scholarly journals Perceived quality of chronic illness care is associated with self-management: Results of a nationwide study in the Netherlands

Health Policy ◽  
2016 ◽  
Vol 120 (4) ◽  
pp. 431-439 ◽  
Author(s):  
L. van Houtum ◽  
M. Heijmans ◽  
M. Rijken ◽  
P. Groenewegen
Keyword(s):  
Chronic Illness ◽  
The Netherlands ◽  
Perceived Quality ◽  
Self Management ◽  
Chronic Illness Care ◽  
Nationwide Study

scholarly journals Exploring the impact of pharmacist comprehensive annual care plans on perceived quality of chronic illness care by patients in Alberta, Canada

2021 ◽  
pp. 171516352110203
Author(s):  
Candace Necyk ◽  
Jeffrey A. Johnson ◽  
Ross T. Tsuyuki ◽  
Dean T. Eurich
Keyword(s):  
Quality Of Care ◽  
Chronic Illness ◽  
Care Plan ◽  
Short Version ◽  
Chronic Illness Care ◽  
Online Questionnaire ◽  
Care Plans ◽  
Funding Program ◽  
The Impact

Background: In 2012, the Government of Alberta introduced a funding program to remunerate pharmacists to develop a comprehensive annual care plan (CACP) for patients with complex needs. The objective of this study is to explore patients’ perceptions of the care they received through the pharmacist CACP program in Alberta. Methods: We invited 3442 patients who received a pharmacist-billed CACP within the previous 3 months and 6888 matched controls across Alberta to complete an online questionnaire. The questionnaire consisted of the short version Patient Assessment of Chronic Illness Care (PACIC-11), with 3 additional pharmacy-specific assessment questions added. Additional questions related to health status and demographics were also included. Results: Overall, most patients indicated a low level of chronic illness care by pharmacists, with few differences noted between CACP patients and non-CACP controls. Of note, controls reported higher quality of care for 5 domains within the adapted PACIC-like tool compared with CACP patients ( p < 0.05 for all). Interestingly, only 79 (44%) of CACP patients reported that they had received a CACP, whereas only 192 (66%) of control patients reported that they did not receive a care plan. In a sensitivity analysis including only these respondents, individuals who received a CACP perceived a significantly higher quality of chronic illness care across all PACIC domains. Conclusion: Overall, chronic illness care incentivized by the pharmacist CACP program in Alberta is perceived to be moderate to low. When limited to respondents who explicitly recognized receiving the service or not, the perceptions of quality of care were more positive. This suggests that better implementation of CACP by pharmacists may be associated with improved quality of care and that some redesign is needed to engage patients more. Can Pharm J (Ott) 2021;154:xx-xx.

scholarly journals Self-Management, Self-Efficacy, and Health-Related Quality of Life in Children With Chronic Illness and Medical Complexity

2020 ◽  
Vol 34 (4) ◽  
pp. 304-314 ◽  
Author(s):  
Lilian Bravo ◽  
Mary K. Killela ◽  
Beck L. Reyes ◽  
Karla Marie Bathan Santos ◽  
Vanessa Torres ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Illness ◽  
Self Efficacy ◽  
Self Management ◽  
Health Related Quality ◽  
Medical Complexity ◽  
Related Quality ◽  
Health Related

scholarly journals The Uptake and Use of Telemonitoring in Chronic Care Between 2014 and 2019: Nationwide Survey Among Patients and Health Care Professionals in the Netherlands (Preprint)

2020 ◽  
Author(s):  
Martine W J Huygens ◽  
Helene R Voogdt-Pruis ◽  
Myrah Wouters ◽  
Maaike M Meurs ◽  
Britt van Lettow ◽  
...  
Keyword(s):  
Health Care ◽  
The Netherlands ◽  
Health Care Professionals ◽  
Chronic Care ◽  
Elderly Care ◽  
Care Plan ◽  
Self Management ◽  
Medical Specialists

BACKGROUND Telemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups. OBJECTIVE This paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014 to 2019 by means of an annual representative survey among patients and health care professionals. METHODS Between 2014 and 2019, approximately 2900 patients with chronic diseases, 700 nurses, and 500 general practitioners (GPs) and medical specialists received a questionnaire. About 30 questions addressed topics about the use of eHealth and experiences with it, including data about telemonitoring. RESULTS Between 2014 and 2019, the use of telemonitoring remained stable for all groups except medical specialists. In medical specialist departments, the use of telemonitoring increased from 11.2% (18/161) in 2014 to 19.6% (36/184) in 2019 (<i>χ</i><sup>2</sup><sub>4</sub>=12.3; <i>P</i>=.02). In 2019, telemonitoring was used by 5.8% (28/485) of people with chronic disease. This was 18.2% (41/225) in GP organizations and 40.4% (44/109), 38.0% (78/205), and 8.9% (29/325) in the organizations of nurses working in primary, secondary, and elderly care, respectively. Up to 10% of the targeted patient group such as diabetics were regarded by health care professionals as suitable for using telemonitoring. The main benefits mentioned by the patients were “comfort” (421/1043, 40.4%) and “living at home for longer/more comfortably” (334/1047, 31.9%). Health care professionals added “improvement of self-management” (63/176, 35.8% to 57/71, 80.3%), “better understanding of the patient’s condition” (47/176, 26.7% to 42/71, 59.2%), “reduction of workload” (53/134, 39.6% of nurses in elderly care), “better tailoring of care plan to the patient’s situation” (95/225, 42.2% of GPs), and “saves time for patients/caregivers” (61/176, 34.7% of medical specialists). Disadvantages mentioned by professionals were that “it takes time to monitor data” (13/130, 10% to 108/225, 48.0%), “it takes time to follow up alerts” (15/130, 11.5% to 117/225, 52.0%), and “it is difficult to estimate which patients can work with telemonitoring” (22/113, 19.5% to 94/225, 41.8%). CONCLUSIONS The uptake of telemonitoring in Dutch chronic care remained stable during 2014-2019 but increased among medical specialists. According to both patients and professionals, telemonitoring improves the quality of life and quality of care. Skills for suitably including eligible patients and for allocating the tasks of data monitoring and follow-up care within the team would help to further increase the use of telemonitoring.

scholarly journals Patients’ Assessment of Care for Type 2 Diabetes: Results of the Patient Assessment of Chronic Illness Care Scale in A Danish Population

2020 ◽  
Author(s):  
Anne Frølich ◽  
Ann Nielsen ◽  
Charlotte Glümer ◽  
Hanne Birke ◽  
Christian U Eriksen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Quality Of Care ◽  
Chronic Illness ◽  
Diabetes Care ◽  
Emergency Department Visits ◽  
Descriptive Statistics ◽  
Chronic Illness Care ◽  
Patient Assessment

Abstract Background: The Patient Assessment of Chronic Illness Care (PACIC) scale is the most appropriate for assessing self-reported experience in chronic care. However, it has yet to be validated in a Danish diabetes population. We aimed to validate the PACIC, assess the quality of care for Danish patients with type 2 diabetes, and identify factors associated with quality of care. Methods: A survey of 7,745 individuals randomly selected from the National Diabetes Registry. Descriptive statistics inter-item and item-rest correlations and factor analysis assessed the PACIC properties. Quality of care was analysed with descriptive statistics; linear and multiple regression assessed the effect of forty-nine covariates on total and subscale scores. Results: In total, 2,696 individuals with type 2 diabetes completed ≥ 50% of items. The floor effect for individual items was 8.5-74.5%; the ceiling effect was 4.1- 47.8 %. Cronbach’s alpha was 0.73-0.86 for the five subscales. The comparative fit index (CFI) and the Tucker–Lewis index (TLI) were 0,87, and 0,84, respectively. Mean PACIC score was 2.44 (± 0.04). Respondents receiving rehabilitation and reporting primary of diabetes care had higher total mean scores; those 70 years or older had lower mean total and subscale scores. A higher number of diabetes visits were associated with higher total scores; higher number of emergency department visits were associated with lower total scores. The effect of healthcare utilisation on subscale scores varied. Conclusions: Floor effects suggest a need for further evaluation of the PACIC questionnaire in Danish settings. Total PACIC scores were lower than in other healthcare systems, possibly being a result of different contexts and cultures, and of a need for improving diabetes care in Denmark.

User Experience and Acceptance of Patients and Healthy Adults testing a personalized self-management app against depression: A non-randomized Mixed-Methods Feasibility Study (Preprint)

2021 ◽  
Author(s):  
Gwendolyn Mayer ◽  
Svenja Hummel ◽  
Neele Oetjen ◽  
Nadine Gronewold ◽  
Stefan Bubolz ◽  
...  
Keyword(s):  
User Experience ◽  
Specific Treatment ◽  
Feasibility Studies ◽  
Perceived Quality ◽  
Healthy Adults ◽  
Self Management ◽  
Technological Advances ◽  
Positive Treatment ◽  
Total Program

BACKGROUND The development of e-mental health applications for patients with depression has shown technological advances to a certain extent. Many feasibility studies reveal the acceptance of patients and evidence for positive treatment outcomes. However, few studies ask for the user experience regarding the personalized help of specific treatment components in self-management apps. OBJECTIVE The aim of the present study is to ask for the user experience and acceptance of patients with depression and healthy adults, who tested the app SELFPASS. The results serve as a source for evidence-based recommendations for developers and clinicians regarding the graphical and conceptual design of a self-management app for patients with depression with and without anxiety symptoms. METHODS The sample consisted of N=110 participants, of which 41 (37.3%) were adult patients and 69 (62.7%) healthy adults. They tested the app SELFPASS over a period of 5 days and filled out a self-developed evaluation questionnaire. Quantitative measures asked with 5-point Likert scaled items (range: -2 to +2) for the perceived quality of the program and its components, its practicality (both referred to as user experience), and its acceptance. Student t tests and Pearson correlations were calculated for comparisons of groups and associations between the measures. Open text fields were analyzed by applying a qualitative structuring content analysis regarding suggestions for usability, therapeutic content and personalization. RESULTS The perceived quality of the total program (PQTP) was rated with M=0.96 (SD=0.82), the practicality (P) was M=0.84 (SD=0.08), and the acceptance (A) was M=0.25 (SD=1.04). Patients rated PQTP and A higher than healthy adults, while there was no difference in P. Acceptance was associated with increased depression scores (r=.33, P=.01), higher scores of PQTP (r=0.48, P<.001) and of P (r=0.45, P<.001). Feedback of both groups regarding the usability, the therapeutic content and personalization revealed a strong wish for guidance and insights into mood progress, opportunities for choice of interventions and features of customization for an individualized treatment. CONCLUSIONS Patients with depression accepted the app SELFPASS more than healthy adults and gave higher ratings in quality. User experience of all users reveals a strong need for features of guidance, choice and personalization, that clinicians and developers of future apps should pay special attention to. CLINICALTRIAL Trial Registration: DRKS (DRKS00015614).

scholarly journals Patient cardiovascular risk self-management: results from a randomized trial of motivational interviewing delivered by practice nurses

2018 ◽  
Vol 36 (4) ◽  
pp. 460-466 ◽  
Author(s):  
Elke Huntink ◽  
Jan Koetsenruijter ◽  
Michel Wensing ◽  
Jan van Lieshout
Keyword(s):  
Risk Management ◽  
Cardiovascular Risk ◽  
Chronic Illness ◽  
Randomized Trial ◽  
Self Management ◽  
Chronic Illness Care ◽  
Cardiovascular Risk Management ◽  
Practice Nurses ◽  
Implementation Programme

Abstract Background To enhance cardiovascular risk management and patients’ self-management, a tailored programme to improve cardiovascular risk management was tested in a randomized trial. The presented study concerned secondary analysis. Objectives To explore the correlations of practice nurses’ counselling skills at baseline on chronic illness care (measured with Patient Assessment of Chronic Illness Care questionnaire) and patients’ self-management (assessed with Patient Activation Measure) at follow-up and to examine the effect of the tailored implementation programme on chronic illness care and patients’ self-management. Methods A two-arm cluster randomized trial was conducted in 34 general practices in the Netherlands. Counselling skills of practice nurses at baseline were abstracted from audio-taped consultations, which were assessed by Motivational Interviewing Treatment Integrity. Data of 2184 patients with established cardiovascular disease or at high cardiovascular risk were gathered at inclusion and at 6 months follow-up by a composite questionnaire. Multilevel regression analysis was applied, controlling for patient characteristics. Results Counselling skills of practice nurses were not associated with chronic illness care and patients’ self-management scores. At follow-up, patients in the intervention group experienced less chronic illness care and were less activated in disease management than patients in the control group. The most important predictors were patients’ age, gender and education level. Conclusions The logic model underlying the implementation programme needs to be reconsidered, because patient perceptions were neither influenced by nurses’ counselling skills nor by other components of the implementation programme.

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