Older patients with multiple chronic conditions desire personalized care plans from their providers
Research Activities, April 2009
Care models that offer strategies for treating patients with chronic conditions such as diabetes often focus on one condition. As adults age, many juggle multiple chronic conditions that have competing requirements, but no care models exists for those patients. Elizabeth A. Bayliss, M.D., M.S.P.H., of Kaiser Permanente Institute for Health Research, and her colleagues interviewed 26 elderly patients who suffered from at least 3 chronic conditions (diabetes, arthritis, and depression) to determine what elements should be included in a care model that addresses multiple chronic health conditions.
The patients, most of whom had four to nine chronic conditions, stressed the need to have an ongoing relationship with their providers so they did not have to spend time educating new providers on their health histories. They also voiced a need for a single care coordinator who could serve as a liaison among providers so patients would not have to continually update all their providers on changes to their health status. They said they wanted convenient access to their providers, including specialists, via telephone, Internet, or in person. However, many viewed in-person visits as a last resort because they did not want to make appointments when they merely needed a question answered. These patients also wanted clear, written care plans so they did not have to rely on their memories. Because they believed themselves to be familiar with their conditions, patients appreciated when their providers took their perspective into account when creating treatment plans.
A system that has these features, the authors suggest, may be labor intensive for the health care system. Identifying which patients would most benefit from this type of support and the right time to provide it should be a future research topic. This study was funded in part by the Agency for Healthcare Research and Quality (HS15476).
See "Processes of care desired by elderly patients with multimorbidities," by Dr. Bayliss, Allison E. Edwards, John F. Steiner, M.D., M.P.H., and Deborah S. Main, Ph.D., in the August 2008 Family Practice 25(4), pp. 287-293.