. The study aims to assess changes in quality of life, satisfaction, self-management, treatment adherence, and communication over six months. Caregivers will also be involved to evaluate their preparedness and burden in providing care.

Who should consider this trial

Good fit: Ideal candidates are adults aged 65 and older with multimorbidity, specifically those managing diabetes or hypertension along with another chronic condition.

Not a fit: Patients with severe cognitive impairments or those living in skilled nursing homes may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could significantly improve the quality of life and self-management skills of older adults with chronic illnesses.

How similar studies have performed: Other studies have shown promising results in enhancing patient engagement and outcomes through similar approaches, indicating potential for success.

Eligibility criteria

PATIENTS:

Inclusion Criteria:

* ≥ 65 years;
* With multimorbidity (diabetes or hypertension plus one of the following: arthritis (osteoarthritis and rheumatoid arthritis), asthma, atrial fibrillation, Alzheimer's disease and related dementia (not severe), cancer, chronic obstructive pulmonary disease, depression, heart disease, heart failure, hyperlipidemia, osteoporosis, kidney disease and stroke. Patients with diabetes plus hypertension are eligible.
* Have had two or more clinic visits in the previous 12 months;
* Plan on receiving ongoing care at the clinic with the enrolled clinician for the subsequent 6 months;
* Do not have vision or hearing problems that cannot be corrected; and
* Have not recorded a clinic visit for personal use in the past 6 months

Exclusion Criteria:

* With no capacity to consent to the project;
* With schizophrenia and other psychotic disorders, current substance-use disorders, uncorrected hearing or visual impairment;
* Living in skilled nursing homes or hospice, because they engage less in self-management;
* With cognitive impairment as identified by a score of ≤3 on the six-item screener (SIS)
* Lacking internet access;
* Who do not speak English or Spanish;
* Who (i) do not have access to a personal email, (ii) do not have an email address shared with a family member or patient-identified caregiver, and/or (iii) are not interested in creating a personal email as this would prevent them from engaging with the intervention(s); and
* Who do not wish to create a patient portal account, if they do not already have one as this would prevent them from engaging with the intervention(s).

CAREGIVERS:

Inclusion criteria:

* Agree to their identified role as a caregiver;
* Speak English or Spanish;
* Have capacity to consent to research participation; and
* ≥ 18 years.

Exclusion criteria:

* No capacity to consent to the project;
* Living in skilled nursing homes or hospice;
* Lacking internet access; or
* Do not speak English or Spanish

Where this trial is running

Manchester, New Hampshire and 2 other locations

• Dartmouth Hitchcock Clinics Manchester — Manchester, New Hampshire, United States (RECRUITING)
• Vanderbit University Medical Center — Nashville, Tennessee, United States (RECRUITING)
• University of Texas Medical Branch — Galveston, Texas, United States (NOT_YET_RECRUITING)

Study contacts

• Principal investigator: Paul J Barr, PhD — Dartmouth College
• Study coordinator: Paul J Barr, PhD

Conditions: Diabetes Mellitus, Hypertension, Audio Recording, Patient-centered communication, Self-management, Older adults, Chronic conditions, After visit summary