Understanding and Honoring Patients with Multiple Chronic Conditions

理解和尊重患有多种慢性病的患者

• 批准号: 9133328
• 负责人: JAMES D. RALSTON
• 金额: $ 49.3万
• 依托单位: KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9133328
• 关键词: Understanding; Honoring; Patients; Multiple; Chronic

DESCRIPTION (provided by applicant): Current systems of care are not meeting the needs of older patients with multiple chronic health conditions. These patients receive more conflicting medical advice, and experience worse quality of life, more physical disability, more adverse drug events, and higher mortality than those without multimorbidity. Patients with multiple chronic conditions often face competing and conflicting health demands: for example, a person with diabetes may get advice to exercise but pain from arthritis or shortness of breath from lung disease can limit activity. To get the best care, patients with several chronic illnesses must communicate what is most important to them to their doctors and other healthcare providers, and doctors must understand and support patients' priorities for care. Unfortunately, we often do not talk to patients about their priorities or make them a part of care. We need care plans that include patients' priorities and tools for sharing them with all caregivers. But first, we must understand what shapes the priorities of patients with multiple chronic conditions and how these priorities can be supported by healthcare providers. In this project, experts in chronic disease care, health information technology, and participatory design methods will first study how patients with multiple chronic conditions understand and set priorities for care. The results will be used in a design process in which patients, their family caregivers, and their healthcare providers will develop a prototype interactive priority plan to be shared between patients and providers. The project focuses on patients with diabetes, who have some combination of osteoarthritis, coronary artery disease and depression. Based on increasing national implementation of meaningful use requirements, we envision the documentation and communication of a patient's priorities to eventually be integrated within an electronic health record shared between patients and healthcare providers. Our study, however, will establish when paper, telephone and in-person communications are needed to ensure common understanding and ongoing communication between patients and providers. We will also evaluate our novel use of participatory design methods to inform their potential wider use in projects that improve chronic care. Our project will help patients, caregivers, and doctors manage complex personal health information, and guide information technology developers on the design elements that are important for incorporating patient priorities into electronic health records.

描述（由申请人提供）：目前的护理系统不能满足患有多种慢性疾病的老年患者的需求。这些患者接受更多相互矛盾的医疗建议，并经历更差的生活质量，更多的身体残疾，更多的药物不良事件和更高的死亡率。患有多种慢性疾病的患者通常面临相互竞争和相互冲突的健康需求：例如，糖尿病患者可能会得到锻炼的建议，但关节炎疼痛或肺病呼吸急促可能会限制活动。为了获得最好的护理，患有多种慢性疾病的患者必须向医生和其他医疗保健提供者传达对他们最重要的事情，医生必须了解并支持患者的护理优先事项。不幸的是，我们经常不与患者谈论他们的优先事项或使他们成为护理的一部分。我们需要护理计划，包括患者的优先事项和工具，与所有护理人员分享。但首先，我们必须了解是什么塑造了患有多种慢性病的患者的优先事项，以及医疗保健提供者如何支持这些优先事项。在这个项目中，慢性病护理，健康信息技术和参与式设计方法的专家将首先研究患有多种慢性病的患者如何理解和设置护理优先级。研究结果将用于设计过程中，患者，他们的家庭护理人员和他们的医疗保健提供者将开发一个原型交互式优先计划，供患者和提供者共享。该项目的重点是糖尿病患者，他们患有骨关节炎，冠状动脉疾病和抑郁症。基于越来越多的国家实施有意义的使用要求，我们设想的文件和病人的优先事项的通信，最终被集成在一个电子健康记录之间共享的病人和医疗保健提供者。然而，我们的研究将确定何时需要纸张，电话和面对面的沟通，以确保患者和提供者之间的共同理解和持续沟通。我们还将评估我们对参与式设计方法的新颖使用，以告知其在改善慢性病护理项目中的潜在更广泛使用。我们的项目将帮助患者，护理人员和医生管理复杂的个人健康信息，并指导信息技术开发人员将患者优先事项纳入电子健康记录的重要设计元素。

项目成果

Eliciting Values of Patients with Multiple Chronic Conditions: Evaluation of a Patient-centered Framework.

得出多种慢性病患者的价值：以患者为中心的框架评估。

• 发表时间: 2017
• 期刊: AMIA ... Annual Symposium proceedings. AMIA Symposium
• 作者: Berry,AndrewBL;Lim,Catherine;Hartzler,AndreaL;Hirsch,Tad;Ludman,Evette;Wagner,EdwardH;Ralston,JamesD
• 通讯作者: Ralston,JamesD