Introduction

Welcome to the March newsletter of the Cochrane Consumers and Communication Group.  We deliver e-newsletters every three months, outlining our latest reviews and other activities.  We welcome your feedback.

Health literacy consultation in Victoria

The Department of Health Victoria, Australia has released a Consultation Paper, Health literacy: enabling communication and participation in health. This is the basis of seven workshops being run around the state with consumers, carers, health professionals, healthcare organisations and key stakeholder groups. Through this process it will seek to:
•         establish key health information and literacy priorities
•         identify tools and resources to improve consumer health information
•         Identify strategies and partnerships to improve the health literacy of communities and healthcare organisations.   
Sophie Hill, Lidia Horvat and Genevieve O’Neill are facilitating the workshops. A copy of the paper can be found at: http://docs.health.vic.gov.au/docs/doc/Health-literacy-enabling-communication-and-participation-in-health.

Staff and editor news

• Congratulations to our Coordinating Editor Dr Sophie Hill on her recent appointment to the role of Head, Department of Public Health in the Faculty of Health Sciences at La Trobe University.
• The Review Group's Managing Editor Dr Megan Prictor will be on maternity leave from mid April 2014 to mid June 2015.  Her replacement will be Dr Sue Cole, who can be contacted at sue.cole@latrobe.edu.au
• We welcome a new statistics editor to our team, Dr Gian Luca di Tanna, who is based at the London School of Hygiene and Tropical Medicine. 

Details of all our Review Group staff and editors can be found at /staff-and-editors

Now on Twitter

The Consumers and Communication Group not only launched a new website in 2013, we also joined the Twitter community.  Follow us on twitter @cochraneccrg

Have you seen our website: Navigating Effective Treatments using Cochrane Systematic Reviews?

A simple online toolkit to help you understand and develop the skills to explore health research.  Our straightforward diagrams of systematic reviews are available for re-use under a Creative Commons licence.

Recent reviews and updates

Interventions for improving patients' trust in doctors and groups of doctors,

by Rolfe A, Cash-Gibson L, Car J,  Sheikh A and McKinstry B.  Updated on the Cochrane Database of Systematic Reviews 2014, Issue 3. DOI: 10.1002/14651858.CD004134.pub3.

Trust is a fundamental part of a patient-doctor relationship, and is associated with increased patient satisfaction, adherence to treatment, and continuity of care, although blind trust may on occasion facilitate poor care.The authors wished to know if there are effective ways of enhancing patient trust in doctors, by involving doctors (e.g. training) or patients (e.g. by providing information).

They searched a wide variety of databases on 18 March 2013 and identified 10 diverse studies, all randomised controlled clinical trials, with 11,063 participants, that met the review's inclusion criteria. Seven of the trials were new for this update. Overall, they did not provide sufficient evidence that a specific intervention affects trust. All were undertaken in the United States. Two were government funded, while seven were funded by charitable trusts and one by a Health Maintenance Organisation (HMO).

Interventions were of three main types; three employed additional physician training, four were education for patients and three provided additional information about doctors in terms of financial incentives or consulting style.

Two trialled physician training interventions to improve behaviours known to be associated with trust. The interventions showed no change in the patients' trust in their physician. The third trial showed that training oncologists in communication skills resulted in a small increase in trust.

For more information see https://summaries.cochrane.org/CD004134/interventions-for-improving-patients-trust-in-doctors-and-groups-of-doctors

Decision aids for people facing health treatment or screening decisions

by Stacey D, Légaré F, Col NF, Bennett CL, Barry MJ, Eden KB, Holmes-Rovner M, et al. Updated on the Cochrane Database of Systematic Reviews 2014 , Issue 1 . Art.No.: CD001431. DOI: 10.1002/14651858.CD001431.pub4

Identifying and making a decision about the best health treatment or screening option can be difficult for patients. Decision aids can be used when there is more than one reasonable option, when no option has a clear advantage in terms of health outcomes, and when each option has benefits and harms that patients may value differently. Decision aids may be pamphlets, videos, or web-based tools. They make the decision explicit, describe the options available, and help people to understand these options as well as their possible benefits and harms. This helps patients to consider the options from a personal view (e.g., how important the possible benefits and harms are to them) and helps them to participate with their health practitioner in making a decision.

The updated review searched to June 2012 includes 115 studies involving 34,444 participants. Findings show that when patients use decision aids they: a) improve their knowledge of the options (high-quality evidence); b) feel more informed and more clear about what matters most to them (high-quality evidence); c) have more accurate expectations of possible benefits and harms of their options (moderate-quality evidence); and d) participate more in decision making (moderate-quality evidence). Patients who used decision aids that included an exercise to help them clarify what matters most to them, were more likely to reach decisions that were consistent with their values. However, the quality of the evidence was moderate for this outcome meaning that further research may change these findings. Decision aids reduce the choice of prostate specific antigen testing and elective surgery when patients consider other options. They have a variable effect on most other actual choices. Decision aids improve communication between patients and their health practitioner. More detailed decision aids are better than simple decision aids for improving people's knowledge and lowering decisional conflict related to feeling uninformed and unclear about their personal values. Decision aids do not worsen health outcomes and people using them are not less satisfied. More research is needed to evaluate adherence with the chosen option, the associated costs, use with patients who have more limited reading skills, and the level of detail needed in a decision aid.

Reviews and updates coming soon:

• Audio-visual presentation of information for informed consent for participation in clinical trials (updated review)
• Cultural competence education for health professionals (new review)
• Interventions to improve safe and effective medicines use by consumers: an overview of systematic reviews (updated overview)

An African collaboration to enhance research-use in public policy - a research report by editor Prof. Ruth Stewart

A team from the University of Johannesburg led by Prof Ruth Stewart has been successful in its collaborative proposal to the UK’s Department for International Development (DFID) in response to a call for tenders to build capacity in using research evidence. The University is working with a network of partners from across Africa, including the South African Cochrane Centre, the Centre for Evidence-Based Health Care, the International Initiative for Impact Evaluation (3ie), the EPPI-Centre and many others. Our goal is to increase the use of evidence in decision-making in the governments of Malawi and South Africa, with an emphasis on systematic review evidence and the principles of rigour and transparency which underlie SRs. In early 2014 we began our inception year, conducting landscape reviews and needs assessments, developing resources and building networks. Our capacity-building programme will employ a mentorship-based model, with practical workshops, mentorships and secondments. We will also engage with a wider community of practice across Africa building and supporting the Africa Evidence Network (www.africaevidencenetwork.org), with two conferences in Johannesburg during the 3-years of the project. We hope this work will engage a broad community of evidence-producers and users, and play a key role in increasing both the production and use of systematic reviews across the region.

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