• Annals of family medicine · May 2022

    Randomized Controlled Trial

    A Virtual Community of Practice to Improve Primary Health Care Professionals' Attitudes Toward Patient Empowerment (e-MPODERA): A Cluster Randomized Trial.

    • Carola Orrego, Lilisbeth Perestelo-Pérez, Ana Isabel González-González, Marta Ballester-Santiago, Débora Koatz, Valeria Pacheco-Huergo, Amado Rivero-Santana, Vanesa Ramos-García, Nuria Mora Fernández, Alezandra Torres-Castaño, and Carlos Bermejo-Caja.
    • Avedis Donabedian Research Institute (FAD), Barcelona, Spain corrego@fadq.org.
    • Ann Fam Med. 2022 May 1; 20 (3): 204-210.

    PurposeWe aimed to evaluate the effectiveness of a virtual community of practice (vCoP) in improving primary health care professionals' (HCPs') attitudes toward empowering patients with chronic disease.MethodsWe conducted a cluster randomized controlled trial. Practices were units of randomization, and primary HCPs and patients were units of analysis. Sixty-three practices in Madrid, Catalonia, and the Canary Islands were randomly allocated to the intervention or control groups. Randominzation of practices was performed after HCP and patient recruitment. The patients and statistician were anonymized to group allocation; it was not possible to anonymize HCPs. The intervention was a 12-month multicomponent tailored vCoP built on the Web 2.0 concept and focused on skills toward patient empowerment. The primary outcome was Patient-Provider Orientation Scale (PPOS) score at baseline and at 12 months. The secondary outcome was the Patient Activation Measure (PAM) score.ResultsA total of 321 HCPs and 1,921 patients were assessed. The intervention had a positive effect on PPOS total score (0.14 points higher in the vCoP arm; 95% CI, 0.03-0.25; P = .011) and the PPOS Sharing subscale (0.3 points higher in the vCoP arm; 95% CI, 0.15-0.44; P < .001). No effect was found for the PPOS Caring subscale, and no significant differences were found for PAM scores.ConclusionsA vCoP led to a minor increase in the PPOS Sharing component and the total score but not in the Caring component. However, considerable uncertainty remains, given the observed attrition and other limitations of the study. Further research is needed on the effectiveness of the vCoP model and on how to improve HCP engagement.VISUAL ABSTRACT.© 2022 Annals of Family Medicine, Inc.

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