High Users of Healthcare Services: Development and Alpha Testing of a Patient Decision Aid for Case Management

Poitras, Marie-Ève; Vaillancourt, Vanessa T.; Godbout, Isabelle; Poirier, Annie; Prévost, Karina; Spence, Claude; Chouinard, Maud‐Christine; Zomahoun, Hervé Tchala Vignon; Khadhraoui, Lobna; Massougbodji, José; Bujold, Mathieu; Pluye, Pierre; Hudon, Catherine

doi:10.1007/s40271-020-00465-0

Cited by 6 publications

(2 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, systematic reviews have shown that case management can improve PCCNs satisfaction, self-management, quality of care, services use/costs, and health outcomes [ 94 – 97 ]. Decision aids have recently been proposed to improve patient engagement in case management programs [ 98 ]. In addition, tools exist that aim to detect, assess, prioritize, and follow up complex care needs, and ultimately to improve PCCN/caregiver-practitioner communication, and communication between practitioners.…”

Section: Discussionmentioning

confidence: 99%

Decision-making and related outcomes of patients with complex care needs in primary care settings: a systematic literature review with a case-based qualitative synthesis

Bujold

Pluye²,

Légaré³

et al. 2022

BMC Prim. Care

Self Cite

View full text Add to dashboard Cite

Background In primary care, patients increasingly face difficult decisions related to complex care needs (multimorbidity, polypharmacy, mental health issues, social vulnerability and structural barriers). There is a need for a pragmatic conceptual model to understand decisional needs among patients with complex care needs and outcomes related to decision. We aimed to identify types of decisional needs among patients with complex care needs, and decision-making configurations of conditions associated with decision outcomes. Methods We conducted a systematic mixed studies review. Two specialized librarians searched five bibliographic databases (Medline, Embase, PsycINFO, CINAHL and SSCI). The search strategy was conducted from inception to December 2017. A team of twenty crowd-reviewers selected empirical studies on: (1) patients with complex care needs; (2) decisional needs; (3) primary care. Two reviewers appraised the quality of included studies using the Mixed Methods Appraisal Tool. We conducted a 2-phase case-based qualitative synthesis framed by the Ottawa Decision Support Framework and Gregor’s explicative-predictive theory type. A decisional need case involved: (a) a decision (what), (b) concerning a patient with complex care needs with bio-psycho-social characteristics (who), (c) made independently or in partnership (how), (d) in a specific place and time (where/when), (e) with communication and coordination barriers or facilitators (why), and that (f) influenced actions taken, health or well-being, or decision quality (outcomes). Results We included 47 studies. Data sufficiency qualitative criterion was reached. We identified 69 cases (2997 participants across 13 countries) grouped into five types of decisional needs: ‘prioritization’ (n = 26), ‘use of services’ (n = 22), ‘prescription’ (n = 12), ‘behavior change’ (n = 4) and ‘institutionalization’ (n = 5). Many decisions were made between clinical encounters in situations of social vulnerability. Patterns of conditions associated with decision outcomes revealed four decision-making configurations: ‘well-managed’ (n = 13), ‘asymmetric encounters’ (n = 21), ‘self-management by default’ (n = 8), and ‘chaotic’ (n = 27). Shared decision-making was associated with positive outcomes. Negative outcomes were associated with independent decision-making. Conclusion Our results could extend decision-making models in primary care settings and inform subsequent user-centered design of decision support tools for heterogenous patients with complex care needs.

show abstract

Section: Discussionmentioning

confidence: 99%

Decision-making and related outcomes of patients with complex care needs in primary care settings: a systematic literature review with a case-based qualitative synthesis

Bujold

Pluye²,

Légaré³

et al. 2022

BMC Prim. Care

Self Cite

View full text Add to dashboard Cite

show abstract

“…Others reported that their projects may have limited generalisability due to a lack of diversity in the participants recruited [ 15 ]. For example, two projects struggled with adequate representation of healthcare professionals in their design group, risking the discussion being dominated by other stakeholders [ 12 , 55 ].…”

Section: Discussionmentioning

confidence: 99%

Co-designing care for multimorbidity: a systematic review

Sumner,

Ng,

Teo

et al. 2024

BMC Med

View full text Add to dashboard Cite

Background The co-design of health care enables patient-centredness by partnering patients, clinicians and other stakeholders together to create services. Methods We conducted a systematic review of co-designed health interventions for people living with multimorbidity and assessed (a) their effectiveness in improving health outcomes, (b) the co-design approaches used and (c) barriers and facilitators to the co-design process with people living with multimorbidity. We searched MEDLINE, EMBASE, CINAHL, Scopus and PsycINFO between 2000 and March 2022. Included experimental studies were quality assessed using the Cochrane risk of bias tool (ROB-2 and ROBINS-I). Results We screened 14,376 reports, with 13 reports meeting the eligibility criteria. Two reported health and well-being outcomes: one randomised clinical trial (n = 134) and one controlled cohort (n = 1933). Outcome measures included quality of life, self-efficacy, well-being, anxiety, depression, functional status, healthcare utilisation and mortality. Outcomes favouring the co-design interventions compared to control were minimal, with only 4 of 17 outcomes considered beneficial. Co-design approaches included needs assessment/ideation (12 of 13), prototype (11 of 13), pilot testing (5 of 13) (i.e. focus on usability) and health and well-being evaluations (2 of 13). Common challenges to the co-design process include poor stakeholder interest, passive participation, power imbalances and a lack of representativeness in the design group. Enablers include flexibility in approach, smaller group work, advocating for stakeholders’ views and commitment to the process or decisions made. Conclusions In this systematic review of co-design health interventions, we found that few projects assessed health and well-being outcomes, and the observed health and well-being benefits were minimal. The intensity and variability in the co-design approaches were substantial, and challenges were evident. Co-design aided the design of novel services and interventions for those with multimorbidity, improving their relevance, usability and acceptability. However, the clinical benefits of co-designed interventions for those with multimorbidity are unclear.

show abstract

How to Identify Patient Needs and Preferences Through Service Design Tools in Shared Decision-Making Processes

Sañudo,

Sierra-Pérez

2024

Lecture Notes in Mechanical Engineering

View full text Add to dashboard Cite

High Users of Healthcare Services: Development and Alpha Testing of a Patient Decision Aid for Case Management

Cited by 6 publications

References 41 publications

Decision-making and related outcomes of patients with complex care needs in primary care settings: a systematic literature review with a case-based qualitative synthesis

Decision-making and related outcomes of patients with complex care needs in primary care settings: a systematic literature review with a case-based qualitative synthesis

Co-designing care for multimorbidity: a systematic review

How to Identify Patient Needs and Preferences Through Service Design Tools in Shared Decision-Making Processes

Contact Info

Product

Resources

About