Can sharing clinic notes improve communication and promote self-management? A qualitative study of patients with COPD

Abstract

Objective: To understand the impact of sharing clinic notes on communication and self-management among patients with COPD and to develop recommendations for writing patient-centered notes.

Methods: Thirty patients with COPD participated in 'think-aloud' interviews in which they reviewed their COPD-specific clinic note. Interviews were coded using conventional content analysis, organized by the six-function communication framework.

Results: Participants were predominantly White (93.3%), with a mean age of 65.5 years. More than half had a high school degree or less, half reported difficulty understanding spoken information, and nearly half sometimes need help reading medical materials. Patients indicated notes provided an opportunity to learn details of their condition and facilitated information sharing - strengthening information exchange. Reading notes enabled self-management through motivation, prompting information seeking, and reminding them of action steps. Patients reacted positively to statements suggesting the provider listened to them, saw them as a person, and was attentive to details, which fostered the relationship. Most patients reacted negatively to medical terminology, incorrect information, and wording that was perceived as disparaging.

Conclusions: Sharing clinic notes with patients can promote information exchange, enable self-management, and strengthen the patient-provider relationship.

Practice implications: Incorporating patients' recommendations for writing notes could strengthen the benefits of sharing notes.

Keywords: Chronic obstructive pulmonary disease; Open Notes; Physician-patient communication; Self-management.