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Priorities to improve the care for chronic conditions and multimorbidity: a survey of patients and stakeholders nested within the ComPaRe e-cohort
  1. Viet-Thi Tran1,2,
  2. Elise Diard1,2,
  3. Philippe Ravaud1,2
  1. 1METHODS Team, Université de Paris, CRESS, INSERM, INRA, Paris, France
  2. 2Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique - Hôpitaux de Paris, Paris, France
  1. Correspondence to Dr Viet-Thi Tran, METHODS, Paris, France; thi.tran-viet{at}aphp.fr

Abstract

Objective To set priorities to improve consultations, care structures and the healthcare system from the perspective of patients with chronic conditions, care professionals, hospital administrators and health policy makers.

Methods Adult patients with chronic conditions recruited from the ComPaRe e-cohort in France ranked their 15 most important areas of improvement among 147 previously defined by patients. Priorities at a population level were obtained by using logit models for sets of ranked items in a data set calibrated to represent the French population of patients with chronic conditions. Care professionals, hospital managers and health policy makers rated the complexity involved in improving the areas identified. We calculated the number of patients who considered as a priority at least one of the areas considered easy to implement.

Results Between September 2018 and May 2019, 3002 patients (84% women, 47% with multimorbidity) and 149 professionals (including 50 care professionals, 79 hospital directors, 11 health policy decision makers) were recruited. Patients’ top priorities were (1) Transforming care to be holistic and personalised, at a consultation level; (2) Smoothing patients' journey in the care system, increasing their knowledge of their own health and improving care coordination, at a care structure level (3) Training clinicians in better interpersonal skills and knowledge of specific conditions/treatments, reducing stigma and making care more affordable, at a healthcare system level. In total, 48%, 71% and 57% patients ranked in their top priorities one area considered easy to improve by professionals at consultation, care structure and health system levels, respectively.

Conclusion This is the first comprehensive map of patients’ priorities to improve the management of chronic conditions. Implementing simple actions could benefit a large number of patients.

  • health services research
  • healthcare quality improvement
  • patient-centred care
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Twitter @thitran3

  • Contributors Generated the idea: V-TT and PR; Conceived and designed the experiments: V-TT, ED and PR; Collected data: V-TT and ED; Analysed data: V-TT; Wrote the first draft of the manuscript: V-TT; Contributed to the writing of the manuscript: V-TT, ED and PR; Agree with manuscript results and conclusions: V-TT, ED and PR; V-TT is the guarantor, had full access to the data in the study, and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval ComPaRe was approved by the Comité de Protection des Personnes Ile de France 1 (IRB: 0008367).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. All data are available under the rules of the ComPaRe e-cohort.

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