Using audio recordings of clinic visits to help older adults manage diabetes

The Effect of Clinic Visit Audio Recordings for Self-management in Older Adults

This study tests if giving older adults with diabetes audio recordings of their clinic visits can help them manage their condition better and improve their quality of life.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 336 (estimated)
• Ages: 65 Years and up
• Sex: All
• Sponsor: Dartmouth-Hitchcock Medical Center (Academic / other)
• Locations: 3 sites (Manchester, New Hampshire and 2 other locations)
• Trial ID: NCT05824572 on ClinicalTrials.gov

What this trial studies

This study evaluates the impact of providing audio recordings of clinic visits to older adults with diabetes and other chronic conditions. Participants will be randomized to receive either the audio recordings along with the usual After Visit Summary or just the summary alone. The study aims to assess the effects on self-management abilities, quality of life, medication adherence, and patient satisfaction over a 12-month period. It will involve three sites and a total of 336 patients, with assessments conducted at baseline, one week, six months, and twelve months.

Who should consider this trial

Good fit: Ideal candidates are older adults aged 65 and above with diabetes and one or more additional chronic conditions.

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 enhance self-management and improve health outcomes for older adults with diabetes.

How similar studies have performed: Previous studies have shown that audio recordings can improve patient understanding and engagement, suggesting potential success for this approach.

Eligibility criteria

Patients participants:

Inclusion Criteria:

* Patients who are ≥ 65 years;
* Patients with multimorbidity (i.e. patient has diabetes and one or more chronic conditions including: arthritis, asthma, atrial fibrillation, cancer, chronic obstructive pulmonary disease, heart disease, depression, heart failure, hypertension, osteoporosis, kidney disease and stroke);
* Have had two or more clinic visits in the previous 12 months;
* Plan on receiving ongoing care at the clinic for the subsequent 12 months;
* Do not have any vision or hearing problems that cannot be corrected;
* Have not recorded a clinic visit for personal use i the past 6 months.

Exclusion Criteria:

* Without capacity to consent to the project;
* With schizophrenia and other psychotic disorders, substance-use disorders, uncorrectable hearing or visual impairment or a six item screener (SIS) cognitive function score ≤ 4;
* Living in skilled nursing homes or hospice;
* Patients who have audio- recorded a clinic visit for their personal use in the previous six months;
* Patients who do not speak English or Spanish;
* Patients who lack internet access;
* Patients who (a) do not have access to a personal email, (b) do not have an email address shared with a family member or patient-identified caregiver, and (c) are not interested in creating an email account between the time they are first contacted by the study team to the time that the study team requires an email address to initiate the online recording software registration.

Clinician participants:

Inclusion criteria:

* Licensed clinician (MD including clinician residents at Dartmouth Health locations, DO, APRN, NP, PA)
* Are based at the study clinic;
* Who treat adult patients.

Exclusion criteria:

* Are trainees, e.g., fellows, medical students or residents, with the exception of clinician residents at Dartmouth Health;
* Commonly audio or video record clinic visits for patient's personal use.

Where this trial is running

Manchester, New Hampshire and 2 other locations

• Dartmouth-Hitchcook 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 (Recruiting)

Study contacts

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

Conditions Diabetes; Audio recording; Diabetes Mellitus; Patient-centered communication; Self-management; Older adults; Doctor patient communication; Technology