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Professional Intervention: Patient-mediated


New clinical information (not previously available) collected directly from patients and given to the provider e.g. depression scores from an instrument.


Three high quality (Archer, Bradley, Thomas) and two key reviews (Arnold, Grimshaw) were identified. While the results from the Grimshaw review showed that this intervention is effective for improving appropriate care behaviour, results from the Arnold review indicated it had mixed effects on improving appropriate care and prescribing behaviours. As well, when compared to continuity of care, Archer found this intervention to be generally ineffective. Two high quality reviews (Thomas, Bradley) had an insufficient number of studies to draw any conclusions about the intervention.

Summary of Overall Findings from Reviews

16 reviews that evaluated the effectiveness of patient-mediated interventions were identified. Of these, 1/3 high quality/key reviews with a sufficient number of studies to draw conclusions found this intervention to be generally effective.

Summary of Findings Related to Prescribing

0/2 high quality/key reviews with a sufficient number of studies to draw conclusions found this intervention to be generally effective for improving prescribing outcomes.

Reviews listed as "Summary Pending" will be analyzed, summarized and reported at a later date.

The findings will then be incorporated in the overall evidence summaries of the interventions they address.

Reviews Addressing This Intervention Quality Assessment Tool:
AMSTAR Score (of 11 points)
Archer J, Bower P, Gilbody S, Lovell K, Richards D, Gask L, Dickens C, Coventry P. Collaborative care for depression and anxiety problems. Cochrane Database of Systematic Reviews 2012 10:CD006525. 9 (High)
Bradley PM, Lindsay B. Care delivery and self-management strategies for adults with epilepsy. Cochrane Database of Systematic Reviews 2008 1:CD006244. 9 (High)
Thomas L, Cullum N, McColl E, Rousseau N, Soutter J, Steen N. Guidelines in professions allied to medicine. Cochrane Database of Systematic Reviews 2000 2:CD000349. 8 (High)
Arnold SR, Straus SE. Interventions to improve antibiotic prescribing practices in ambulatory care. Cochrane Database of Systematic Reviews 2005 4:CD003539. 7 (Medium)
Glynn LG, Murphy AW, Smith SM, Schroeder K, Fahey T. Interventions used to improve control of blood pressure in patients with hypertension. Cochrane Database of Systematic Reviews 2010 3:CD005182. 7 (Medium)
Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L, Whitty P, Eccles MP, Matowe L, Shirran L, Wensing M, Dijkstra R, Donaldson C. Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technology Assessment 2004 8 (6):iii-iiv. 7 (Medium)
Legare F, Turcotte S, Stacey D, Ratte S, Kryworuchko J, Graham ID. Patients' perceptions of sharing in decisions: a systematic review of interventions to enhance shared decision making in routine clinical practice. The Patient: Patient-Centered Outcomes Research 2012 5 (1):43466. 7 (Medium)
Smolders M, Laurant M, Roberge P, van Balkorn A, van Rijswijk E, Bower P, Grol R. Knowledge transfer and improvement of primary and ambulatory care for patients with anxiety. Canadian Journal of Psychiatry 2008 53 (5):277-93. 7 (Medium)
Brusamento S, Legido-Quigley H, Panteli D, Turk E, Knai C, Saliba V, Car J, McKee M, Busse R. Assessing the effectiveness of strategies to implement clinical guidelines for the management of chronic diseases at primary care level in EU Member States: a systematic review. Health Policy 2012 107 (41700):169-183. 6
Summary Pending
Ouwens M, Hulscher M, Hermens R, Faber M, Marres H, Wollersheim H, Grol R. Implementation of integrated care for patients with cancer: A systematic review of interventions and effects. International Journal for Quality in Health Care 2009 21 (2):137-44. 6 (Medium)
Ricci-Cabello I, Ruiz-Perez I, Nevot-Cordero A, Rodriguez-Barranco M, Sordo L, Goncalves DC. Health care interventions to improve the quality of diabetes care in African Americans: a systematic review and meta-analysis. Diabetes Care 2013 36 (3):760-768. 6
Summary Pending
Christensen A, Osterberg LG, Hansen EH. Electronic monitoring of patient adherence to oral antihypertensive medical treatment: a systematic review. Journal of Hypertension 2009 27 (8):1540-51. 5 (Medium)
Cleveringa FG, Gorter KJ, van den Donk M, van GJ, Rutten GE. Computerized decision support systems in primary care for type 2 diabetes patients only improve patients' outcomes when combined with feedback on performance and case management: a systematic review. Diabetes Technology & Therapeutics 2013 15 (2):180-192. 5
Summary Pending
Dijkstra R, Wensing M, Thomas R, Akkermans R, Braspenning J, Grimshaw J, Grol R. The relationship between organisational characteristics and the effects of clinical guidelines on medical performance in hospitals, a meta-analysis. BMC Health Services Research 2006 6:53. 5 (Medium)
Espallargues M, Valderas JM, Alonso J. Provision of feedback on perceived health status to health care professionals: a systematic review of its impact. Medical Care 2000 38 (2):175-86. 5 (Medium)
Omboni S, Guarda A. Impact of home blood pressure telemonitoring and blood pressure control: A meta-analysis of randomized controlled studies. American Journal of Hypertension 2011 24 (9):989-998. 5 (Medium)
Balas E, Krishna S, Kretschmer R, Cheek T, Lobach D, Boren S. Computerized knowledge management in diabetes care. Medical Care 2004 42 (6):610-21. 4 (Medium)
Katz EB, Carrier ER, Umscheid CA, Pines JM. Comparative effectiveness of care coordination interventions in the emergency department: a systematic review. Annals of Emergency Medicine 2012 60 (1):45261. 4
Summary Pending
Ostini R, Hegney D, Jackson C, Williamson M, Mackson JM, Gurman K, Hall W, Tett SE. Systematic review of interventions to improve prescribing. Annals of Pharmacotherapy 2009 43 (3):502-13. 4 (Medium)
van Steenkiste B, Grol R, van der Weijden T. Systematic review of implementation strategies for risk tables in the prevention of cardiovascular diseases. Vascular Health and Risk Management 2008 4 (3):535-45. 4 (Medium)
Alsaleh K. Routine administration of standardized questionnaires that assess aspects of patients' quality of life in medical oncology clinics: a systematic review. Journal of Egyptian National Cancer Institute 2013 25 (2):63-70. Summary Pending