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Table 4 Primary studies of evaluations of interventions to improve communication

From: Patient and service-related barriers and facitators to the acceptance and use of interventions to promote communication in health and social care: a realist review

Barber, et al. (2015) Evaluation UK

Aims: An evaluation of ‘My Medication Passport’ - its value to older patients

Population: Older patients

Intervention: A booklet, recording details on patient’s medicines.

A total of N = 200 patients were given the passport

Follow-up study of n = 133 who participated in structure telephone interview interviewed 40% aged 70+ years

Findings: More than half of the respondents had found their medication passport useful or helpful in some way; 42% through sharing details from it with others (most frequently family, carer or doctor) or using it as a platform for conversations with healthcare professionals.; One-third of those questioned carried the passport with them at all times. Conclusions: My Medication Passport has been positively evaluated; the study provided a better understanding of (a) how it is used by patients, (b) what they are recording and (c) how it can be an aid to dialogue about medicines with family, carers and healthcare professionals. Further development and spread is underway including an App for smartphones that will be subject to wider evaluation to include feedback from clinicians.

Ito, et al. (2015) Japan Evaluation [45]

Aims: utility of patient-held records for patients with dementia in the community.


PLWD living in community Intervention patient-held records

workshops with health professional across Japan on

Family held/ patient-held records. Searches of the literature were also conducted.

Findings: The searches identified were eight sets of family-held/patient-held records in Japanese communities of various sizes, all of which were aimed at integrating information from various services, including information provided by medical and psychiatric professionals to the family and patient. The review did not examine effectiveness of these tools. Innovative tools have been available in the areas of the hopes and preferences of the patient, medication and monitoring, sharing information, and the use of information technology. Family held/ -held records may have potential as a tool to enhance the integrated care of people with dementia.

Stacy, et al. (2008) USA [46]

To examine (a) mothers’ satisfaction with use of a personal parent-held child health record (PHCHR), (b) frequency of use (c) behaviour changes, and (d) perceived barriers Intervention

Patient held records

A total of N = 100 mothers were given the PHCHR for one year. n = 82 mothers completed the 22-item validated evaluation instrument.

Findings: Patients reported high levels of satisfaction with all applicable use of the PHCHR. Respondents believed the PHCHR was a useful tool that served as a cue to increase their action in health seeking behaviours.

Robinson et al. (2010)

An intervention to improve patient centred communication in outpatient reviews of patients with dementia. A thematic analysis of recordings, with interviews and literature review.




No specific intervention – exploratory study

Semi-structured interviews with patients, carers and clinicians on their views about barriers and facilitators to patient centred care

Difficulties included:

• Developing a therapeutic alliance, especially with patient companion conflict

• Facilitating shared responsibility whilst promoting patient autonomy

• Presenting information in manageable amounts so that patients with dementia can make informed decisions

• Exploring person with dementia’s experience and promoting quality of life.

• People with dementia very rarely identified issues in response to direct questions

• Consultations tended to focus on negative aspects of a patient’s life.

• The way in which doctors structured their consultations could be as important as the communication skills they use.

Young, et al.



Development of a communications advice package for PLWD.




Communication Advice

Package (for professionals)

Iterative consultation process with multidisciplinary professional and lay stakeholders, including PLWD in the UK.

Stakeholders were asked

to reflect in detail on their own experiences of communication in relation to dementia.

Findings: Participants reported dissatisfaction with current communicative practices, particularly during contact with medical professionals. Both lay and professional participants reported general

dissatisfaction with currently available communication advice. An agreed version of a dementia toolkit for effective communication (DEMTEC) was produced. This consists of three “levels”.

• The foundation Level details beliefs about the psychosocial effects of dementia on communication, as well as empowering approaches to communication involving PLWD.

• Level 2 consists of practical considerations and advice in eight key areas.

• Level 3 uses case studies to show how the principles and advice in preceding levels are applicable to individuals in different care contexts and at different stages of dementia.

This project has produced a free-to-users instrument that is empirically supported and adaptable.