The feasibility of sharing digital audio-recordings of clinic visits online with older adults in primary care settings: A multisite trial.

The trial was designed to test feasibility and acceptability. It was not powered to detect significant differences in exploratory health outcomes. Most participants were White, female, and non-Hispanic, and all needed email access, so the results may not apply to more diverse older adults or those without email. Patients with cognitive impairment, uncorrectable hearing or vision problems, certain mental health or substance-use conditions, skilled nursing home or hospice residence, or recent personal visit recording were excluded. Of 420 patients approached, 137 declined and 65 could not be reached. The paper cannot separate lack of interest in recording from lack of interest in research. Research assistants knew group assignment during assessments, although approximately 69% of patients completed assessments independently online. Interviews were conducted only with patients and clinicians from the recording group, so usual-care clinician views were not captured. The higher mental health score was an exploratory finding, and other exploratory outcomes showed no difference. Only eight patients had a follow-up visit during data collection, so pre-visit listening reminders were poorly tested.

No funding or conflict-of-interest declaration is reported in the supplied text. The recording application, HealthPAL, was developed by one author.

Do not read the higher PROMIS Mental score as proof that visit recordings improve mental health. The trial was not powered for exploratory outcomes, the recording group also received usual care, and no differences were observed for other exploratory measures. The study cannot separate the contribution of recordings from usual care.