Informing patients about laboratory results within the framework of patient empowerment.

Patient empowerment fits the trend that patients want to be better informed.
This applies equally to the results of laboratory testing. Patients want to
know which tests are done and why, and what the results of the tests mean. From
a small survey among patients in which a blood sample was taken, it was shown
that 82% of them would like to receive a copy of the results. This indicates
that there is great need among patients for information with regard to
laboratory tests. The Dutch Diabetes Association (DVN) and the Dutch Federation
of Patients and Consumers (NPCF) both endorse this need and are supporting this
development. However, the provision of laboratory results by the laboratory to
the patient is currently not a common practice in the Netherlands. In other
countries such as Italy, France and Hungary, this is already a routine
procedure.

An important initiative concerns the possibility for patients to ask questions
to laboratory specialists (via the NVKC website). In the UMC St. Radboud
(third line hospital) in Nijmegen it is possible for patients to view parts of
their medical record, including laboratory results, via a secure website. There
is also much attention in other countries with respect to the involvement of
patients with all aspects of health care. In addition, there is growing
evidence showing that patient empowerment can contribute to an improvement of
the treatment, especially in patients with a chronic disease. Recent European
studies have shown that patient empowerment results in increased satisfaction
among patients and healthcare professionals, a better application of guidelines
and/or treatment advice, and an improvement in clinical outcome .

The innovative aspect of the current project is informing patients which were
referred from primary care for blood tests, by the laboratory. By giving
patients access to their results the control over their treatment will be
enhanced, resulting in an increase in patient satisfaction. Finally, a patient
who is well informed about his/her own health is often better motivated to
follow certain advice/treatment. This improves the quality of care of the
patient.

The objectives of the study are:

1) to give the laboratory a role in informing patients about their laboratory
results, in order to meet the information needs of the patient
2) to provide patients with validated (background) information with respect to
their laboratory results.

The study is an open, randomized parallel study.

Four general practitioners (GPs) in the neighbourhood of **the Atrium Medical
Center Parkstad, Heerlen will cooperate in the study. If blood tests are
requested in a patient, his/her GP will explain briefly the objectives of the
study. The patient will be given written information about the study. In case
of agreement (optionally after a reflection period of one to several days),
the patient signs the informed consent form. The GP ticks on a box on the
regular application form for blood testing, in case the patient wants to
receive the results. The GP will receive the laboratory results of
participating patient first, including an interpretative comments and links to
additional information. If the GP agrees, the patient receives the same data
(results, comments and information) by post.

In the study, 40 patients (10 per participating GP) will be informed about
their laboratory results. Then patients will be interviewed to determine how
they perceive this process. All participating GPs will be interviewed twice:
before and after the study.

Burden and risks of participation in the study are minimal, since patients
nowadays can receive a copy of their laboratory results. In addition,
interpretive comments will be added to the results as well as links to reliable
(background) information. Finally, the data are first sent to the GP, and only
after approval also to the patient.