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ISDM Conference 2017

Presentation of initial results of the e-mpodera project at the 9th International Shared Decision Making Conference, Lyon July 2nd-5th

A mixed methods pilot study of the acceptability and feasibility of a virtual community of practice to improve primary care professional attitude towards the empowerment of patients with chronic diseases (e-MPODERA trial)

Perestelo-Perez L, Orrego C, Bermejo C, González AI, Koatz D, Ballester M, Mora N, del Pino T, Toledo A

1 Evaluation Unit of the Canary Islands Health Service (SESCS). Tenerife. Spain
2 Health Services Research on Chronic Patients Network (REDISSEC). Spain
3 Center for Biomedical Research of the Canary Islands (CIBICAN). Tenerife. Spain
4 Fundación Avedis Donabedian, Barcelona. Spain
5 Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud. Madrid. Spain
6 Canary Islands Foundation of Health Research (FUNCANIS). Tenerife. Spain

Background

Virtual Communities of Practice (vCoP) are based on the idea of learning through the participation of a group of interested people via the exchange of experiences and knowledge. The e-MPODERA project aims to assess the effectiveness of a vCoP in improving attitudes of primary care health professionals on the empowerment of patients with chronic diseases.

Objective

We pilot tested a virtual platform of CoP in primary care professionals (PCP) to evaluate the acceptability and feasibility of the intervention and make adjustments for the implementation of a cluster randomised control trial.

Methodology

A mixed methods pilot study was conducted using surveys and two discussion groups to determine
professional's experience and platform use. Three primary care centres were selected to participate in the pilot test.

Intervention

The intervention consisted in a vCoP including an online platform with activities, forums and gamification methods for some of the activities. For the activities design, a competence framework was used including four learning objectives and twelve core competences. Contents were developed considering patient health literacy, self-efficacy, coping with the disease, shared decision-making, self-monitoring, etc. Contents were included gradually during a three-month test period.

Results

Twenty-nine PCPs accepted to participate in the pilot test, 15 nurses and 14 general practitioners GPs). All of them entered vCOP and 31% contributed with comments. Topics with most comments were health literacy, shared decision-making and communication.
Fourteen PCPs answered the survey. Satisfaction and impact evaluation showed low to moderate results mainly due to issues of access to the platform and lack of time.
Six PCPs participated in the two discussion groups (one with GPs and one with practice nurses), who
expressed technological issues, lack of time, and work-overload as the most important barriers. Nurses also considered as a barrier that some of the material was only available in English.
The existing disagreement between hospital and primary care and some organizational issues that hinder a better communication with patients were two of the barriers mentioned by the participants for the implementation of patient empowerment strategies.

Participants expressed great interest for learning how to engage patients to be more active in their care, and related concepts including patient education, communication techniques, shared decision-making and practical tools. They also considered this type of learning methodology interesting because they were able to learn from other participating professionals experience and they could do it at home and in any moment.
In addition we found some insights regarding learning methods and about the facilitator role.

Conclusion

vCoP have the potential to facilitate learning and create professional awareness about patient
empowerment; however, in order to be successful, strict attention is needed for technological issues,
accessibility issues and time requirements for professionals. Based on the pilot test, several
recommendations for further work are given and an updated training program for patient empowerment is presented.

Trial registration:
ClinicalTrials.gov Identifier NCT02757781, May 2016.

© REDISSEC 2013. All rights reserved.

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