January 1, 2013Applied Clinical InformaticsOpen Access

Novel Computerized Health Risk Appraisal May Improve Longitudinal Health and Wellness in Primary Care

Q: What is the clinical evidence from this study?

Study design: Other. Population: Primary care (n=200). Intervention: Web-based Health Risk Appraisal (HRA) tool vs. Control (HRA questionnaire without feedback report). Primary outcome: Better self-rated overall health (OR 4.94, 95% CI 3.85-6.36).

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Key result

A comprehensive, web-based Health Risk Appraisal tool was strongly associated with better self-rated overall health (OR 4.94) and improved up-to-dateness for preventive services in primary care patients.

Why the study?

Does a comprehensive, web-based Health Risk Appraisal (HRA) tool improve the receipt of preventive services, patient-centeredness of care, and wellness indicators in primary care patients?

Population

200 primarily middle-aged and older adults with multiple health conditions from four pair-matched primary…

Comparison

A novel, web-based Health Risk Appraisal tool… vs Completed the HRA questionnaire and a…

Design

Cohort

Follow-up

12 months

Authors

VVViola Voncken-BrewsterMaastricht University Medical Centre CACheryl B. AspyUniversity of Central Oklahoma JMJim MoldUniversity of Oklahoma Health Sciences Center

Discussion

Member takes

Implication

Does not support routine HRA adoption; leaves open efficacy pending randomized trials.

Structured PICO

Does a comprehensive, web-based Health Risk Appraisal (HRA) tool improve the receipt of preventive services, patient-centeredness of care, and wellness indicators in primary care patients?

Population

200 middle-aged and older adults with multiple health conditions in primary care practices, followed for 12 months to evaluate a novel computerized health risk appraisal tool.

Intervention

A novel, web-based Health Risk Appraisal (HRA) tool providing detailed feedback, estimated life expectancy, Real Age, Wellness Score, and a prioritized list of tailored recommendations for preventive care, discussed at an annual wellness visit.

Comparator

Completed the HRA questionnaire and a self-administered survey, but did not receive an HRA report.

Outcome

Estimated life expectancy and its derivatives (Real Age and Wellness Score), overall rate of 10 preventive maneuvers, and patient-centeredness of care (CAHPS PCC-10 survey) at 12 months.patient reported

Main Result

Odds Ratio: 4.94 (95% CI 3.85–6.36)

A comprehensive, web-based, and goal-directed HRA tool can improve the receipt of preventive services, patient-centeredness of care, behavioral health outcomes, and various wellness indicators in primary care settings.

Limitations

Insufficient power to draw unequivocal conclusions (pilot study)
Self-reported outcomes not corroborated by medical record abstractions
Potential response bias from using the same instruments pre- and post-implementation
Sample tended to be more Caucasian, educated, and female
Self-selection bias (less healthy persons may tend to be seen and/or sign up for an HRA in the context of primary care)

Cite This Study

Voncken-Brewster et al. (2013) studied Primary care (n=200). Web-based Health Risk Appraisal (HRA) tool vs. Control (HRA questionnaire without feedback report) was evaluated on Better self-rated overall health (OR 4.94, 95% CI 3.85-6.36). A comprehensive, web-based Health Risk Appraisal tool was strongly associated with better self-rated overall health (OR 4.94) and improved up-to-dateness for preventive services in primary care patients.

synapsesocial.com/papers/6a220fa24d10104e8b4e998b https://doi.org/10.4338/aci-2012-10-ra-0048

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