Patient‐mediated interventions to improve professional practice
Appendices
Appendix 1. MEDLINE search strategy
MEDLINE: Epub Ahead of Print, In‐Process & Other Non‐Indexed Citations, MEDLINE Daily and MEDLINE 1946 to Present, OvidSP
| # | Searches | Results |
| 1 | patient mediated.ti,ab. | 54 |
| 2 | Patient Participation/ | 20468 |
| 3 | Consumer Participation/ | 15147 |
| 4 | Caregivers/ | 25960 |
| 5 | Parents/ | 49390 |
| 6 | Patient Education as Topic/ | 76131 |
| 7 | Consumer Health Information/ | 2614 |
| 8 | Feedback/ | 27487 |
| 9 | Formative Feedback/ | 134 |
| 10 | Feedback, Psychological/ | 2814 |
| 11 | Reminder Systems/ | 2745 |
| 12 | or/2‐11 | 213538 |
| 13 | Professional Practice/ | 15901 |
| 14 | Professional Competence/ | 21963 |
| 15 | Clinical Competence/ | 74869 |
| 16 | Practice Patterns, Physicians'/ | 47862 |
| 17 | Practice Patterns, Nurses'/ | 1566 |
| 18 | Practice Patterns, Dentists'/ | 1862 |
| 19 | Guideline Adherence/ | 25308 |
| 20 | "Quality of Health Care"/ | 62808 |
| 21 | Quality Improvement/ | 11527 |
| 22 | Professional‐Patient Relations/ | 23579 |
| 23 | Physician‐Patient Relations/ | 64883 |
| 24 | Dentist‐Patient Relations/ | 7897 |
| 25 | Nurse‐Patient Relations/ | 32680 |
| 26 | Patient Satisfaction/ | 66788 |
| 27 | "Patient Acceptance of Health Care"/ | 35813 |
| 28 | General Practice/ | 9828 |
| 29 | Family Practice/ | 63023 |
| 30 | or/13‐29 | 494874 |
| 31 | 12 and 30 | 34568 |
| 32 | ((patient? or consumer? or user? or client? or caregiver? or care giver? or parent*) adj3 (involv* or driven or participat* or input or notif* or inform* or guideline? or remind* or prompt* or advise or advising or advice or feedback or feed back or empower* or education? or educator? or activation or activator? or motivation or motivator? or evaluation? or evaluator?) adj6 ((guideline? or recommend* or procedure* or standard of care or best practice) adj3 (adher* or comply or compliance? or according or accordance? or concordance? or uptake? or up take?))).ti,ab. | 792 |
| 33 | ((patient? or consumer? or user? or client? or caregiver? or care giver? or parent*) adj3 (involv* or driven or participat* or input or notif* or inform* or guideline? or remind* or prompt* or advise or advising or advice or feedback or feed back or empower* or education? or educator? or activation or activator? or motivation or motivator? or evaluation? or evaluator?) adj6 ((chang* or improv* or enhanc* or optimiz* or optimis* or optimalisation or optimalization) adj3 (performance or competence or practice or behavior or behaviour or ability))).ti,ab. | 525 |
| 34 | ((patient? or consumer? or user? or client? or caregiver? or care giver? or parent*) adj3 (involv* or driven or participat* or input or notif* or inform* or guideline? or remind* or prompt* or advise or advising or advice or feedback or feed back or empower* or education? or educator? or activation or activator? or motivation or motivator? or evaluation? or evaluator?) adj6 (quality of health care or quality of healthcare or quality of patient care or quality of care or quality improvement or healthcare quality or health care quality)).ti,ab. | 655 |
| 35 | ((patient? or consumer? or user? or client? or caregiver? or care giver? or parent*) adj3 (involv* or driven or participat* or input or notif* or inform* or guideline? or remind* or prompt* or advise or advising or advice or feedback or feed back or empower* or education? or educator? or activation or activator? or motivation or motivator? or evaluation? or evaluator?) adj6 ((patient* or doctor* or physician* or clinician* or practitioner* or nurse? or dentist?) adj3 (satisfied or satisfaction or acceptance or acceptability))).ti,ab. | 1431 |
| 36 | ((patient? or consumer? or user? or client? or caregiver? or care giver? or parent*) adj3 (involv* or driven or participat* or input or notif* or inform* or guideline? or remind* or prompt* or advise or advising or advice or feedback or feed back or empower* or education? or educator? or activation or activator? or motivation or motivator? or evaluation? or evaluator?) adj6 (patient* adj3 (doctor* or physician* or clinician* or practitioner* or nurse? or dentist?) adj3 (relation* or interaction?))).ti,ab. | 385 |
| 37 | or/32‐36 | 3714 |
| 38 | 31 or 37 | 37746 |
| 39 | 1 or 38 | 37794 |
| 40 | Randomized Controlled Trial.pt. | 428256 |
| 41 | Controlled Clinical Trial.pt. | 91547 |
| 42 | pragmatic clinical trial.pt. | 404 |
| 43 | (randomis* or randomiz* or randomly).ti,ab. | 691559 |
| 44 | (trial or groups).ti,ab. | 1984239 |
| 45 | or/40‐44 | 2413723 |
| 46 | exp Animals/ | 20541489 |
| 47 | Humans/ | 16243418 |
| 48 | 46 not (46 and 47) | 4298071 |
| 49 | review.pt. | 2175046 |
| 50 | meta analysis.pt. | 72305 |
| 51 | news.pt. | 179746 |
| 52 | comment.pt. | 682924 |
| 53 | editorial.pt. | 415524 |
| 54 | cochrane database of systematic reviews.jn. | 16025 |
| 55 | comment on.cm. | 682932 |
| 56 | (systematic review or literature review).ti. | 82232 |
| 57 | or/48‐56 | 7447684 |
| 58 | 45 not 57 | 1842864 |
| 59 | 39 and 58 | 6543 |
| 60 | (2005* or 2006* or 2007* or 2008* or 2009* or 2010* or 2011* or 2012* or 2013* or 2014* or 2015* or 2016*).yr,ed. | 11538402 |
| 61 | 59 and 60 | 4556 |
| 62 | remove duplicates from 61 | 4378 |
| Examples of different types of patient‐mediated interventions | Possible mechanisms of action | How it might have positive effects | How it might have adverse effects |
| Patient information where patients are informed about recommended care | Information to patient from others → impact on healthcare professionals' performance | Giving recommendations or evidence to patients might lead them to ask for recommended care, and professionals might respond by providing it. | Healthcare professionals might feel threatened by this or disagree with the information given to patients. Patients might become distrustful of the healthcare professionals. |
| Patient education/training/counselling to increase patients' knowledge about their condition | Activation of patient by others → impact on healthcare professionals' performance | Education/training/counselling to increase patients' knowledge about their condition, which can increasing their self‐efficacy and self‐care skills. This in turn, might encourage patients to get more involved in decisions about their treatment and management and professionals might respond by providing recommended healthcare. | Healthcare professionals might feel threatened by this or disagree with the patient. It might increase healthcare professionals' burden if they need to spend more time finding answers to patients' questions. Patients might feel more uncomfortable if they have more questions but do not feel comfortable asking them. Patients might not like the answers they are given. This might lead to longer consultations without measurable improvements in the quality of care. |
| Patient feedback about clinical practice (collecting information from patients and giving it to professionals before, during or after an encounter) | Information to healthcare professionals from patients → impact on healthcare professionals' performance | Clinical performance feedback from patients might ensure that professionals get important information that they might otherwise not have received. This information might prompt professionals to improve their practice and provide recommended healthcare. | This might distract healthcare professionals from focusing on other things or lead to longer consultations without measurable improvements in the quality of care, if the information that is collected turns out not to be important. |
| Patient decision aids to ensure that the choices about treatment and management reflect recommended care and the patients' values and preferences | Activation of patient by others → impact on healthcare professionals' performance | Giving recommendations or evidence to patients and encouraging them to engage with their own values and preferences for treatment options might encourage healthcare professionals to provide recommended healthcare. | Healthcare professionals might feel threatened by this or disagree with the patient. It might increase healthcare professionals' burden if they need to spend more time finding answers to patients' questions. Patients might feel more uncomfortable if they have more questions but do not feel comfortable asking them. Patients might not like the answers they are given. This might lead to longer consultations without measurable improvements in the quality of care. |
| Patients, or patient representatives, being members of a committee or board | Information to healthcare professionals from patients → impact on healthcare professionals' performance | Patients being part of a prioritisation or agenda deciding process at the health system level might influence professional practice and result in giving patients the recommended healthcare | Healthcare professionals on the committee or board might feel threatened by this or disagree with the patients' prioritisation or decisions. This might in turn, lead to poor implementation of recommendations or guidelines made within this format. |
| Patient‐led training or education of healthcare professionals | Information and/or activation of healthcare professionals by patients → impact on healthcare professionals' performance | Patients being part of the education or training of healthcare professional might influence professional practice and result in providing recommended healthcare | Healthcare professionals might feel threatened by this or disagree with the patient trainer or educator. This might result in non‐adherence to the care recommended in this training or education. |
