JMIR Publications

ABSTRACT

Background:

The provision of reliable patient education is essential for shared decision making. However, many clinicians are reluctant to use commonly available resources, as they are generic and may contain information of insufficient quality. Clinician-created education, implemented during the waiting time prior to consultation, can potentially benefit clinical practice if developed in a time and resource-efficient manner.

Objective:

To evaluate utility in improving patient decision making, as well as consultation satisfaction and anxiety, of an approach within the outpatient management of chronic disease (represented by atrial fibrillation [AF]), whereby clinicians create audiovisual patient education in a time and resource-efficient manner for opportunistic delivery, using mobile smart devices with internet access, during waiting time before consultation.

Methods:

We implemented this educational approach in outpatient clinics and collected patient responses through an electronic survey. The educational module was a web-based combination of four short videos viewed sequentially, followed by a patient experience survey using 5-point Likert scales and 0-100 visual analogue scales. The clinician developed the audiovisual module over a 2-day span while performing usual clinical tasks, utilising existing hardware and software resources (laptop and tablet). Patients presenting for the outpatient management of AF accessed the module during waiting time before their consultation using either a URL or QR Code on a provided tablet, or their own mobile smart devices. The primary outcome of the study was the module’s utility in improving patient decision making ability, as measured on 0-100 visual analogue scale. Secondary outcomes were the level of patient satisfaction on 5-point Likert scales for the videos, in addition to the patient’s value for clinician narration, the module’s utility in improving understanding, anxiety, and long-term treatment adherence as represented on 0-100 visual analogue scales.

Results:

This study enrolled 116 patients presenting for the outpatient management of AF. The proportion of responses that were ‘very satisfied’ with the educational video content across the 4 videos ranged from 93.5% to 96.3% and this was between 97.8% and 99.1% for ‘satisfied’ or ‘very satisfied’. There were no reports of dissatisfaction for the first three videos, and only 1.1% of responders reported dissatisfaction for the fourth video. The median reported scores (on 0-100 visual analogue scales) were 90 (IQR: 82.5-97) for improving patient decision making, 89 (IQR: 81-95) for reducing consultation anxiety, 90 (IQR: 81-97) for improving treatment adherence, and 82 (IQR: 70-90) for the clinician’s narration adding benefit to the patient experience.

Conclusions:

Clinician-created educational videos for chronic disease management resulted in improvements in patient-reported informed decision-making ability, expected long-term treatment adherence, and anxiety reduction. This form of patient education was also time-efficient as it utilised the sunk time cost of waiting time to provide education without requiring additional clinician input.