Discutons Santé: Implementing the Use of a Website to Help Chronic Disease Patients Prepare their Primary Care Encounters

Lussier, MT (NPI); Boivin, N; Richard, C; Boustani, E; Hudon, C; Levert, MJ; Thoer, C; Jbilou, J; Diallo, FB; Gemme, A.

Background

Website interventions directed at patients can increase patient participation in healthcare encounters (HCE). Discutons Santé (DS) is a unique French language personal health record intended to activate chronic disease (CD) patients and help them prepare for a HCE.

Project Aims

1) Study the adoption of DS in primary care (PC); 2) Evaluate its impact on the HCE.

Design

Observational case study in 6 PC clinics in two French speaking provinces.

Participants

51 healthcare providers (HCP) and 156 adult patients with one or more CD.


Intervention

Patients invited to use DS website.

Outcome Variables

Uptake of DS; perception of its usefulness and impact on the HCE.


Instruments

HCP and patient questionnaires and focus groups.

Findings

Average patient participation rate was 16.5%. It varied according to site, onsite research staff support, and method of invitation. Patients reported positive impact of DS use : 1) active participation in the HCE (93%); 2) reduced HCE-related stress (99%); 3) more confident to ask questions (94%); 4) more motivated to prepare their PC visits (90%); 5) felt DS contributed to improved CD follow-up (91%). HCP reported that patients had clear reason to consult them (87%); the DS summary sheet was easy to integrate into visits (80%). However, they did not feel the summary sheet provided new information (33%) or that it helped organize the visit (56%). Patient focus group discussions confirmed these findings. However, HCP expressed doubts about the usefulness of DS and their intention to continue its use.

Discussion

Uptake of the DS website into clinical routines was not homogeneous. Most CD patients indicated a favorable evaluation of DS and its usefulness in helping them adopt an active role in the HCE and engage in a partnership with their HCP. The disconnect between HCP and patient perceptions needs further exploration before scaling up is possible.