Whole-person assessments may not yet be suitable for general practice

1. In this systematic review, there was no single multipurpose approach for performing a whole-person assessment (WPA) that was suitable for implementation in general practice.

2. However, some WPAs, such as the health status graph assessment, Personalized Health Planning, and the Patient Perspective Survey, were considered suitable for specific purposes.

Evidence Rating Level: 1 (Excellent)

Whole-person assessments (WPA) may be superior to single-disease models in evaluating patients. The scope of WPA is broad, and many have argued that better approaches are required before they are used in practice. Currently, no study has evaluated the applicability of the WPA framework to general practice. As a result, the objective of the present systematic review was to identify clinical approaches to WPA and to determine if there were approaches suitable for implementation into general practice.

Of 7535 identified records, 59 (n=42 WPA methods) studies were included from various databases from inception to March 2020. Studies were included if they were published in English, included WPAs used to assess biological, physical, emotional, or psychological contexts, and involved patient-clinician interactions. Studies were excluded if they focused on cross-cultural or single-disease validation of tools or if the WPA approach was longer than 1 hour in length. The review was performed using PRISMA guidelines. Quality assessment was performed using the Johanna Briggs Institutes’ Checklist and Terwee’s criteria for validation studies. The primary outcome was the suitability of WPAs for general practice.

The results demonstrated that there was no appropriate and validated multipurpose WPA that would be ideal for implementation in general practice. However, the health status graph assessment, Personalized Health Planning, and the Patient Perspective Survey were found to be useful in eliciting patient perspectives and facilitating patient care planning. Despite these results, the study was limited by the lack of Indigenous perspectives, which may have impacted the generalizability of the findings. Nonetheless, the present study was the first to assess the suitability of WPAs for general practice.

Click to read the study in BMJ Open

Image: PD

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