Helping doctors to improve the ‘Patient’s Part’ of consultation using the ‘Macro-Micro Supervision’ teaching method

Larsen, Jan-Helge; Nordgren, Gunnar; Ahlkvist, Joanna; Grafström, Johan

doi:10.1080/14739879.2019.1565926

Cited by 7 publications

(2 citation statements)

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“…The consultation is structured into three sections: the patient’s part, the physician’s part and the shared part. Since the 1990s, this way of promoting a communicative approach and structure to consultations to promote patient-centeredness has been taught and practised in Denmark and is quite well known and established among Danish GPs 37–39. Although it has been developed for acute encounters, it is also suitable for a holistic follow-up visit for chronic disease, and it is also mentioned in the existing guideline from the Danish College of General Practitioners 36.…”

Section: Methods and Analysismentioning

confidence: 99%

“…Since the 1990s, this way of promoting a communicative approach and structure to consultations to promote patient-centeredness has been taught and practised in Denmark and is quite well known and established among Danish GPs. [37][38][39] Although it has been developed for acute encounters, it is also suitable for a holistic follow-up visit for chronic disease, and it is also mentioned in the existing guideline from the Danish College of General Practitioners. 36 We decided to use this well-known framework rather than developing a new one to ease implementation.…”

Section: The Interventionmentioning

confidence: 99%

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Effectiveness of an adaptive, multifaceted intervention to enhance care for patients with complex multimorbidity in general practice: protocol for a pragmatic cluster randomised controlled trial (the MM600 trial)

Holm,

Lyhnebeck,

Rozing

et al. 2024

BMJ Open

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IntroductionPatients with complex multimorbidity face a high treatment burden and frequently have low quality of life. General practice is the key organisational setting in terms of offering people with complex multimorbidity integrated, longitudinal, patient-centred care. This protocol describes a pragmatic cluster randomised controlled trial to evaluate the effectiveness of an adaptive, multifaceted intervention in general practice for patients with complex multimorbidity.Methods and analysisIn this study, 250 recruited general practices will be randomly assigned 1:1 to either the intervention or control group. The eligible population are adult patients with two or more chronic conditions, at least one contact with secondary care within the last year, taking at least five repeat prescription drugs, living independently, who experience significant problems with their life and health due to their multimorbidity. During 2023 and 2024, intervention practices are financially incentivised to provide an extended consultation based on a patient-centred framework to eligible patients. Control practices continue care as usual. The primary outcome is need-based quality of life. Outcomes will be evaluated using linear and logistic regression models, with clustering considered. The analysis will be performed as intention to treat. In addition, a process evaluation will be carried out and reported elsewhere.Ethics and disseminationThe trial will be conducted in compliance with the protocol, the Helsinki Declaration in its most recent form and good clinical practice recommendations, as well as the regulation for informed consent. The study was submitted to the Danish Capital Region Ethical Committee (ref: H-22041229). As defined by Section 2 of the Danish Act on Research Ethics in Research Projects, this project does not constitute a health research project but is considered a quality improvement project that does not require formal ethical approval. All results from the study (whether positive, negative or inconclusive) will be published in peer-reviewed journals.Trial registration numberNCT05676541.

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Section: Methods and Analysismentioning

confidence: 99%

Section: The Interventionmentioning

confidence: 99%