Using Action Plans to Help Primary Care Patients Adopt Healthy Behaviors: A Descriptive Study
Margaret Handley, PhD, MPH; Kate MacGregor, MPH; Dean Schillinger, MD; Claire Sharifi; Sharon Wong, MPH; Thomas Bodenheimer, MD
J Am Board Fam Med. 2006;19(3):224-231. ©2006 American Board of Family Medicine
Posted 06/05/2006
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An Action Plan, as defined in this article, is “an agreement between clinician and patient that the patient will make a specific behavior change.”
Regardless of the name given to this process, action plan, contract, agreement, etc., it has proven a seductive notion in healthcare. In the treatment of asthma, for example, contracts appear to be accepted as fundamental to effective therapy. In contrast, there is a dearth of reserch supporting the use of “no-suicide contracts” in psychiatry.1
The results presented in this study follow:
- 83% of the 228 patients in the study made an action plan during a primary care visit.
- 79% recalled making the action plan when interviewed by telephone 3 weeks later
- Of these, 56% recalled the details of their action plan and another 33% recalled the general nature of the action plan
- 53% of patients making an action plan reported making a behavior change consistent with that action plan.
Commentary
While these findings appear encouraging, they are limited by their dependence on the patients’ self-report, a notoriously unreliable methodology in the assessment of medical compliance. Most significantly, the end point of the study, as the authors point out, was limited to the questions of “whether patients remembered discussing an action plan with their clinician” and, if so, how much they recalled about the plan and if they reported carrying it out. The study did not address the actual effectiveness of action plans to bring about positive behavioral change.
Footnotes
__________- Are No-Suicide Contracts Effective in Preventing Suicide in Suicidal Patients Seen by Primary Care Physicians?
Katherine T. Kelly, PhD; Mark P. Knudson, MD, MSPH, Fam Med. 2000;9:1119-1121.↩
