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Abstract
Objective: To systematically study the effects of shared medical appointments (SMAs) compared with individual appointments for patients with a chronic neuromuscular disorder and their partners.
Methods: In this randomized controlled trial with a follow-up of 6 months, we included patients with a chronic neuromuscular disorder and their partners. Participants were randomly allocated to an SMA or an individual outpatient appointment. The primary outcome measure was patients' health-related quality of life (QOL) (36-Item Short Form Health Survey). Secondary outcome measures included self-efficacy, social support, patient and partner satisfaction with the appointment, and time available per patient.
Results: Two hundred seventy-two patients and 149 partners were included. Health-related QOL showed greater improvement in patients who had attended an SMA (mean difference 2.8 points, 95% confidence interval 0.0–5.7, p = 0.05). Secondary outcomes showed small improvements in the control group for satisfaction with the appointment (p = 0.01). Neurologists spent less time per patient during the SMAs: mean 16 minutes (range 11–30) vs 25 minutes (range 20–30) for individual appointments.
Conclusions: This study provides evidence that SMAs can improve aspects of QOL of patients with a chronic neuromuscular disorder. This could result in an alternative to individual appointments and improvements in both effectiveness and efficiency. Further research to optimize SMAs and to identify critical success factors seems warranted. These data extend evidence on SMAs for neurologic patients.
Classification of evidence: This study provides Class III evidence that for patients with chronic neuromuscular disorders, SMAs improve QOL as compared with individual medical appointments.
GLOSSARY
- CONSORT=
- Consolidated Standards of Reporting Trials;
- EQ-5D=
- EuroQOL 5 dimensions questionnaire;
- HRQOL=
- health-related quality of life;
- INQoL=
- Individualized Neuromuscular Quality of Life Questionnaire;
- QOL=
- quality of life;
- QUOTE=
- QUality Of care Through the patient's Eyes;
- RCT=
- randomized controlled trial;
- SF-36=
- 36-Item Short Form Health Survey;
- SMA=
- shared medical appointment;
- VAS=
- visual analog scale
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
↵* These authors contributed equally to this work.
Supplemental data at Neurology.org
- Received July 4, 2013.
- Accepted in final form April 14, 2014.
- © 2014 American Academy of Neurology
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