Making care more patient centered; experiences of healthcare professionals and patients with multimorbidity in the primary care setting.
Care delivery
General practice
Multimorbidity
Patient-centered care
Primary care
Journal
BMC family practice
ISSN: 1471-2296
Titre abrégé: BMC Fam Pract
Pays: England
ID NLM: 100967792
Informations de publication
Date de publication:
09 04 2021
09 04 2021
Historique:
received:
08
10
2020
accepted:
23
03
2021
entrez:
10
4
2021
pubmed:
11
4
2021
medline:
25
9
2021
Statut:
epublish
Résumé
The present study describes how primary care can be improved for patients with multimorbidity, based on the evaluation of a patient-centered care (PCC) improvement program designed to foster the eight PCC dimensions (patient preferences, information and education, access to care, physical comfort, coordination of care, continuity and transition, emotional support, and family and friends). This study characterizes the interventions implemented in practice as part of the PCC improvement program and describes the experiences of healthcare professionals and patients with the resulting PCC delivery. This study employed a mixed-methods design. Semi-structured interviews were conducted with nine general practitioners and nurse practitioners from seven primary care practices in Noord-Brabant, the Netherlands, that participated in the program (which included interventions and workshops). The qualitative interview data were examined using thematic analysis. A longitudinal survey was conducted with 138 patients with multimorbidity from these practices to assess perceived improvements in PCC and its underlying dimensions. Paired sample t tests were performed to compare survey responses obtained at a 1-year interval corresponding to program implementation. The PCC improvement program is described, and themes necessary for PCC improvement according to healthcare professionals were generated [e.g. Aligning information to patients' needs and backgrounds, adapting a coaching role]. PCC experiences of patients with multimorbidity improved significantly during the year in which the PCC interventions were implemented (t = 2.66, p = 0.005). This study revealed how primary PCC can be improved for patients with multimorbidity. It emphasizes the importance of investing in PCC improvement programs to tailor care delivery to heterogenous patients with multimorbidity with diverse care needs. This study generates new perspectives on care delivery and highlights opportunities for its improvement according to the eight dimensions of PCC for patients with multimorbidity in a primary care setting.
Sections du résumé
BACKGROUND
The present study describes how primary care can be improved for patients with multimorbidity, based on the evaluation of a patient-centered care (PCC) improvement program designed to foster the eight PCC dimensions (patient preferences, information and education, access to care, physical comfort, coordination of care, continuity and transition, emotional support, and family and friends). This study characterizes the interventions implemented in practice as part of the PCC improvement program and describes the experiences of healthcare professionals and patients with the resulting PCC delivery.
METHODS
This study employed a mixed-methods design. Semi-structured interviews were conducted with nine general practitioners and nurse practitioners from seven primary care practices in Noord-Brabant, the Netherlands, that participated in the program (which included interventions and workshops). The qualitative interview data were examined using thematic analysis. A longitudinal survey was conducted with 138 patients with multimorbidity from these practices to assess perceived improvements in PCC and its underlying dimensions. Paired sample t tests were performed to compare survey responses obtained at a 1-year interval corresponding to program implementation.
RESULTS
The PCC improvement program is described, and themes necessary for PCC improvement according to healthcare professionals were generated [e.g. Aligning information to patients' needs and backgrounds, adapting a coaching role]. PCC experiences of patients with multimorbidity improved significantly during the year in which the PCC interventions were implemented (t = 2.66, p = 0.005).
CONCLUSION
This study revealed how primary PCC can be improved for patients with multimorbidity. It emphasizes the importance of investing in PCC improvement programs to tailor care delivery to heterogenous patients with multimorbidity with diverse care needs. This study generates new perspectives on care delivery and highlights opportunities for its improvement according to the eight dimensions of PCC for patients with multimorbidity in a primary care setting.
Identifiants
pubmed: 33836652
doi: 10.1186/s12875-021-01420-0
pii: 10.1186/s12875-021-01420-0
pmc: PMC8035730
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
70Références
PLoS One. 2011;6(10):e25987
pubmed: 22028802
J Gen Intern Med. 2005 Oct;20(10):953-7
pubmed: 16191145
Health Care Manage Rev. 2019 Jun 20;:
pubmed: 31233424
BMC Fam Pract. 2020 Apr 26;21(1):71
pubmed: 32336277
Health Manage Q. 1993;15(3):2-6
pubmed: 10129190
Health Qual Life Outcomes. 2004 Sep 20;2:51
pubmed: 15380021
Soc Sci Med. 2003 May;56(10):2191-200
pubmed: 12697207
J Affect Disord. 2017 Oct 15;221:36-46
pubmed: 28628766
J Gerontol A Biol Sci Med Sci. 2019 Apr 23;74(5):659-666
pubmed: 29726918
Health Policy. 2018 Jan;122(1):36-43
pubmed: 29129270
J Eval Clin Pract. 2010 Oct;16(5):947-56
pubmed: 20553366
BMJ Open. 2013 Jan 03;3(1):
pubmed: 23293244
Ageing Res Rev. 2019 Aug;53:100903
pubmed: 31048032
J Comorb. 2017 Jan 27;7(1):11-21
pubmed: 29090185
N Engl J Med. 2004 Dec 30;351(27):2870-4
pubmed: 15625341
PLoS One. 2014 Dec 05;9(12):e114742
pubmed: 25478876
J Comorb. 2016 Feb 17;6(1):4-11
pubmed: 29090166
BMJ. 1996 Oct 5;313(7061):858-9
pubmed: 8870574
BMC Health Serv Res. 2017 Jul 11;17(1):472
pubmed: 28693569
BMC Fam Pract. 2019 Dec 27;20(1):179
pubmed: 31881942
Fam Pract. 2018 Mar 27;35(2):132-141
pubmed: 28973173
Arch Gerontol Geriatr. 2016 Nov-Dec;67:130-8
pubmed: 27500661
Fam Pract. 2008 Aug;25(4):287-93
pubmed: 18628243
Patient Educ Couns. 2013 Jul;92(1):3-12
pubmed: 23453850
Ageing Res Rev. 2011 Sep;10(4):430-9
pubmed: 21402176
Ann Fam Med. 2005 May-Jun;3(3):223-8
pubmed: 15928225
Gen Hosp Psychiatry. 2017 Mar - Apr;45:1-6
pubmed: 28274332
PLoS One. 2019 Aug 1;14(8):e0220116
pubmed: 31369582
J Adv Nurs. 2016 May;72(5):968-79
pubmed: 26751971
BMC Health Serv Res. 2019 Jan 8;19(1):13
pubmed: 30621688
BMC Fam Pract. 2016 Jun 06;17:68
pubmed: 27267905
Med Care Res Rev. 2013 Aug;70(4):351-79
pubmed: 23169897