Communicating to Improve the Quality of Informal Care

DESCRIPTION (provided by applicant): Primary care providers are seeing increasing numbers of older adults, many of whom have chronic conditions that involve multiple medications and complex treatment regimens. The majority of this care is provided by family members (informal caregivers) who often accompany the older patient to the provider visit. Communication with a care triad (e.g., older patient, informal caregiver, and provider) presents challenges to all involved. Most providers have no formalized instruction to develop skills in triadic communication, yet clear and effective communication is critical to ensuring accurate and adequate adherence to a treatment regimen. This project will develop and evaluate a Web-based, continuing education (CME/CE accredited) program for primary care providers to develop/enhance skills for effective communication with care triads. The program targets physicians and nurses, although it will be extremely relevant to any health care professional involved in the care of older adults. The Specific Aims of Phase I are to: 1) develop a content outline for the full program; 2) develop the design and format of the Web-based program; 3) develop a script and storyboard for one program module; 4) develop this module (prototype) on the Web; 5) conduct a feasibility evaluation of the prototype; and 6) develop a plan and schedule for production of the full-length program and CME/CE accreditation in Phase II. This project directly extends the investigative team's research on physician communication with older patients (AG15248; AG23366). Primary care providers have responsibility for clear and effective communication with patients. In the case of these caregiving dyads, they also have an opportunity to support informal caregivers in a way that can enhance treatment adherence and improve health care outcomes. This project involves the close collaboration of NERI, the Boston University School of Medicine, and the Harvard School of Public Health. The Web-based program will be marketed as a CME/CE product for primary care physicians and nurses through NERI's e-commerce website and also through the Boston University School of Medicine Office of Continuing Medical Education. The main outcome in the Phase I feasibility test (N=80) will be change in knowledge from baseline to endpoint. In addition, detailed questions about accessibility, usability, and satisfaction with content will be asked. Phase I feasibility will be demonstrated if 1) there is a gain in knowledge for a majority of participants (physicians, nurses), and 2) at least 75% of the sample report satisfaction (satisfied or very satisfied) with the content, access, and usability of the prototype.