Chronic conditions, financial burden and pharmaceutical pricing: insights from Australian consumers

Objective To explore the perceptions of Australian consumers and carers about the financial burden associated with medicines used for the treatment of chronic conditions. Method Semi-structured interviews were undertaken with individuals (n = 97) who identified as having a chronic condition(s) (n = 70), cared for someone with a chronic condition(s) (n = 8), or both (n = 19). Participants included individuals identifying with an Aboriginal or Torres Strait Islander (n = 23) or Culturally and Linguistically Diverse (n = 19) background. Data were analysed using the constant comparison method and reported thematically. Results Participants described substantial costs associated with medicines use, along with aggravating factors, including the duration and number of medicines used, loss of employment, lack of pricing consistency between pharmacies and the cost of dose administration aids. Consequences included impacts on medicine adherence, displacement of luxury items and potentially a reduced financial incentive to work. Understanding and beliefs related to pharmaceutical pricing policy varied and a range of proactive strategies to manage financial burden were described by some participants. Conclusions The financial burden associated with medicines used for the management of chronic conditions by Australian consumers is substantial. It is compounded by the ongoing need for multiple medicines and indirect effects associated with chronic conditions, such as the impact on employment. What is known about the topic? Medicines are a common form of treatment in chronic conditions. The financial burden related to medicines use, including co-payments, is associated with reduced adherence and other cost-coping strategies. Out of pocket costs for prescription medicines are relatively high in Australia compared with some other countries, including New Zealand and the United Kingdom. Australian consumers with chronic illness are likely to be at particular risk of financial burden associated with medicines use. What does this paper add? This paper explores the perceptions of consumers and carers around the financial burden associated with the use of medicines for the treatment of chronic conditions in Australia. It draws on the experiences and perceptions of a diverse group of consumers in Australia who identify as having, or caring for someone with, a chronic condition(s). What are the implications for practitioners? Health professionals who assist consumers to manage their medicines need to be aware of the potential for financial burden associated with medicines use and its potential impact on adherence. There is a need for health professionals to educate and assist consumers with chronic conditions to ensure they can navigate the health system to maximum benefit and receive financial entitlements for which they are eligible.

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What skills do primary health care professionals need to provide effective self-management support?Seeking consumer perspectives

Australian Journal of Primary Health ◽

10.1071/py08053 ◽

2009 ◽

Vol 15 (1) ◽

pp. 37 ◽

Cited By ~ 40

Author(s):

Sharon Lawn ◽

Malcolm Battersby ◽

Helen Lindner ◽

Rebecca Mathews ◽

Steve Morris ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Professionals ◽

Chronic Conditions ◽

Chronic Condition ◽

Community Support ◽

Self Management ◽

Management Support ◽

Primary Health ◽

The Impact

This research aimed to identify the skills required by primary health care (PHC) professionals to provide effective chronic condition prevention and self-management support, according to the perceptions of a sample of Australian consumers and carers. Qualitative data were collected and integrated from a focus group, key informant interviews and National Stakeholder meetings and a National Workshop, supported by an extensive literature review. With the exception of health professionals specifically trained or currently working in this area, consumers and carers perceive there is a lack of understanding, competence and practice of chronic condition prevention and self-management support among PHC professionals. The PHC workforce appears not to have the full set of skills needed to meet the growing burden of chronic conditions on the health system. Recommendations include education and training that focuses on improved communication skills, knowledge of community support resources, identification of consumers’ strengths and current capacities, collaborative care with other health professionals, consumers and carers and psychosocial skills to understand the impact of chronic conditions from the person’s perspective.

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Mental health professionals’ perceptions on patients control of data sharing

Health Informatics Journal ◽

10.1177/1460458219893845 ◽

2020 ◽

Vol 26 (3) ◽

pp. 2011-2029 ◽

Cited By ~ 1

Author(s):

Julia Ivanova ◽

Adela Grando ◽

Anita Murcko ◽

Michael Saks ◽

Mary Jo Whitfield ◽

...

Keyword(s):

Mental Health ◽

Health Information ◽

Data Sharing ◽

Mental Health Professionals ◽

Health Professionals ◽

Health Care Professionals ◽

Health Data ◽

Structured Interviews ◽

Timely Access ◽

The Impact

Integrated mental and physical care environments require data sharing, but little is known about health professionals’ perceptions of patient-controlled health data sharing. We describe mental health professionals’ views on patient-controlled data sharing using semi-structured interviews and a mixed-method analysis with thematic coding. Health information rights, specifically those of patients and health care professionals, emerged as a key theme. Behavioral health professionals identified patient motivations for non-sharing sensitive mental health records relating to substance use, emergency treatment, and serious mental illness (94%). We explore conflicts between professional need for timely access to health information and patient desire to withhold some data categories. Health professionals’ views on data sharing are integral to the redesign of health data sharing and informed consent. As well, they seek clarity about the impact of patient-controlled sharing on health professionals’ roles and scope of practice.

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Managing chronic conditions care across primary care and hospital systems: lessons from an Australian Hospital Avoidance Risk Program using the Flinders Chronic Condition Management Program

Australian Health Review ◽

10.1071/ah17099 ◽

2018 ◽

Vol 42 (5) ◽

pp. 542 ◽

Cited By ~ 5

Author(s):

Sharon Lawn ◽

Sara Zabeen ◽

David Smith ◽

Ellen Wilson ◽

Cathie Miller ◽

...

Keyword(s):

Emergency Department ◽

Heart Disease ◽

Length Of Stay ◽

Chronic Conditions ◽

Chronic Condition ◽

Hospital Admissions ◽

Self Management ◽

Psychosocial Needs ◽

Post Discharge ◽

The Impact

Objective The study aimed to determine the impact of the Flinders Chronic Condition Management Program for chronic condition self-management care planning and how to improve its use with Bendigo Health’s Hospital Admission Risk Program (HARP). Methods A retrospective analysis of hospital admission data collected by Bendigo Health from July 2012 to September 2013 was undertaken. Length of stay during admission and total contacts post-discharge by hospital staff for 253 patients with 644 admissions were considered as outcome variables. For statistical modelling we used the generalised linear model. Results The combination of the HARP and Flinders Program was able to achieve significant reductions in hospital admissions and non-significant reduction in emergency department presentations and length of stay. The generalised linear model predicted that vulnerable patient groups such as those with heart disease (P = 0.037) and complex needs (P < 0.001) received more post-discharge contacts by HARP staff than those suffering from diabetes, renal conditions and psychosocial needs when they lived alone. Similarly, respiratory (P < 0.001), heart disease (P = 0.015) and complex needs (P = 0.050) patients had more contacts, with an increased number of episodes than those suffering from diabetes, renal conditions and psychosocial needs. Conclusion The Flinders Program appeared to have significant positive impacts on HARP patients that could be more effective if high-risk groups, such as respiratory patients with no carers and respiratory and heart disease patients aged 0–65, had received more targeted care. What is known about the topic? Chronic conditions are common causes of premature death and disability in Australia. Besides mental and physical impacts at the individual level, chronic conditions are strongly linked to high costs and health service utilisation. Hospital avoidance programs such as HARP can better manage chronic conditions through a greater focus on coordination and integration of care across primary care and hospital systems. In support of HARP, self-management interventions such as the Flinders Program aim to help individuals better manage their medical treatment and cope with the impact of the condition on their physical and mental wellbeing and thus reduce health services utilisation. What does this paper add? This paper sheds light on which patients might be more or less likely to benefit from the combination of the HARP and Flinders Program, with regard to their impact on reductions in hospital admissions, emergency department presentations and length of stay. This study also sheds light on how the Flinders Program could be better targeted towards and implemented among high-need and high-cost patients to lessen chronic disease burden on Australia’s health system. What are the implications for practitioners? Programs targeting vulnerable populations and applying evidence-based chronic condition management and self-management support achieve significant reductions in potentially avoidable hospitalisation and emergency department presentation rates, though sex, type of chronic condition and living situation appear to matter. Benefits might also accrue from the combination of contextual factors (such as the Flinders Program, supportive service management, clinical champions in the team) that work synergistically.

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DOES ONSET OF CHRONIC CONDITIONS MODERATE THE IMPACT OF RELATIONAL LIFE EVENTS ON DEPRESSED MOOD?

Innovation in Aging ◽

10.1093/geroni/igz038.970 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S260-S260

Author(s):

Aaron M Ogletree ◽

Rosemary Blieszner ◽

Rachel Pruchno ◽

Jyoti Savla ◽

Laura P Sands

Keyword(s):

Mental Health ◽

Older Adults ◽

Depressive Symptoms ◽

Life Events ◽

Chronic Conditions ◽

Chronic Condition ◽

Process Model ◽

Mixed Effect ◽

The Impact ◽

Over Time

Abstract More than 62% of adults aged 65+ have more than one chronic condition; this number increases to more than 82% for those 85+. Older adults simultaneously experience changes in their relationships due to negative relational life events, including illness, injury, or death of a loved one. Stressors occurring in tandem can overload psychological resources and increase risk for poor mental health. Informed by the stress process model, we assessed the influence of relational life events on depressive symptoms over time and evaluated the moderating effects of chronic condition onset. Self-reports of four stressful life events, five chronic conditions, and depressive symptoms as measured by the CES-D came from 2,948 older adults participating in the ORANJ BOWL panel. Using longitudinal multilevel mixed effect modeling, we examined trajectories of depressive symptoms across three waves. While depressive symptoms increased over time, they were greater for people who experienced more relational life events and the onset of more chronic conditions. Participants who reported experiencing all four relational life events but no chronic conditions had an average CES-D score of 5.28 (p<.0001); average CES-D score increased to 12.72 (p<.0001) for those who reported four life events and the onset of four or more new chronic conditions during the study period. In summary, chronic condition onset moderated the relationship between life events and depressive symptoms. Findings highlight the need for practitioner awareness of increased mental health risks for people experiencing stressors in multiple domains of life.

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STUDY FACTORS THAT TRIGGER A LACK OF TRUST IN HOTEL IN BANGKOK: RECOMMEND ACTION THAT CONTRIBUTE TO LONG TERM TRUSTING RELATIONSHIP BY THE DOMESTIC GUEST

BSSS Journal of Commerce ◽

10.51767/joc1308 ◽

2021 ◽

Vol XIII (1) ◽

pp. 81-90

Author(s):

Mayprapawee Varnakomola ◽

Keyword(s):

Research Method ◽

Comparison Method ◽

Tourism Industry ◽

Structured Interviews ◽

Travel Experience ◽

Personal Experiences ◽

Domestic Tourism ◽

The Government ◽

The Impact

Thailand is hit hard by the impact of the on the COVID 19 situation, to cope with the international boycotts of flights and the lots in revenue from international tourists, the government has shift it attention to domestic tourists. However, the domestic tourism industry is not well prepared for the pandemic situation, lots of people don’t travel as locals fear to be sick and get the disease. So, this study contributes to adding knowledge and understanding of how hotels can best satisfy and meet the needs of domestic tourists in this new COVID 19 pandemic area. The Qualitative research method is used for the collection of data and in-depth and semi-structured interviews were conducted with domestic tourists in Bangkok from November 10, 2020, to November 12, 2020, the interview was focus on domestic tourist personal experiences, opinion and preferences towards different issues related to the pandemic situation and new expectation towards hotel services. Constant Comparison Method is used for analyzing the data collected with ten domestic tourists at Khao San road, Thailand. Results reveal that the domestic tourists visiting Bangkok specific demands travel experience during covers-19 starting which leads to personalize demand to manage by the hotel in order to fulfill the need and provide fruitful experience including indoor activates and recreation events

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Research priorities for childhood chronic conditions: a workshop report

Archives of Disease in Childhood ◽

10.1136/archdischild-2018-315628 ◽

2018 ◽

Vol 104 (3) ◽

pp. 237-245 ◽

Cited By ~ 2

Author(s):

Pamela Lopez-Vargas ◽

Allison Tong ◽

Sally Crowe ◽

Stephen I Alexander ◽

Patrina Ha Yuen Caldwell ◽

...

Keyword(s):

Health Professionals ◽

Chronic Conditions ◽

Chronic Condition ◽

Research Priorities ◽

Well Being ◽

Financial Loss ◽

Paediatric Hospital ◽

Health And Social Care ◽

Consumer Organisations ◽

Childhood Chronic Conditions

BackgroundChronic conditions are the leading cause of mortality, morbidity and disability in children. However, children and caregivers are rarely involved in identifying research priorities, which may limit the value of research in supporting patient-centred practice and policy.ObjectiveTo identify priorities of patients, caregivers and health professionals for research in childhood chronic conditions and describe the reason for their choices.SettingAn Australian paediatric hospital and health consumer organisations.MethodsRecruited participants (n=73) included patients aged 8 to 14 years with a chronic condition (n=3), parents/caregivers of children aged 0 to 18 years with a chronic condition (n=19), representatives from consumer organisations (n=13) and health professionals including clinicians, researches (n=38) identified and discussed research priorities. Transcripts were thematically analysed.ResultsSeventy-eight research questions were identified. Five themes underpinned participants’ priorities: maintaining a sense of normality (enabling participation in school, supporting social functioning, promoting understanding and acceptance), empowering self-management and partnership in care (overcoming communication barriers, gaining knowledge and skills, motivation for treatment adherence, making informed decisions, access and understanding of complementary and alternative therapies),strengthening ability to cope (learning to have a positive outlook, preparing for home care management, transitioning to adult services), broadening focus to family (supporting sibling well-being, parental resilience and financial loss, alleviating caregiver burden), and improving quality and scope of health and social care (readdressing variability and inequities, preventing disease complications and treatment side effects, identifying risk factors, improving long-term outcomes, harnessing technology, integrating multidisciplinary services).ConclusionResearch priorities identified by children, caregivers and health professionals emphasise a focus on life participation, psychosocial well-being, impact on family and quality of care. These priorities may be used by funding and policy organisations in establishing a paediatric research agenda.

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Acesso de crianças em condição crônica na atenção primária: estudo exploratório descritivo

Online Brazilian Journal of Nursing ◽

10.17665/1676-4285.20165518 ◽

2016 ◽

Vol 15 ◽

pp. 549

Author(s):

Daisy Cristina Rodrigues ◽

Eliane Tatsch Neves ◽

Leonardo Bigolin Jantsch ◽

Andressa Da Silveira

Keyword(s):

Health Professionals ◽

Chronic Conditions ◽

Family Health ◽

Coordination Of Care ◽

Structured Interviews ◽

Health Strategy ◽

The Family ◽

Family Health Strategy ◽

South Of Brazil ◽

Basic Health Units

Aim: to describe the access of children in chronic conditions toprimary health care from the perspective of health professionals. Method: this is an exploratory and descriptive study, using a qualitative approach. For the collection of data, semi-structured interviews will be carried out with health professionals that integrate the teams of Basic Health Units and the Family Health Strategy in the South of Brazil. The data will be treated through the thematic inductive analysis. Expected results: the expectation is to contribute with resources for the planning of the assistance, allowing access for the coordination of care. In addition to encouraging moments and spaces for reflection for the health professionals participating in the study, who can rethink their daily practices.

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The Effects of a Digital Well-Being Intervention on Patients With Chronic Conditions: Observational Study (Preprint)

10.2196/preprints.16211 ◽

2019 ◽

Author(s):

Acacia C Parks ◽

Allison L Williams ◽

Gina M Kackloudis ◽

Julia L Stafford ◽

Eliane M Boucher ◽

...

Keyword(s):

Chronic Illness ◽

Chronic Conditions ◽

Chronic Condition ◽

Intervention Program ◽

Behavioral Therapy ◽

Past Research ◽

Well Being ◽

Subjective Well Being ◽

The Impact ◽

Over Time

BACKGROUND Chronic conditions account for 75% of health care costs, and the impact of chronic illness is expected to grow over time. Although subjective well-being predicts better health outcomes, people with chronic conditions tend to report lower well-being. Improving well-being might mitigate costs associated with chronic illness; however, existing interventions can be difficult to access and draw from a single theoretical approach. Happify, a digital well-being intervention program drawing from multiple theoretical traditions to target well-being, has already been established as an efficacious means of improving well-being in both distressed and nondistressed users. OBJECTIVE This study aimed to compare change in well-being over time after using Happify for users with and without a chronic condition. METHODS Data were obtained from Happify users, a publicly available digital well-being program accessible via website or mobile phone app. Users work on tracks addressing a specific issue (eg, conquering negative thoughts) composed of games and activities based on positive psychology, cognitive behavioral therapy, and mindfulness principles. The sample included 821 users receiving at least 6 weeks’ exposure to Happify (ranging from 42 to 179 days) who met other inclusion criteria. As part of a baseline questionnaire, respondents reported demographic information (age and gender) and whether they had any of the prespecified chronic conditions: arthritis, diabetes, insomnia, multiple sclerosis, chronic pain, psoriasis, eczema, or some other condition (450 reported a chronic condition, whereas 371 did not). Subjective well-being was assessed with the Happify Scale, a 9-item measure of positive emotionality and life satisfaction. To evaluate changes in well-being over time, a mixed effects linear regression model was fit for subjective well-being, controlling for demographics and platform usage. RESULTS At baseline, users with a chronic condition had significantly lower subjective well-being (mean 38.34, SD 17.40) than users without a chronic condition (mean 43.65, SD 19.13). However, change trajectories for users with or without a chronic condition were not significantly different; both groups experienced equivalent improvements in well-being. We also found an effect for time from baseline (<italic>b</italic>=0.071; SE=0.010; <italic>P</italic><.01) and number of activities completed (<italic>b</italic>=0.03; SE=0.009; <italic>P</italic><.01), and a 2-way interaction between number of activities completed and time from baseline (<italic>b</italic>=0.0002; SE=0.00006; <italic>P</italic><.01), such that completing more activities and doing so over increasingly longer periods produced improved well-being scores. CONCLUSIONS Data from this study support the conclusion that users with a chronic condition experienced significant improvement over time. Despite reporting lower subjective well-being on the whole, their change trajectory while using Happify was equivalent to those without a chronic condition. Consistent with past research, users who completed more activities over a longer period showed the most improvement. In short, the presence of a chronic condition did not prevent users from showing improved well-being when using Happify.

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Scoring interventions in family relations regarding the care for the child with a chronic condition

Texto & Contexto - Enfermagem ◽

10.1590/0104-07072015001820013 ◽

2015 ◽

Vol 24 (1) ◽

pp. 87-95 ◽

Cited By ~ 2

Author(s):

Daniele Castro Barbosa ◽

Francisca Georgina Macedo de Sousa ◽

Joséte Luzia Leite

Keyword(s):

Chronic Conditions ◽

Chronic Condition ◽

Family Relations ◽

Family Members ◽

Structured Interviews ◽

Family Experiences ◽

The Family ◽

Complex Thought ◽

Children With Chronic Conditions

The study aimed to reveal intervening conditions towards the care of children with chronic condition. The Complex Thought was used as theoretical framework and the Grounded Theory as methodological. Data were collected from January to August 2012, through semi-structured interviews in two follow-up services for children with chronic conditions and in the homes of participants. Participated 16 relatives of children with chronic conditions, divided into three sample groups. The category "Scoring the intervening conditions towards care of the child with chronic condition" reveals that multiple events experienced by the family in the care of children with chronic conditions are determined by the relationships and interactions of family members and influence the forms of organization for the care of child. Highlights the importance of the nurse to know and understand the multiple family experiences in order to encompass child and their family members as care units.

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Preparing Christian Health Workers for International Work: Evaluating a Short Global Health Course

Christian Journal for Global Health ◽

10.15566/cjgh.v7i5.415 ◽

2020 ◽

Vol 7 (5) ◽

pp. 21-30

Author(s):

Sneha Kirubakaran ◽

Douglas Shaw ◽

Lawrie McArthur ◽

Angus Miller ◽

Anthony Radford

Keyword(s):

Health Education ◽

Global Health ◽

Health Professionals ◽

Online Survey ◽

Health Workers ◽

International Health ◽

Structured Interviews ◽

Global Health Education ◽

Health And Development ◽

The Impact

Improving global health education to ensure health professionals are prepared and competent in the world’s increasingly interconnected health-scape is a vital need. For many health professionals, global health education is facilitated through short, pre-departure courses in cross-cultural health and development work. There is currently limited literature on both the availability and the effectiveness of such courses. Our research aim was to explore the impact of a short course in global health education, designed and delivered by an Australian not-for-profit organisation, Intermed SA (Intermed). We conducted a short online survey of Intermed graduates, followed by semi-structured interviews with selected participants. The results indicate that Intermed’s International Health and Development course was effective in achieving the course objectives as assessed by graduates, whilst also having a positive practical impact on the graduates’ professional development.

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