Case Management in Primary Care for Frequent Users of Health Care Services: A Mixed Methods Study

Annals of Family Medicine
Catherine HudonDanielle Bouliane

Abstract

This study aimed to evaluate the effects of the V1SAGES case management intervention (Vulnerable Patients in Primary Care: Nurse Case Management and Self-management Support) for frequent users of health care services with chronic disease and complex care needs on psychological distress and patient activation. We used a 2-phase sequential mixed methods design. The first phase was a pragmatic randomized controlled trial with intention-to-treat analysis that measured the effects of the intervention compared with usual care on psychological distress and patient activation before and after 6 months. The second phase had a qualitative descriptive design and entailed thematic analysis of in-depth interviews (25 patients, 6 case management nurses, 9 health managers) and focus groups (8 patients' spouses, 21 family physicians) to understand stakeholders' perceived effects of the intervention on patients. A total of 247 patients were randomized into the intervention group (n = 126) or the control group (n = 121). Compared with usual care, the intervention reduced psychological distress (odds ratio = 0.43; 95% CI, 0.19-0.95, P = .04), but did not have any significant effect on patient activation (P = .43). Qualitative results suggested th...Continue Reading

Citations

Mar 18, 2020·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Nicolas SennJean-Christophe Zuchuat
Sep 19, 2019·The Canadian Journal of Nursing Research = Revue Canadienne De Recherche En Sciences Infirmières·Laurence GuillaumieSophie Lauzier
Jan 23, 2021·Journal of General Internal Medicine·Maelys AmatKelly L Graham
Nov 19, 2020·International Journal of Environmental Research and Public Health·Catherine HudonVéronique Sabourin
Mar 30, 2021·International Journal of Integrated Care·Marlène KaramCatherine Hudon
Jun 3, 2021·International Journal of Environmental Research and Public Health·Cynthia F CorbettDennis G Dyck

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