Implementation and evaluation of patient-centred care in experimental studies from 2000-2010: systematic review

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Salman Rawaf
Federica Amati
Andrea McDonald
Azeem Majeed
Elizabeth Dubois


Background: Key areas have been identified in the British National Health Service where patient-centred care is not achieved. Although patient-centred care is an effective as well as an innovative way to improve multiple aspects of health services, it is unclear how exactly it should be defined and thus how it should be implemented and evaluated.Objective: To investigate how patient-centred care interventions are currently implemented and evaluated in experimental studies and to determine whether there have been any recent developments in the approach. Methods: A systematic literature review was conducted to identify experimental studies investigating the impact of patient-centred care on outcomes including clinical indicators and patient satisfaction scores. Studies were required to have a suitable control or comparison group and be published between August 2000 and July 2010.Results: Each of the eligible studies used different methods to implement and evaluate patient-centred care. Study quality was mixed and although there was frequently statistical significance, several studies lacked clinical relevance. Patients did not appear to be involved in designing the implementation or evaluation of patient-centred care.Conclusion: The standardisation of a patient-centred approach will make the implementation and evaluation of a future patient-centred NHS a much more achievable goal. A combination of study methods is required and any attempt at a consensus of patient-centred care indicators must include input from patients.

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Author Biographies

Salman Rawaf, WHO Centre at Imperial College London; and St George’s University of London

Salman Rawaf qualified in medicine with subsequent training in paediatrics and public health. Professor Rawaf until January 2009 was the Director of Public Health in NHS Wandsworth, London: a post which he held since 1988 in South West London. He is currently Professor of Public Health and Director of WHO Centre at Imperial College London, Hon. Professor of Public Health at the Middlesex University, Hon Professor of Primary care at Ghent University Belgium, and Senior Lecturer at St George’s University of London. He serves on many national and international committees and groups. He has published more than 120 scientific papers, 2 books (Assessing Health Needs RCP Publishing Group, and Health Improvement Programmes RSM Publishers) and many international reports. He is the Founder and Editor-in-Chief of the journal Public Health Medicine and a member of other editorial boards. He is well known for his international work and his contribution to global health. He is an adviser to the WHO on primary care, public health, health system and medical education. He has been invited to undertake many international assignments in many countries around the world.Professor Rawaf is a Fellow of the Royal Colleges of Physicians London and the UK Faculty of Public Health and Member of the Faculty of Public Health Medicine Ireland. He is the Chair of the International Committee, Faculty of Public Health UK, Executive Member of the International Committee of the Academy of the Royal Medical Colleges, Council Member of Chelsea and Westminster Hospital Foundation Trust, Member of WHO Advisory Committee for Health research, and Programme Leader of the Postgraduate Diploma/MSc in Family Medicine Middlesex University. His contributions to public health and primary care in research and service delivery are well documented. Among the many innovative approaches are young people and addictive behaviour and Staying Healthy: a programme to assess risk factors for chronic diseases in community settings and enable individuals to engage in their own health. Since started his work in 1988 in South West London as a Director of Public Health, he and his team received many awards and recognitions for the works to improve health. At International level is well recognised in his work supporting countries in strengthening their health system including primary and public health. He runs well renowned training programme of health system development both in and outside the UK.   

Federica Amati, Imperial College, London UK

Postgraduate Student, Imperial College, London UK


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