scholarly journals How general practitioners perceive and assess self-care in patients with multiple chronic conditions: a qualitative study

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Mads Aage Toft Kristensen ◽  
Bibi Hølge-Hazelton ◽  
Frans Boch Waldorff ◽  
Ann Dorrit Guassora
Keyword(s):  
Qualitative Study ◽  
General Practitioners ◽  
Chronic Conditions ◽  
Self Care ◽  
Multiple Chronic Conditions

scholarly journals ‘More constricting than inspiring’ — GPs find chronic care programmes of limited clinical utility. A qualitative study

BJGP Open ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. bjgpopen18X101591 ◽  
Author(s):  
Mads Aage Toft Kristensen ◽  
Tina Drud Due ◽  
Bibi Hølge-Hazelton ◽  
Ann Dorrit Guassora ◽  
Frans Boch Waldorff
Keyword(s):  
Disease Management ◽  
Qualitative Study ◽  
Chronic Conditions ◽  
Self Care ◽  
Multiple Chronic Conditions ◽  
Patient Stratification ◽  
Complex Chronic Conditions ◽  
Healthcare Needs ◽  
Clinical Applicability ◽  
Disease Management Programmes

BackgroundAs in other countries, Danish health authorities have introduced disease management programmes (DMPs) to improve care quality. These contain clinical practice guidelines (CPGs) and guidelines for patient stratification based on doctors’ assessments of disease severity and self-care. However, these programmes are challenged when patients have complex chronic conditions.AimTo explore how GPs experience the clinical applicability of disease management programmes for patients with multiple chronic conditions and lowered self-care ability.Design & settingA qualitative study from general practice, conducted in rural areas of Denmark with economically disadvantaged populations.MethodData were collected through case-based, semi-structured interviews with 12 GPs. The principles of systematic text condensation were used in the analysis.ResultsGPs found DMPs inadequate, particularly for patients with multiple conditions and lowered self-care ability. Their experience was that adhering to multiple programmes’ CPGs resulted in too much medication, conflicting treatments, an overload of appointments, and fragmented health care. They disregarded stratifying according to guidelines because they deemed stratification criteria to reflect neither patients’ need for self-care support, nor flexible referral options to hospitals and municipalities. Therefore, GPs were often solely responsible for treatment of patients with very complex chronic conditions.ConclusionGPs found DMPs to be of limited clinical applicability due to challenges related to CPGs, patient stratification, and lack of adequate health services to support patients with complex healthcare needs. To increase the benefits of these programmes, they should be more flexible, and adjusted to the needs of patients with multiple chronic conditions and lowered self-care ability.

scholarly journals The complexity of caregiving for community-living older adults with multiple chronic conditions: A qualitative study

2020 ◽  
Vol 10 ◽  
pp. 2235042X2098119
Author(s):  
Jenny Ploeg ◽  
Anna Garnett ◽  
Kimberly D Fraser ◽  
Lisa Garland Baird ◽  
Sharon Kaasalainen ◽  
...  
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Chronic Conditions ◽  
Social Inclusion ◽  
Secondary Analysis ◽  
Community Support ◽  
Care Recipient ◽  
Community Living ◽  
Multiple Chronic Conditions ◽  
Structured Interviews

Background: Older adults with multiple chronic conditions (MCC) rely heavily on caregivers for assistance with care. However, we know little about their psychosocial experiences and their needs for support in managing MCC. The purpose of this study was to explore the experiences of caregivers of older adults living in the community with MCC. Methods: This qualitative study was a secondary analysis of previously collected data from caregivers in Ontario and Alberta, Canada. Participants included caregivers of older adults (65 years and older) with three or more chronic conditions. Data were collected through in-depth, semi-structured interviews. Interview transcripts were coded and analyzed using Thorne’s interpretive description approach. Results: Most of the 47 caregiver participants were female (76.6%), aged 65 years of age or older (61.7%), married (87.2%) and were spouses to the care recipient (68.1%). Caregivers’ experiences of caring for community-living older adults with MCC were complex and included: (a) dealing with the demands of caregiving; (b) prioritizing chronic conditions; (c) living with my own health limitations; (d) feeling socially isolated and constrained; (e) remaining committed to caring; and (f) reaping the rewards of caregiving. Conclusions: Healthcare providers can play key roles in supporting caregivers of older adults with MCC by providing education and support on managing MCC, actively engaging them in goal setting and care planning, and linking them to appropriate community health and social support services. Communities can create environments that support caregivers in areas such as social participation, social inclusion, and community support and health services.

scholarly journals IMPLEMENTATION OF PATIENT PRIORITIES CARE WITHIN A VA GERIATRICS CLINIC

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S774-S774
Author(s):  
Jennifer Freytag ◽  
Lilian Dindo ◽  
Angela Catic ◽  
Aanand Naik ◽  
Mary Tinetti
Keyword(s):  
Older Adults ◽  
Social Interactions ◽  
Medical Records ◽  
Social Engagement ◽  
Chronic Conditions ◽  
Self Care ◽  
Routine Care ◽  
Mean Difference ◽  
Multiple Chronic Conditions ◽  
Geriatric Clinic

Abstract Patient Priorities Care (PPC) is an approach to decision-making for older adults with multiple chronic conditions (MCC). PPC trains facilitators to have structured conversations with patients to identify their priorities (the outcomes that matter most given what care they are willing/able to do or receive). Clinicians then align care to achieve patient priorities rather than focusing on multiple single-disease guidelines. We piloted PPC in a VA geriatrics clinic and compared it to usual care (UC) for multimorbid adults. This retrospective cohort study (n=36 PPC, 36 UC) describes changes made by clinicians after Veterans with MCC had facilitated conversations in a VA geriatric clinic. UC Veterans were matched by prognosis, same primary clinician, and timeframe. Coders used a standardized rubric to assess documented care within medical records. Changes to care examined include medications added/removed, referrals made/avoided, self-care recommendations, and recommendations for social engagement. Although PPC and UC patients were seen by the same clinicians, patients receiving PPC had fewer added medications (mean difference -.47, t(70)=-1.99, p=.05); received more recommendations for self-care aligned with priorities (mean difference .25, t(69)=2.14, p=.003); received more recommended consultations with desired care, including podiatry, transportation, and dermatology (mean difference .55, t(70)=2.06, p=.01), and more recommendations for care and services to facilitate social interactions (p<.0001). PPC produced documented changes in care that better align with patient priorities within the routine care workflow of a busy geriatrics clinic. Our results provide evidence that structured priorities conversations change the way clinicians provide care for older adults with MCC.

scholarly journals Barriers and facilitators associated with colonoscopy completion in individuals with multiple chronic conditions: a qualitative study

2017 ◽  
Vol Volume 11 ◽  
pp. 985-994 ◽  
Author(s):  
Shahnaz Sultan ◽  
Melissa Partin ◽  
Phalgoon Shah ◽  
Jennifer LeLaurin ◽  
Ivette Magaly Freytes ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Chronic Conditions ◽  
Barriers And Facilitators ◽  
Multiple Chronic Conditions

scholarly journals Understanding What Is Most Important to Individuals with Multiple Chronic Conditions: A Qualitative Study of Patients’ Perspectives

2017 ◽  
Vol 32 (12) ◽  
pp. 1278-1284 ◽  
Author(s):  
Catherine Y. Lim ◽  
Andrew B. L. Berry ◽  
Tad Hirsch ◽  
Andrea L. Hartzler ◽  
Edward H. Wagner ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions

scholarly journals Facilitators and Barriers of Managing Patients with Multiple Chronic Conditions in the Community: A Qualitative Study

2019 ◽  
Author(s):  
Kah Mun Foo ◽  
Meena Sundram ◽  
Helena Legido-Quigley
Keyword(s):  
Qualitative Study ◽  
Waiting Time ◽  
Chronic Conditions ◽  
Resource Constraints ◽  
Healthcare Providers ◽  
Policy Formulation ◽  
Care Quality ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Facilitators And Barriers

Abstract Background About one-third of all adults worldwide were diagnosed with multiple chronic conditions (MCCs). Literature had found several challenges of providers and patients coping with managing MCCs in the community, and yet limited research studies that consider their viewpoints in combination. A qualitative study involving healthcare providers and users was thus conducted to examine facilitators and barriers of managing patients with MCCs in the community in Singapore. Methods This involves 26 semi-structured interviews with 10 physicians, 2 caregivers and 14 patients seeking treatment in the polyclinics that provides subsidised primary care services. Topic guides were developed with reference from literature review, Chronic Care Model (CCM) and Framework for patient-centred access to healthcare. Results Despite perceived affordable charges and availability of support system, some patients still encountered financial difficulties in managing care. These include inadequacy of the nation-wide medical savings scheme to cover outpatient treatment and medications. Half of the healthcare users did not know where to seek help. While patients could access comprehensive services in polyclinics, those that did not turn up might not receive timely care. Furthermore, patients reported long consultation waiting time. Physicians were able to propose and drive quality improvement projects to improve care quality. However, there were challenges of delivering safe and quality care with limited consultation duration due to the need to manage waiting time, inadequate communication with specialists to coordinate care, and resource constraints in managing complex patients. Although providers could equip patients with self-management and lifestyle related guidelines, patients’ actions are influenced by multiple factors including work nature, beliefs and environment. Conclusions There were barriers on care access, delivery and self-management as reported. It is crucial to adopt whole-of-society approach involving individuals, community, institutions and policymakers to improve and support MCCs management. This study has also highlighted the importance to consider different viewpoints of healthcare providers and users in policy formulation and community care planning.

scholarly journals A Web-Based Intervention to Help Caregivers of Older Adults With Dementia and Multiple Chronic Conditions: Qualitative Study

JMIR Aging ◽  
2018 ◽  
Vol 1 (1) ◽  
pp. e2 ◽  
Author(s):  
Jenny Ploeg ◽  
Carrie McAiney ◽  
Wendy Duggleby ◽  
Tracey Chambers ◽  
Annie Lam ◽  
...  
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions ◽  
Web Based
Sign in / Sign up

Export Citation Format

Share Document