Characteristics of Clinic Visits With Study Physician, as Reported by Patients and Unannounced Standardized Patients: Intention-to-Treat Analysis
| Characteristic | Control | MD-Ed | MD-Ed vs Control AMD (95% CI) | MD-Ed+A | MD-Ed+A vs Control AMD (95% CI) |
|---|---|---|---|---|---|
| Clinic visits by patients, No. | 291 | 188 | 102 | ||
| Discussed prostate cancer screening, % | 38 | 41 | 0.03 (−0.05 to 0.12) | 65 | 0.27 (0.14 to 0.40) |
| Time spent with physician, % | |||||
| <10 min | 19 | 24 | 0.06 (−0.01 to 0.13) | 15 | −0.02 (−0.10 to 0.05) |
| 10–20 min | 59 | 55 | −0.04 (−0.16 to 0.07) | 54 | −0.05 (−0.17 to 0.06) |
| >21–30 min | 22 | 21 | −0.02 (−0.11 to 0.06) | 31 | 0.07 (−0.04 to 0.18) |
| Discussed health prevention (exercise, nutrition, screening tests, etc), % | 74 | 74 | 0.01 (−.007 to 0.10) | 79 | −0.04 (−0.13 to 0.05) |
| Doctor addressed main concern during this visit, % | 100 | 100 | −0.05 (−0.10 to 0.003) | 100 | −0.02 (−0.06 to 0.09) |
| Satisfaction with this visit, No. (SD)b | 18 (3) | 18 (2) | 0.04 (−0.54 to 0.61) | 18 (3) | 0.22 (−0.45 to 0.88) |
| Clinic visits by unannounced standardized patients, No. | 43 | 41 | 36 | ||
| Physician engaged in discussion on PSA, % | 19 | 33 | 0.16 (−0.04 to 0.37) | 32 | 0.032 (−0.10 to 0.54) |
| Physician elicited preference for PSA test, mean score (SD)c | 2.3 | 2.4 | 0.12 (−0.24 to 0.49) | 2.4 | −0.01 (−0.40 to 0.38) |
| Doctor neither suggested nor recommended for or against PSA test, % | 15 | 33 | 0.16 (−0.05 to 0.37) | 50 | 0.32 (0.10–0.54) |
AMD = adjusted mean difference; MD-Ed = physician education; MD-Ed+A = physician education with patient activation; PSA = prostate-specific antigen Note: Between-arm contrasts in outcome means estimated in mixed-effects models for clustered data, with statistical adjustments for health system site.
a Percentage yes vs no or don’t know.
↵b Sum of 5 satisfaction items, ranging from 5 = least satisfied to 20 = most satisfied.
↵c Scored on a range from 1 to 5, where 1 = strongly agree and 5 = strongly disagree.