The effectiveness of the shared medical visit among patients with a gynecologic malignancy undergoing chemotherapy along the Texas-Mexico border.

Abstract

63 Background: The goal of this program was developed in response to The Institute of Medicine’s (IOM) “Crossing the Quality Chasm: A New Health System for the 21st Century” (2001) to provide patient-centered care that would result in improved patient satisfaction and decreased stress through the use of a shared medical visit (SMV) for patients with a gynecologic malignancy undergoing chemotherapy in place of an individual visit. Methods: The study design was a prospective cohort at a university health sciences center located on the Texas-Mexico border. A total of 20 patients will be enrolled in the SMV and 20 in the individualized visit. Participants attended group sessions with the provider that combined assessment, education, and social support. Patient-centered care was achieved by assisting them to obtain their own vital signs and by using a facilitative learning approach during the educational and social support component. Patients in the comparison group were patients who continued in the individual visits. The average differences between the pre- and post-session scores for perceived stress and patient satisfaction were calculated for both groups. Differences between both patient groups were tested for statistical significance using the Student’s independent two sample t-test. Results: The first twelve patients completed pre- and post-session questionnaires on perceived stress and patient satisfaction. For perceived stress, a lower score indicated lower stress. The average change in score for the individual group (n=6) was 0.67, and the average change in score for the SMV group (n=6) was -2.83 (p=0.28). For patient satisfaction, a higher score indicated higher satisfaction. The average change in score for the individual group (n=6) was -5.5; the average change in score for the SMV group (n=6) was -7.5 (p=0.80). Conclusions: Overall, patients felt they benefited from the shared medical visit. While the results of our interim analyses were not statistically significant, it appears that patient stress with the shared medical visit model may decrease over time. Based on our preliminary results we will continue to enroll patients and evaluate this unique program.