Abstract
Introduction:
Goal-setting is recommended for patients with multimorbidity, but there is little evidence to support its use in general practice.
Objective:
To assess the feasibility of goal-setting for patients with multimorbidity, before undertaking a definitive trial.
Design and setting:
Cluster-randomised controlled feasibility trial of goal-setting compared to control in six general practices.
Participants:
Adults with 2 or more long term health conditions and at risk of unplanned hospital admission.
Interventions:
General Practitioners (GPs) underwent training and patients were asked to consider goals before an initial goal-setting consultation and a follow-up consultation six months later. The control group received usual care planning.
Outcome measures:
Health-related quality of life (EQ5D5L), capability (ICEpop CAPability measure for Older people (ICECAP-O)), patient assessment of chronic illness care (PACIC) and health care use. All consultations were video or audio-recorded, and focus groups were held with participating GPs and patients.
Results:
Fifty-two participants were recruited with a response rate of 12%. Full follow-up data were available for 41. In the goal-setting group, mean age was 80.4 years 54% were female and the median number of prescribed medications was 13, compared to 77.2 years, 39% female and 11.5 medications in the control group. The mean initial consultation time was 23.0 minutes in the goal-setting group and 19.2 in the control group. Overall 28% of patient participants had no cognitive impairment. Participants set between one and three goals on a wide range of subjects, such as chronic disease management, walking, maintaining social and leisure interests, and weight management. Patient participants found goal-setting acceptable and would have liked more frequent follow-up. GPs unanimously liked goal-setting, felt it delivered more patient-centred care and highlighted the importance of training.
Conclusions:
This goal-setting intervention was feasible to deliver in general practice. A larger, definitive study is needed to test its effectiveness.
Goal-setting is recommended for patients with multimorbidity, but there is little evidence to support its use in general practice.
Objective:
To assess the feasibility of goal-setting for patients with multimorbidity, before undertaking a definitive trial.
Design and setting:
Cluster-randomised controlled feasibility trial of goal-setting compared to control in six general practices.
Participants:
Adults with 2 or more long term health conditions and at risk of unplanned hospital admission.
Interventions:
General Practitioners (GPs) underwent training and patients were asked to consider goals before an initial goal-setting consultation and a follow-up consultation six months later. The control group received usual care planning.
Outcome measures:
Health-related quality of life (EQ5D5L), capability (ICEpop CAPability measure for Older people (ICECAP-O)), patient assessment of chronic illness care (PACIC) and health care use. All consultations were video or audio-recorded, and focus groups were held with participating GPs and patients.
Results:
Fifty-two participants were recruited with a response rate of 12%. Full follow-up data were available for 41. In the goal-setting group, mean age was 80.4 years 54% were female and the median number of prescribed medications was 13, compared to 77.2 years, 39% female and 11.5 medications in the control group. The mean initial consultation time was 23.0 minutes in the goal-setting group and 19.2 in the control group. Overall 28% of patient participants had no cognitive impairment. Participants set between one and three goals on a wide range of subjects, such as chronic disease management, walking, maintaining social and leisure interests, and weight management. Patient participants found goal-setting acceptable and would have liked more frequent follow-up. GPs unanimously liked goal-setting, felt it delivered more patient-centred care and highlighted the importance of training.
Conclusions:
This goal-setting intervention was feasible to deliver in general practice. A larger, definitive study is needed to test its effectiveness.
| Original language | English |
|---|---|
| Article number | e025332 |
| Journal | BMJ Open |
| Volume | 9 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 3 Jun 2019 |