# The impact of sharing audio recorded clinic visits on self-management in older adults: a multisite trial

> **NIH NIH R56** · DARTMOUTH COLLEGE · 2020 · $756,134

## Abstract

PROJECT SUMMARY
Up to eighty percent of clinic visit information is forgotten by patients immediately post visit. This is a significant
barrier to self-management, especially in older adults with multimorbidity leading to poor health outcomes.
After visit summaries (AVS) can improve recall, yet concerns exist about their layout, accuracy and low patient
uptake. Patients and clinicians have begun audio recording clinic visits. When patients receive an audio
recording of the visit, 71% listen and 68% share it with a caregiver, resulting in greater recall. Despite its
growing use, to date there is no research on the impact of recording and sharing clinic visits of patient self-
management ability, health outcomes or healthcare utilization. The objective of this proposal is to conduct a
multi-site trial evaluating the impact of adding an audio recording of clinic visits (AUDIO) to usual care in older
adults with multimorbidity, compared to AVS alone (Usual Care; UC). The specific aims are: Aim 1 Conduct a
three-site trial in primary care where older patients with multimorbidity (n=540) will be randomized to receive an
AVS plus audio recording (AUDIO) versus AVS alone (UC) for all scheduled clinic visits over 12 months;
patients will be assessed at baseline, 1 week, 6 months and 12 months; Aim 2 Investigate and describe
barriers and facilitators of the implementation of audio recordings among patients, caregivers, clinicians and
clinic staff. Applicants hypothesize: (1a) Compared to those receiving the AVS alone (UC), patients
randomized to also receive audio recordings (AUDIO) of clinic visits will report a greater self-management
ability (measured by the Patient Activation Measure–Short Form) at 12 months. Applicants will also explore the
impact of AUDIO on the clinic visit, health outcomes, healthcare utilization and whether these impacts are
mediated by PAM-SF; (1b) The effect of AUDIO on self-management compared to UC will be greater for
patients with low health literacy than for those with high health literacy. Applicants will explore whether the
impact of audio recordings is greater for individuals with caregiver support or at highest risk of poor self-
management, e.g., high disease burden, moderate to severe depression. In Aim 2, applicants will investigate
factors related to the implementation of audio recording and develop recommendations for an implementation
toolkit to guide future dissemination of recording. The research is innovative because: i) it seeks to shift current
clinical practice where visit information is provided via AVS, by adding audio recording; ii) the routine provision
of visit recordings over time moves beyond prior studies that focus on single recordings of specialty visits; and
iii) a trial in real-world settings of patients with multimorbidity, regularly excluded from trials, is novel and has
greater external validity. The results are expected to have a major positive impact as they will increase clinical
understandi...

## Key facts

- **NIH application ID:** 10017803
- **Project number:** 5R56AG061522-02
- **Recipient organization:** DARTMOUTH COLLEGE
- **Principal Investigator:** PAUL JAMES BARR
- **Activity code:** R56 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $756,134
- **Award type:** 5
- **Project period:** 2019-09-15 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10017803

## Citation

> US National Institutes of Health, RePORTER application 10017803, The impact of sharing audio recorded clinic visits on self-management in older adults: a multisite trial (5R56AG061522-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10017803. Licensed CC0.

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