• Rachel Hess, Hilary Tindle, Molly B Conroy, Sunday Clark, Eric Yablonsky, and Ron D Hays.
• Division of General Internal Medicine, Department of Medicine and Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA, rachel.hess@hsc.utah.edu.
• J Gen Intern Med. 2014 Dec 1; 29 (12): 1641-9.

BackgroundHealthcare providers play an important role in encouraging healthy behaviors and improving health-related quality of life (HRQoL). They are most effective when they partner with informed, engaged patients.ObjectiveTo examine the impact of a new health-information technology intervention (FAST-Feedback) that provides patients with immediate, personalized, guideline-based feedback regarding tobacco use, physical activity, and HRQoL, and encourages patients to initiate discussions regarding these topics with their primary care physician.DesignA pilot, randomized controlled trial clustered by resident physician, with patients as the unit of analysis.ParticipantsResident physicians and their out-patients in a single academic health center between May and October 2011.InterventionPatients received (intervention) or did not receive (control) FAST-Feedback prior to the clinical encounter.Main Outcome MeasuresPrimary outcomes were patient reports of initiating any discussions regarding tobacco use, physical activity, and HRQoL. Subgroup analyses examined patient reports of discussions regarding tobacco use, physical activity, and HRQoL, respectively.Key ResultsThirty of the 36 eligible resident physicians (83%) agreed to participate; 173 of their 415 eligible patients (42%) expressed interest in the study and 99 (24%) consented to participate. Compared to controls, a higher percentage of intervention patients reported initiating any discussion with their resident physician, although this difference was not statistically significant (40% vs. 27%; p = 0.12). For subgroup analyses regarding specific topics of discussion, patients in the intervention group reported initiating more discussions regarding mental HRQoL than controls (23% vs. 0%; p = 0.02). There was no difference in patient reports of initiating discussions regarding smoking, physical activity or physical HRQoL.ConclusionsProviding patients with immediate, personalized, guideline-based feedback prior to the clinical encounter can increase patient-initiated discussions regarding mental HRQoL. Future work should test FAST-Feedback in a larger population and evaluate the impact on tobacco cessation, increased physical activity, and improvements in HRQoL.

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