scholarly journals Discussing patient preferences for levels of life-sustaining treatment: development and pilot testing of a Danish POLST form

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Lone Doris Tuesen ◽  
Hans-Henrik Bülow ◽  
Anne Sophie Ågård ◽  
Sverre Mainz Strøm ◽  
Erik Fromme ◽  
...  
Keyword(s):  
Patient Preferences ◽  
Chronically Ill ◽  
Pilot Test ◽  
Inappropriate Care ◽  
Life Sustaining Treatment ◽  
Patient Values ◽  
American Physician ◽  
Chronically Ill Patients ◽  
High Degree ◽  
Hospital Wards

Abstract Background Medically frail and/or chronically ill patients are often admitted to Danish hospitals without documentation of patient preferences. This may lead to inappropriate care. Modelled on the American Physician Orders for Life-Sustaining Treatment (POLST) form, the purpose of the study was to develop and pilot test a Danish POLST form to ensure that patients’ preferences for levels of life-sustaining treatment are known and documented. Methods The study was a mixed methods study. In the initial phase, a Danish POLST form was developed on the basis of literature and recommendations from the National POLST organisation in the US. A pilot test of the Danish POLST form was conducted in hospital wards, general practitioners’ clinics, and nursing homes. Patients were eligible for inclusion if death was assessed as likely within 12 months. The patient and his/her physician engaged in a conversation where patient values, beliefs, goals for care, diagnosis, prognosis, and treatment alternatives were discussed. The POLST form was completed based on the patient’s values and preferences. Family members and/or nursing staff could participate. Participants’ assessments of the POLST form were evaluated using questionnaires, and in-depth interviews were conducted to explore experiences with the POLST form and the conversation. Results In total, 25 patients participated, 45 questionnaires were completed and 14 interviews were conducted. Most participants found the POLST form readable and understandable, and 93% found the POLST form usable to a high or very high degree for discussing preferences regarding life-sustaining treatment. Three themes emerged from the interviews: (a) an understandable document is essential for the conversation, (b) handling and discussing wishes, and (c) significance for the future. Conclusion The Danish version of the POLST form is assessed by patients, families, physicians, and nurses as a useful model for obtaining and documenting Danish patients’ preferences for life-sustaining treatment. However, this needs to be confirmed in a larger-scale study.

Unobtrusive and comprehensive health screening using an intelligent toilet system

2015 ◽  
Vol 60 (1) ◽  
Author(s):  
Thomas Schlebusch ◽  
Wolfgang Fichtner ◽  
Michael Mertig ◽  
Steffen Leonhardt
Keyword(s):  
Heart Failure ◽  
Home Monitoring ◽  
Chronically Ill ◽  
Levels Of Care ◽  
Comprehensive Health ◽  
Treatment Of Diabetes ◽  
Quality Of Medical Care ◽  
Chronically Ill Patients ◽  
High Degree

AbstractHome monitoring is a promising technology to deal with the increasing amount of chronically ill patients while ensuring quality of medical care. Most systems available today depend on a high degree of interaction between the user and the device. Especially for people relying on advanced levels of care, this scheme is impracticable. In this paper, we are presenting an “intelligent toilet” performing an extensive health check while being as simple to use as a conventional toilet. The main focus of the system is to support the treatment of diabetes and chronic heart failure, but additional applications are possible.

Prevalence and correlates for stress among caregivers for chronically ill patients at Ndola teaching hospital

2017 ◽  
Vol 4 (3) ◽  
pp. 107-111
Author(s):  
Davies Simukoko ◽  
◽  
David Mulenga ◽  
Victor Mwanakasale ◽  
◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Chronically Ill ◽  
Chronically Ill Patients

PatientConcept App � an innovative tool to improve therapy adherence and to implement risk management plans. (Preprint)

2018 ◽  
Author(s):  
Michael Lang ◽  
Martin Mayr ◽  
Stefan Ringbauer ◽  
Lukas Cepek
Keyword(s):  
Risk Management ◽  
Disease Management ◽  
Chronically Ill ◽  
Patient Reported Outcome ◽  
Outcome Data ◽  
Daily Routine ◽  
Software Application ◽  
Patient Reported ◽  
Management Plans ◽  
Chronically Ill Patients

UNSTRUCTURED Background: Adherence constitutes a great challenge for disease management, particularly when treating chronically ill patients facing an extensive, complex and long-term therapy. Earlier studies emphasize the relevance of adherence for improving therapy benefits. Besides the positive impact of increased patient support, the use of mobile health applications has gained importance in disease management. Objective: We aimed to develop a software application providing innovative features to simplify the contact between patients and treating physicians in order to overcome adherence barriers, to implement risk management plans and to collect patient reported outcome data. Methods: A novel software application ensuring data security was developed. Various innovative modules have been implemented, enabling bidirectional communication between treating physicians and patients, supporting therapy monitoring and management and allowing the collection of large sets of anonymous patient data. Results: The PatientConcept app is freely available for download and is tested since 2016, with more than 1800 generated patient IDs and 279 patients documenting health data according to risk management plans online in 2017. The impact on adherence issues is currently tested in larger patient populations. Conclusion: This innovative app provides a feasible and cost-optimized possibility to intensify and simplify the communication between patients and their treating physicians across indications, thus promising an exceptional benefit to both. It may not only support chronically ill patients in managing their daily life and improving adherence, but can also facilitate the implementation of risk management plans through automated monitoring, thus supporting physicians in their daily routine. Furthermore, patient reported outcome data can be collected. Importantly, a secure ID-associated data management ensures patient anonymity complying with highest data safety standards.

Understanding care transition notifications for chronically ill patients

2021 ◽  
pp. 1-14
Author(s):  
Sarah Kianfar ◽  
Ann Schoofs Hundt ◽  
Peter L.T. Hoonakker ◽  
Doreen Salek ◽  
Janet Tomcavage ◽  
...  
Keyword(s):  
Chronically Ill ◽  
Care Transition ◽  
Chronically Ill Patients

scholarly journals Attitudes to and experience of disease management programs in primary care—an exploratory survey of general practitioners in Germany

2021 ◽  
Author(s):  
Julian Wangler ◽  
Michael Jansky
Keyword(s):  
Primary Care ◽  
Disease Management ◽  
Patient Care ◽  
General Practitioners ◽  
Linear Regression Analysis ◽  
Chronically Ill ◽  
Disease Management Programs ◽  
Federal States ◽  
Set Up ◽  
Chronically Ill Patients

Summary Background Disease management programs (DMPs) were set up in Germany in 2003 to improve outpatient care of chronically ill patients. The present study looks at the attitudes and experiences of general practitioners (GPs) in relation to DMPs, how they rate them almost 20 years after their introduction and where they see a need for improvement. Methods A total of 1504 GPs in the Federal States of Rhineland Palatinate, Saarland and Hesse were surveyed between December 2019 and March 2020 using a written questionnaire. Results In total, 58% of respondents rate DMPs positively and regard them as making a useful contribution to primary care. The guarantee of regular, structured patient care and greater compliance are regarded as particularly positive aspects. It was also established that diagnostic and therapeutic knowledge was expanded through participation in DMPs. 57% essentially follow the DMP recommendations for (drug) treatment. Despite positive experiences of DMPs in patient care, the GPs surveyed mention various challenges (documentation requirements, frequent changes to the programmes, inflexibility). Univariant linear regression analysis revealed factors influencing the satisfaction with DMPs, such as improvement of compliance and clearly defined procedures in medical care. Conclusion Most of the GPs surveyed consider the combination of continuous patient care and evidence-based diagnosis and treatment to be a great advantage. To better adapt DMPs to the conditions of primary care, it makes sense to simplify the documentation requirements, to regulate cooperation with other healthcare levels more clearly and to give GPs more decision-making flexibility. Increased inclusion of GP experience in the process of developing and refining DMPs can be helpful.

Post-discharge intervention in vulnerable, chronically ill patients

2011 ◽  
Vol 7 (2) ◽  
pp. 124-130 ◽  
Author(s):  
Devan Kansagara ◽  
Rebecca S. Ramsay ◽  
David Labby ◽  
Somnath Saha
Keyword(s):  
Chronically Ill ◽  
Post Discharge ◽  
Chronically Ill Patients
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