scholarly journals Health Self-Efficacy Among Populations with Multiple Chronic Conditions: the Value of Patient-Centered Communication

2016 ◽  
Vol 33 (8) ◽  
pp. 1440-1451 ◽  
Author(s):  
Lila J. Finney Rutten ◽  
Bradford W. Hesse ◽  
Jennifer L. St. Sauver ◽  
Patrick Wilson ◽  
Neetu Chawla ◽  
...  
Keyword(s):  
Self Efficacy ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions ◽  
Patient Centered

GPS' PERCEPTION OF THE PATIENT ORIENTED INTERVENTIONS AS KEY ELEMENTS OF PATIENT CENTRED CARE FOR PEOPLE WITH MULTIMORBIDITY.pdf

2018 ◽  
Vol 28 (2) ◽  
pp. 561-565
Author(s):  
Radost Assenova ◽  
Levena Kireva ◽  
Gergana Foreva
Keyword(s):  
Chronic Conditions ◽  
Patient Centered Care ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Positive Health ◽  
Patient Centered ◽  
Effective Response ◽  
Patient Centred Care ◽  
Centered Care ◽  
Health Related

Background: Patients with multimorbidity represent a significant portion of the primary healthcare population. For healthcare providers, managing patients with multiple chronic conditions represents a challenge given the complexity and the intensity of interventions. Integrated and patient-centered care is considered an effective response to the needs of people who suffer from multiple chronic conditions. According to the literature providing patient-centered care is one of the most important interventions in terms of positive health-related outcomes for patients with multimorbidity.Aim: The aim of the study is to evaluate the GPs’ perception of patient oriented interventions as key elements of patient centred care for patients with multimorbidity.Material and methods: A cross-sectional pilot study was conducted among randomly selected 73 GPs. A direct individual anonymous survey was performed to explore the opinion of respondents about the importance of two patient-oriented interventions, each one including specific elements of patient-centered care for patients with multimorbidity. The tool was developed as a result of the scoping review performed by Smith et al. (2012;2016). A 5-point Likert scale (0-not at all, 1-little, 2-rather, 3-much, 4-very strong) was used. The data were analysed using descriptive statistics. In processing the data, the software product for statistical analyses - SPSS version 17 was performed for Windows XP.Results: Our results show that both categories - providing patient-oriented approach and self-management support interventions were highly accessed by the respondents. The most frequent categories of interventions identified in our study were Creating individualized and adapted interventions, Performing regular contacts and Reinforcing adherence. Less frequently reported elements such as Considering relatives’ needs and Developing self-management plan are still underestimated by the Bulgarian GPs.Conclusions: The acceptance and understanding of innovative patient-centered interventions adapted to patients with multimorbidity could be accepted as a good indicator for improving health-related outcomes and care for patients with multiple chronic conditions.

scholarly journals Innovative Strategies to Facilitate Patient-Centered Research in Multiple Chronic Conditions

2021 ◽  
Vol 10 (10) ◽  
pp. 2112
Author(s):  
Tullika Garg ◽  
Courtney A. Polenick ◽  
Nancy Schoenborn ◽  
Jane Jih ◽  
Alexandra Hajduk ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Clinical Care ◽  
Intervention Development ◽  
Healthcare Services ◽  
Multiple Chronic Conditions ◽  
Patient Centered ◽  
Older Americans ◽  
Innovative Strategies ◽  
Department Of Health ◽  
Innovative Methods

Multiple chronic conditions (MCC) are one of today’s most pressing healthcare concerns, affecting 25% of all Americans and 75% of older Americans. Clinical care for individuals with MCC is often complex, condition-centric, and poorly coordinated across multiple specialties and healthcare services. There is an urgent need for innovative patient-centered research and intervention development to address the unique needs of the growing population of individuals with MCC. In this commentary, we describe innovative methods and strategies to conduct patient-centered MCC research guided by the goals and objectives in the Department of Health and Human Services MCC Strategic Framework. We describe methods to (1) increase the external validity of trials for individuals with MCC; (2) study MCC epidemiology; (3) engage clinicians, communities, and patients into MCC research; and (4) address health equity to eliminate disparities.

scholarly journals Improving the External Validity of Clinical Trials: The Case of Multiple Chronic Conditions

2013 ◽  
Vol 3 (2) ◽  
pp. 30-35 ◽  
Author(s):  
Fortin Martin ◽  
Smith M. Susan
Keyword(s):  
Clinical Trials ◽  
External Validity ◽  
Chronic Conditions ◽  
Evidence Base ◽  
Specific Reference ◽  
Multiple Chronic Conditions ◽  
Patient Centered ◽  
Department Of Health ◽  
Patient Groups ◽  
Intervention Trials

The U.S. Department of Health and Human Services vision and strategic framework on multiple chronic conditions (MCCs) incorporates recommendations designed to facilitate research that will improve our knowledge about interventions and systems that will benefit individuals with MCCs (or multimorbidity). The evidence base supporting the management of patients with MCCs will be built through intervention trials specifically designed to address multimorbidity and identification of MCCs in participants across the clinical trial range. This article specifically focuses on issues relating to external validity with specific reference to trials involving patients with MCCs. The exclusion of such patients from clinical trials has been well documented. Randomized control trials (RCTs) are considered the “gold standard” of evidence, but may have drawbacks in relation to external validity, particularly in relation to multimorbidity. It may, therefore, be necessary to consider a broader range of research methods that can provide converging evidence on intervention effects to address MCCs. Approaches can also be taken to increase the usefulness of RCTs in general for providing evidence to inform multimorbidity management. Additional improvements to RCTs would include better reporting of inclusion and exclusion criteria and participant characteristics in relation to MCCs. New trials should be considered in terms of how they will add to the existing evidence base and should inform how interventions may work in different settings and patient groups. Research on treatments and interventions for patients with MCCs is badly needed. It is important that this research includes patient-centered measures and that generalizability issues be explicitly addressed.

scholarly journals Crafting Care That Fits: Workload and Capacity Assessments Complementing Decision Aids in Implementing Shared Decision Making (Preprint)

2019 ◽  
Author(s):  
Thomas H Wieringa ◽  
Manuel F Sanchez-Herrera ◽  
Nataly R Espinoza ◽  
Viet-Thi Tran ◽  
Kasey Boehmer
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Chronic Conditions ◽  
Decision Aids ◽  
Multiple Chronic Conditions ◽  
Shared Decision ◽  
Patient Centered ◽  
Patient Goals ◽  
Minimally Disruptive Medicine ◽  
Workload Capacity

UNSTRUCTURED About 42% of adults have one or more chronic conditions and 23% have multiple chronic conditions. The coordination and integration of services for the management of patients living with multimorbidity is important for care to be efficient, safe, and less burdensome. Minimally disruptive medicine may optimize this coordination and integration. It is a patient-centered approach to care that focuses on achieving patient goals for life and health by seeking care strategies that fit a patient’s context and are minimally disruptive and maximally supportive. The cumulative complexity model practically orients minimally disruptive medicine–based care. In this model, the patient workload-capacity imbalance is the central mechanism driving patient complexity. These elements should be accounted for when making decisions for patients with chronic conditions. Therefore, in addition to decision aids, which may guide shared decision making, we propose to discuss and clarify a potential workload-capacity imbalance.

scholarly journals Increasing Clinical, Community, and Patient-Centered Health Research for Preventing and Managing Multimorbidity

2013 ◽  
Vol 3 (2) ◽  
pp. 41-44 ◽  
Author(s):  
Jose M. Valderas
Keyword(s):  
Health Research ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions ◽  
Patient Centered ◽  
Related Research ◽  
Department Of Health ◽  
Clinical Community ◽  
Usual Clinical Practice ◽  
Secondary Analyses ◽  
Research Initiatives

The report “Multiple Chronic Conditions: A Strategic Framework,” which was developed by the U.S. Department of Health & Human Services (HSS), has identified as one of the key goals for improving health and the provision of healthcare for people with multiple chronic conditions “to increase clinical, community and patient-centered research.” In their linked commentary of this special journal issue, Parekh and Goodman identify and consider the potential impact of a number of related research initiatives supported by the National Institutes of Health and the Agency for Health Research and Quality, particularly focusing on two very specific areas: behavioral medicine and secondary analyses of available datasets. In this paper, I comment on both documents and discuss the opportunities offered by the current approaches and highlight related research needs; in particular, the need for an improved and expanded conceptual model of healthcare for people with multimorbidity, and the need for further exploration of the use of multimorbidity-relevant outcomes as part of usual clinical practice.

scholarly journals Factors associated with successful dietary changes in an energy-reduced Mediterranean diet intervention: a longitudinal analysis in the PREDIMED-Plus trial

2021 ◽  
Author(s):  
Cesar I. Fernandez-Lazaro ◽  
Estefanía Toledo ◽  
Pilar Buil-Cosiales ◽  
Jordi Salas-Salvadó ◽  
Dolores Corella ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Longitudinal Analysis ◽  
Self Efficacy ◽  
Chronic Conditions ◽  
Dietary Intervention ◽  
Dietary Change ◽  
Multiple Chronic Conditions ◽  
Dietary Changes ◽  
Factors Associated ◽  
Baseline Factors

Abstract Purpose Long-term nutrition trials may fail to respond to their original hypotheses if participants do not comply with the intended dietary intervention. We aimed to identify baseline factors associated with successful dietary changes towards an energy-reduced Mediterranean diet (MedDiet) in the PREDIMED-Plus randomized trial. Methods Longitudinal analysis of 2985 participants (Spanish overweight/obese older adults with metabolic syndrome) randomized to the active intervention arm of the PREDIMED-Plus trial. Dietary changes were assessed with a 17-item energy-reduced MedDiet questionnaire after 6 and 12 months of follow-up. Successful compliance was defined as dietary changes from baseline of ≥ 5 points for participants with baseline scores < 13 points or any increase if baseline score was ≥ 13 points. We conducted crude and adjusted multivariable logistic regression models to identify baseline factors related to compliance. Results Consistent factors independently associated with successful dietary change at both 6 and 12 months were high baseline perceived self-efficacy in modifying diet (OR6-month: 1.51, 95% CI 1.25–1.83; OR12-month: 1.66, 95% CI 1.37–2.01), higher baseline fiber intake (OR6-month: 1.62, 95% CI 1.07–2.46; OR12-month: 1.62, 95% CI 1.07–2.45), having > 3 chronic conditions (OR6-month: 0.65, 95% CI 0.53–0.79; OR12-month: 0.76, 95% CI 0.62–0.93), and suffering depression (OR6-month: 0.80, 95% CI 0.64–0.99; OR12-month: 0.71, 95% CI 0.57–0.88). Conclusion Our results suggested that recruitment of individuals with high perceived self-efficacy to dietary change, and those who initially follow diets relatively richer in fiber may lead to greater changes in nutritional recommendations. Participants with multiple chronic conditions, specifically depression, should receive specific tailored interventions. Trial registration ISRCTN registry 89898870, 24th July 2014 retrospectively registered http://www.isrctn.com/ISRCTN89898870.

Exploring the association between diabetes and breast cancer outcomes among Latinas.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 221-221
Author(s):  
Kimlin Tan Ashing ◽  
Raynald Samoa ◽  
Lily L. Lai ◽  
Arti Hurria ◽  
Mayra Serrano ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Chronic Conditions ◽  
Breast Cancer Survivors ◽  
Cancer Registries ◽  
Self Report ◽  
Multiple Chronic Conditions ◽  
Coordinated Care ◽  
Patient Centered ◽  
The Impact

221 Background: In cancer patients, diabetes increases the risk for poor overall health and cancer-specific outcomes even death. Moreover, both breast cancer (BC) and diabetes are amongst the most common illnesses in Latinas, who have documented poorer outcomes for both diseases. This study examined the impact of co-occurring diabetes on patient outcomes in a sample of Latina breast cancer survivors (BCS). Methods: 137 Latina BCS were recruited from the California Cancer Registry, hospital cancer registries, and community agencies. BCS completed a self-report questionnaire consisting of items related to demographic and medical characteristics, including diagnoses of cancer and diabetes, and physical and functional outcomes. Results: Thirty nine (28%) BCS reported a co-occurring diagnosis of diabetes; this is over twice the rate in the general population. Diabetes was most prevalent among BCS 65 years and older with 43% reporting co-occuring diabetes. BCS with diabetes, controlling for age, were more likely to report advanced BC staging at diagnosis ( p= 0.036) and more severe lymphedema symptoms than BCS without diabetes ( p= 0.038). BCS with diabetes also endorsed lower general health and greater social functioning limitations and physical role limitations than BCS without diabetes ( p= 0.048). Conclusions: This investigation sheds new light on emerging evidence documenting the negative associations of co-occurring chronic conditions, such as diabetes, on cancer patients’ outcomes. Our findings highlight the urgent need for additional inquiry examining multiple chronic conditions, particularly in the face of cancer. Early integrative and coordinated care that attends to multiple chronic conditions, especially among elderly and ethnic minority patients, may serve as a critical target for addressing disparate cancer risk and outcomes to improve quality, patient-centered care and patients’ outcomes. Clinical trial information: NCT00932997.

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