RE: A Virtual Community of Practice to Improve Primary Health Care Professionals’ Attitudes Toward Patient Empowerment (e-MPODERA): A Cluster Randomized Trial

  • Alissa M Ray, Undergraduate, The Ohio State University
  • Other Contributors:
    • Isabella A Goncalves, Undergraduate, The Ohio State University
    • Theryn K Marsh, Undergraduate, The Ohio State University
    • Lorraine S Wallace, Associate Professor—College of Medicine, The Ohio State University
17 October 2022

In light of greater emphasis on patient-centered care and shared decision-making, this study focused on both timely and valuable research questions. While patient-centered care has gained traction across diverse patient settings, it is important to recognize that not all healthcare providers (HCPs) have received patient empowerment training and/or may feel unable to implement new techniques due to clinical time constraints. While the virtual community of practice (vCoP) used in this study slightly improved HCPs’ attitudes toward patient empowerment, based on patient activation measure (PAM) scores, HCPs did not empower patients as expected.

Over the course of this study, a significant proportion of HCPs dropped out (27% in the intervention group versus 14% in the control group). Contrary to our expectations, HCP age was not a significant predictor of dropping out of the study. However, baseline patient-provider orientation scale (PPOS) scores did predict HCP dropout. This finding underscores the need to explore whether a stand-alone vCoP can alter the beliefs of long-term practicing HCPs. As such, we wonder if these findings indicate the need for increased emphasis on patient empowerment much earlier on in the career trajectory of HCPs (e.g., during training).

Importantly, only HCPs in the intervention group had access to the vCoP. All patients recruited to participate in the study had at least one of ten chronic diseases. In retrospect, do the authors feel that the list of chronic diseases was too broad and ultimately influenced study findings? In the future, would it be beneficial to expand upon existing disease-specific vCoPs for patients as a means of providing more robust and clinically relevant information? Furthermore, while training HCPs to implement patient-centered techniques is laudable, not all patients feel they possess sufficient knowledge about their condition and/or treatment options to share in the decision-making process, even if their HCP actively encourages their input.

Reference
1. Toledo-Chávarri A, Ramos-García V, Koatz D, et al. Co-design process of a virtual community of practice for the empowerment of people with ischemic heart disease. Int J Integr Care. 2020;20(4):9. Published 2020 Nov 9. doi:10.5334/ijic.5514

Competing Interests: None declared.
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