Person-centred care for patients with chronic heart failure – a cost–utility analysis

Hanssoń, Elisabeth; Ekman, Inger; Swedberg, Karl; Wolf, Axel; Dudas, Kerstin; Ehlers, Lars Holger; Olsson, Lars-Eric

doi:10.1177/1474515114567035

Cited by 79 publications

(101 citation statements)

References 24 publications

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“…For example, in chronic conditions such as chronic heart failure (CHF), PCC has been shown to reduce length of hospital stay [5]; reduce uncertainty about the disease [6] and treatment and improve the efficiency of the discharge process [7]; lower healthcare costs [8, 9]; reduce re-hospitalization rates and improve health-related quality of life [10]; and improve adherence to medications [11]. A study evaluating the effects of PCC along the chain of health care in patients with acute coronary syndromes (ACS) showed a three-fold higher chance [12] (even higher when complemented with an eHealth tool [13]), of improved general self-efficacy in combination with return to work or previous activity level without increasing the risk of cardiovascular events or death.…”

Section: Introductionmentioning

confidence: 99%

Effects of a person-centred telephone-support in patients with chronic obstructive pulmonary disease and/or chronic heart failure – A randomized controlled trial

et al. 2018

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PurposeTo evaluate the effects of person-centred support via telephone in two chronically ill patient groups, chronic obstructive pulmonary disease (COPD) and/or chronic heart failure (CHF).Method221 patients ≥ 50 years with COPD and/or CHF were randomized to usual care vs. usual care plus a person-centred telephone-support intervention and followed for six months. Patients in the intervention group were telephoned by a registered nurse initially to co-create a person-centred health plan with the patient and subsequently to discuss and evaluate the plan. The primary outcome measure was a composite score comprising General Self-Efficacy (GSE), re-hospitalization and death. Patients were classified as deteriorated if GSE had decreased by ≥ 5 points, or if they had been re-admitted to hospital for unscheduled reasons related to COPD and/or CHF or if they had died.ResultsAt six-month follow-up no difference in the composite score was found between the two study groups (57.6%, n = 68 vs. 46.6%, n = 48; OR = 1.6, 95% CI: 0.9–2.7; P = 0.102) in the intention-to-treat analysis (n = 221); however, significantly more patients in the control group showed a clinically important decrease in GSE (≥ 5 units) (22.9%, n = 27 vs. 9.7%, n = 10; OR = 2.8, 95% CI: 1.3–6.0; P = 0.011). There were 49 clinical events (14 deaths, 35 re-admissions) in the control group and 41 in the intervention group (9 deaths, 32 re-admissions). Per-protocol analysis (n = 202) of the composite score showed that more patients deteriorated in the control group than in the intervention group (57.6%, n = 68 vs. 42.9%, n = 36; OR = 1.8, 95% CI 1.0–3.2; P = 0.039).ConclusionPerson-centred support via telephone mitigates worsening self-efficacy without increasing the risk of clinical events in chronically ill patients with CHF and/or COPD. This indicates that a patient-healthcare professional partnership may be established without the need for face-to-face consultations, even in vulnerable patient groups.Trial registrationISRCTN.com ISRCTN55562827.

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Section: Introductionmentioning

confidence: 99%

Effects of a person-centred telephone-support in patients with chronic obstructive pulmonary disease and/or chronic heart failure – A randomized controlled trial

et al. 2018

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“…PCC has also been shown to produce improved outcomes such as increased security and satisfaction with hospital care, shorter hospital stays, and a more efficient discharge process (Dudas et al, 2013;Ekman, Wolf, et al, 2011;Ulin, Olsson, Wolf, & Ekman, 2016). Other studies report improved self-efficacy (Fors et al, 2015), and reduced costs (Hansson et al, 2016;Sahlen, Boman, & Brännström, 2016).…”

Section: Introductionmentioning

confidence: 99%

Person‐centred inpatient care – A quasi‐experimental study in an internal medicine context

Jakobsson

Eliasson

Andersson

et al. 2019

Journal of Advanced Nursing

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Aim The aim of this study was to evaluate effects of person‐centred inpatient care on care processes in terms of satisfaction with care and person‐centred content in medical records, and to evaluate effects on self‐reported health and self‐efficacy. Background Internal medicine inpatient care is complex, covering patients varying in age, medical conditions, health status, and other aspects. There has been limited research on the impact of person‐centred care (PCC) on satisfaction with care and health outcomes in internal medicine care environments regardless of diagnosis and care pathway. Design A quasi‐experimental study with pre‐ and postmeasurements. Methods Adult patients admitted to an internal medicine inpatient unit were consecutively included over 16 weeks in 2014 and 24 weeks in 2015–2016. Data were collected before a person‐centred inpatient care intervention (N = 204) and 12 months after the intervention was implemented (N = 177). Data on satisfaction with care and self‐reported health were collected at discharge and medical records were reviewed. The intervention included systematically applied person‐centred assessment, health plans, and persistent PCC. Results After the intervention, patients rated higher satisfaction with care regarding essential components of PCC and more patients had received effective pain relief. There were no differences in information on self‐care or medications, self‐rated health, or self‐efficacy. Conclusion Care focused on the foundations of person‐centredness seems to enhance both patients’ perceptions of satisfaction and symptom management. Situational aspects such as care pathways should be considered when implementing person‐centred inpatient care. Trial registration: ClinicalTrials.gov, registration number: NCT03725813

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“…Research has shown that these actions improve patients' quality of life [2,3] and the discharge process [4] as well as metabolic control and self-efficacy [5,6]. Furthermore, studies show such efforts decrease patients' fatigue [5] and uncertainty [7], which results in lower costs [8,9] due to shorter hospital stays [3,10,11]. Moreover, staff report higher job satisfaction, a friendlier working environment, and reduced conscience stress when person-centred care is implemented [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Development of an Academic Course in Person-Centred Care for Students in Higher Education: Teachers’ Perspectives

Rosengren

Danielsson

Jansson

et al. 2018

Education Research International

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Few studies describe the development of academic courses with interprofessional perspectives. Therefore, the aim of this study was to describe teachers’ experiences with developing an academic course in person-centred care (PCC). Data collection was divided into three parts: (1) written material/documentation describing the process (text and pictures, 16 meetings), (2) SWOT analysis in relation to being a lecturer (n=7), and (3) interviews with the lecturers (n=4). The data were analysed using mixed methods, descriptive statistics (1) and qualitative content analysis (2-3). The results are presented in three categories (Co-creating a pilot course, Challenges of managing unfamiliar knowledge, and Wanting to understand new educational approach). This study highlights three challenges: (1) unfamiliarity with the field of person-centred care and selected educational activities and teaching skills; (2) unfamiliar colleagues, which delayed partnership efforts; and (3) limited experience working with other lecturers in light of the institute’s structure and routines. However, these challenges served as both barriers and facilitators; the lecturers developed knowledge and experiences from collaborations (educational and/or content skills/knowledge) focusing on resources and skills.

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Person-centred care for patients with chronic heart failure – a cost–utility analysis

Abstract: It must be emphasized, however, that these positive effects, both cheaper and somewhat better, were obtained only among those receiving the PCC intervention in its intended form, PCC(PP).

Cited by 79 publications

References 24 publications

Effects of a person-centred telephone-support in patients with chronic obstructive pulmonary disease and/or chronic heart failure – A randomized controlled trial

Effects of a person-centred telephone-support in patients with chronic obstructive pulmonary disease and/or chronic heart failure – A randomized controlled trial

Person‐centred inpatient care – A quasi‐experimental study in an internal medicine context

Development of an Academic Course in Person-Centred Care for Students in Higher Education: Teachers’ Perspectives

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