Research paper Digital audio recordings improve the outcomes of patient consultations: A randomised cluster trial Maiken Wolderslund a,b, *, Poul-Erik Kofoed b,c , René Holst b , Mette Axboe a , Jette Ammentorp a,b a Health Services Research Unit, Lillebaelt Hospital, Vejle, Denmark b Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark c Department of Paediatrics, Lillebaelt Hospital, Kolding, Denmark A R T I C L E I N F O Article history: Received 22 February 2016 Received in revised form 26 August 2016 Accepted 28 August 2016 Keywords: Digital audio recording Consultation recordings Question prompt list Patient communication aids Outpatients Health communication Information level A B S T R A C T Objectives: To investigate the effects on patients’ outcome of the consultations when provided with: a Digital Audio Recording (DAR) of the consultation and a Question Prompt List (QPL). Methods: This is a three-armed randomised controlled cluster trial. One group of patients received standard care, while the other two groups received either the QPL in combination with a recording of their consultation or only the recording. Patients from four outpatient clinics participated: Paediatric, Orthopaedic, Internal Medicine, and Urology. The effects were evaluated by patient-administered questionnaires. Results: A total of 4349 patients participated in the study. DAR significantly increased the probability of fulfilling the participants’ self-perceived information needs by 4.1% to 6.3%, particularly with regard to test results (OR = 1.41, 95%CI: 1.14-1.74, p = 0.001) and treatment options (OR = 1.39, 95%CI: 1.13-1.71, p = 0.002). Additionally, the interventions positively influenced the participants’ satisfaction with the treatment, their relationship with the health professional, and their experience of being involved in the decision-making. Conclusion: Providing outpatients with a QPL and DAR of their consultation positively influences the patients’ perception of having adequate information after the consultation. Practice implications: The implementation of a QPL and audio recording of consultations should be considered in routine practice. ã 2016 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Communication between patients and health professionals is a cornerstone in modern healthcare and is a necessity for adequate treatment as well as a positive patient experience. As in other Western countries [1,2], the Danish Healthcare System encourages patients to participate in decision-making [3] and patients often request involvement in decision-making concerning their care [4]. To facilitate successful participation in decision making, some basic assumptions must be met: patients need to receive relevant and sufficient information, understand and retain complex information [5], and evaluate and employ this in their communication with health professionals [6]. Despite government policies and legal rights on patient information and participation [7], communication aspects constitute a considerable part of patient complaints [8]. Along with the results from healthcare evaluations [9], patient complaints reveal a potential gap between the information given by health professionals and patients’ understandings. A simple explanation could be that patients tend to forget a considerable amount of the medical information provided [5]. Disadvantageous circumstances caused by the disease itself or stressful information might also be a factor. In recent years, several initiatives have been made to improve the communication between patients and health professionals. Some research focused on health professionals, identified a positive impact of communication skills training [10,11]. Other studies have focused on improving patients’ skills and knowledge, e.g., through preparation prior to the consultation [12,13], provision of access to different information sources after the consultation such as summary letters [14], or by giving take-home audio recordings * Corresponding author at: Health Services Research Unit, Lillebaelt Hospital, Kabbeltoft 25, Bygning S100, DK-7100 Vejle, Denmark. E-mail addresses: Maiken.Wolderslund@rsyd.dk (M. Wolderslund), Poul.Erik.Kofoed@rsyd.dk (P.-E. Kofoed), rholst@health.sdu.dk (R. Holst), mette@axboe.dk (M. Axboe), Jette.Ammentorp@rsyd.dk (J. Ammentorp). http://dx.doi.org/10.1016/j.pec.2016.08.029 0738-3991/ã 2016 Elsevier Ireland Ltd. All rights reserved. Patient Education and Counseling xxx (2016) xxx–xxx G Model PEC 5447 No. of Pages 8 Please cite this article in press as: M. Wolderslund, et al., Digital audio recordings improve the outcomes of patient consultations: A randomised cluster trial, Patient Educ Couns (2016), http://dx.doi.org/10.1016/j.pec.2016.08.029 Contents lists available at ScienceDirect Patient Education and Counseling journal homepage: www.else vie r.com/locate /pateducou