Effectiveness of strategies for informing, educating, and involving patients

doi:10.1136/bmj.39246.581169.80

Search all BMJ comment articles:

From

Limit by

Our online table of contents is updated at least twice each day. Read all articles published in the last 7 days.
Rapid responses are electronic letters to the editor and new ones are published each day. Read latest responses.
The BMJ iPad app brings you the best of print and online, including live links to the latest news, blogs, video, and podcasts. Get the BMJ iPad app.
OPEN ACCESS: All research articles are freely available online, with no word limit. Find out more about the BMJ's open access policy. Submit your paper.

Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

Angela Coulter, chief executive1,
Jo Ellins, project manager (organisational development)2

¹Picker Institute Europe, King's Mead House, Oxford OX1 1RX
²The NHS Centre for Involvement, Vanguard Centre, University of Warwick, Coventry CV4 7AL

Correspondence to: angela.coulter{at}pickereurope.ac.uk

Accepted 28 April 2007

Evidence that strategies to strengthen patient engagement are effective is substantial, argue Angela Coulter and Jo Ellins, but any strategy to reduce health inequalities must promote health literacy

Policymakers increasingly believe that encouraging patients to play a more active role in their health care could improve quality, efficiency, and health outcomes. But critics have dismissed talk about patient engagement and patient centred care as political correctness—a misplaced concern with the “touchy feely” aspects of health care, with no scientific basis and little relevance to the quest for excellence in clinical care. Who is right? To what extent is the planned shift towards greater patient engagement supported by robust research evidence?

Engaging patients

Patient focused quality interventions recognise and try to support patients in actively securing appropriate, effective, safe, and responsive health care. Initiatives may aim to engage patients in their own or their family's individual clinical care, or they may try to involve the public in improving the responsiveness of health services. This article focuses on the first of these two initiatives (box 1).

Box 1 Patient focused quality interventions

To improve health literacy

Provision of printed leaflets and health information packages
Provision of computer based and internet health information
Targeted approaches to tackle low levels of health literacy in disadvantaged groups
Targeted mass media campaigns

To improve clinical decision making

Patient decision aids
Training for clinicians in communication skills
Coaching and question prompts for patients

To improve self care

Self management education
Self monitoring and self administered treatment
Self help groups and peer support
Patient access to personal medical information
Patient centred telecare

To improve patient safety

Information to help choose safe providers
Patient involvement in infection control
Encouraging adherence to treatment regimens
Checking records and care processes
Patient reporting of adverse drug events

Methods

As part of a wider research initiative to collate and synthesise research on performance, quality, and cost effectiveness in health care, we searched the literature for evidence on patient …