Improving healthy behaviors among patients with chronic disease is a priority for physicians, but how best to do so in a meaningful way during brief doctors’ office visits is unclear.
New UC Davis Health System research shows that physicians can quickly and easily use a directed communication approach known as SEE IT (or Self-Efficacy Enhancing Interviewing Techniques) that is designed to boost patient confidence in managing chronic disease symptoms and increase the likelihood that they will make healthy changes that improve outcomes.
Published in the Journal of General Internal Medicine, the study was led by Anthony Jerant, professor of family and community medicine and the SEE IT author.
“Controlling chronic disease takes a sustained commitment to lifestyle change and medication management that most, if not all, patients find extremely challenging,” Jerant said. “SEE IT helps primary care doctors like me make the most of our time with patients by encouraging positive, gradual changes that are possible to achieve.”
Jerant and his team tested SEE IT with 28 primary care providers at 12 UC Davis and Sutter Health medical offices in Sacramento, Calif. A trainer visited each physician in a patient exam room during his/her regular office hours for 20 minutes on three separate occasions.
During the first portion of the visits, the trainers portrayed patients struggling to manage one or more common chronic disorders, such as consistent use of diabetes medications or motivation to exercise to help overcome depression. For the last portion of the visits, the trainers provided instruction on the SEE IT communication model together with opportunities for doctors to practice using the approach. (See the graphic of the model below.)
A control group of 24 primary care physicians were also visited by trainers in clinical settings. However, they only were shown a video on new diabetes treatments.
Participants in both groups generally liked their training. Compared with the control group, physicians receiving the SEE IT intervention were much more likely to use what they learned during follow-up office visits with actors who once again portrayed patients struggling to manage common chronic disorders. In addition, providers’ perceptions of the feasibility and usefulness of SEE IT were high.
“The results give us confidence that our communications tool can help physicians use patient visits as powerful teaching opportunities,” Jerant said. “Our next step is to test whether or not SEE IT changes the way physicians communicate with real patients. We also want to find out if it improves their patients’ confidence with lifestyle change as well as their chronic illness outcomes.”
The study was supported by National Institute of Mental Health grant R34MH095893 and the UC Davis Department of Family and Community Medicine. Jerant’s UC Davis collaborators were Richard Kravitz, Daniel Tancredi, Debora Paterniti, Lynda White, Lynn Baker-Nauman, Dionne Evans-Dean, Chloe Villareal and senior author Peter Franks. His Sutter Health collaborators were Andrew Hudnut and Lori Ried.
More information about UC Davis Health System and its Department of Family and Community Medicine is at www.ucdmc.ucdavis.edu