AutomedicationFrancoV1, Main, Exploration, bibRecord, 000E25

Potential workload in applying clinical practice guidelines for patients with chronic conditions and multimorbidity: a systematic analysis.

Identifieur interne : 000E25 ( Main/Exploration ); précédent : 000E24; suivant : 000E26

Potential workload in applying clinical practice guidelines for patients with chronic conditions and multimorbidity: a systematic analysis.

Auteurs : Céline Buffel Du Vaure [France] ; Philippe Ravaud [États-Unis] ; Gabriel Baron [France] ; Caroline Barnes [France] ; Serge Gilberg [France] ; Isabelle Boutron [France]

Source :

BMJ open [ 2044-6055 ] ; 2016.

RBID : pubmed:27006342

Descripteurs français

KwdFr :
- Autosoins (MeSH), Charge de travail (MeSH), Comorbidité (MeSH), Guides de bonnes pratiques cliniques comme sujet (MeSH), Humains (MeSH), Maladie chronique (psychologie), Observance par le patient (MeSH), Polypharmacie (MeSH), Soins de santé primaires (MeSH), États-Unis (épidémiologie).
MESH :
- psychologie : Maladie chronique.
- épidémiologie : États-Unis.
- Autosoins, Charge de travail, Comorbidité, Guides de bonnes pratiques cliniques comme sujet, Humains, Observance par le patient, Polypharmacie, Soins de santé primaires.

English descriptors

KwdEn :
- Chronic Disease (psychology), Comorbidity (MeSH), Humans (MeSH), Patient Compliance (MeSH), Polypharmacy (MeSH), Practice Guidelines as Topic (MeSH), Primary Health Care (MeSH), Self Care (MeSH), United States (epidemiology), Workload (MeSH).
MESH :
- epidemiology : United States.
- psychology : Chronic Disease.
- Comorbidity, Humans, Patient Compliance, Polypharmacy, Practice Guidelines as Topic, Primary Health Care, Self Care, Workload.

Abstract

OBJECTIVES

To describe the potential workload for patients with multimorbidity when applying existing clinical practice guidelines.

DESIGN

Systematic analysis of clinical practice guidelines for chronic conditions and simulation modelling approach.

DATA SOURCES

National Guideline Clearinghouse index of US clinical practice guidelines.

STUDY SELECTION

We identified the most recent guidelines for adults with 1 of 6 prevalent chronic conditions in primary care (ie hypertension, diabetes, coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD), osteoarthritis and depression).

DATA EXTRACTION

From the guidelines, we extracted all recommended health-related activities (HRAs) such as drug management, self-monitoring, visits to the doctor, laboratory tests and changes of lifestyle for a patient aged 45-64 years with moderate severity of conditions.

SIMULATION MODELLING APPROACH

For each HRA identified, we performed a literature review to determine the potential workload in terms of time spent on this HRA. Then, we used a simulation modelling approach to estimate the potential workload needed to comply with these recommended HRAs for patients with several of these chronic conditions.

RESULTS

Depending on the concomitant chronic condition, patients with 3 chronic conditions complying with all the guidelines would have to take a minimum of 6 to a maximum of 13 medications per day, visit a health caregiver a minimum of 1.2 to a maximum of 5.9 times per month and spend a mean (SD) of 49.6 (27.3) to 71.0 (34.5) h/month in HRAs. The potential workload increased greatly with increasing number of concomitant conditions, rising to 18 medications per day, 6.6 visits per month and 80.7 (35.8) h/month in HRAs for patients with 6 chronic conditions.

DOI: 10.1136/bmjopen-2015-010119
PubMed: 27006342
PubMed Central: PMC4809109

Affiliations:

Links toward previous steps (curation, corpus...)

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Le document en format XML

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<term>Charge de travail</term>
<term>Comorbidité</term>
<term>Guides de bonnes pratiques cliniques comme sujet</term>
<term>Humains</term>
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<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b>
</p>
<p>To describe the potential workload for patients with multimorbidity when applying existing clinical practice guidelines.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>DESIGN</b>
</p>
<p>Systematic analysis of clinical practice guidelines for chronic conditions and simulation modelling approach.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>DATA SOURCES</b>
</p>
<p>National Guideline Clearinghouse index of US clinical practice guidelines.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>STUDY SELECTION</b>
</p>
<p>We identified the most recent guidelines for adults with 1 of 6 prevalent chronic conditions in primary care (ie hypertension, diabetes, coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD), osteoarthritis and depression).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>DATA EXTRACTION</b>
</p>
<p>From the guidelines, we extracted all recommended health-related activities (HRAs) such as drug management, self-monitoring, visits to the doctor, laboratory tests and changes of lifestyle for a patient aged 45-64 years with moderate severity of conditions.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>SIMULATION MODELLING APPROACH</b>
</p>
<p>For each HRA identified, we performed a literature review to determine the potential workload in terms of time spent on this HRA. Then, we used a simulation modelling approach to estimate the potential workload needed to comply with these recommended HRAs for patients with several of these chronic conditions.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Depending on the concomitant chronic condition, patients with 3 chronic conditions complying with all the guidelines would have to take a minimum of 6 to a maximum of 13 medications per day, visit a health caregiver a minimum of 1.2 to a maximum of 5.9 times per month and spend a mean (SD) of 49.6 (27.3) to 71.0 (34.5) h/month in HRAs. The potential workload increased greatly with increasing number of concomitant conditions, rising to 18 medications per day, 6.6 visits per month and 80.7 (35.8) h/month in HRAs for patients with 6 chronic conditions.</p>
</div>
</front>
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<Day>02</Day>
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<Abstract><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">To describe the potential workload for patients with multimorbidity when applying existing clinical practice guidelines.</AbstractText>
<AbstractText Label="DESIGN" NlmCategory="METHODS">Systematic analysis of clinical practice guidelines for chronic conditions and simulation modelling approach.</AbstractText>
<AbstractText Label="DATA SOURCES" NlmCategory="METHODS">National Guideline Clearinghouse index of US clinical practice guidelines.</AbstractText>
<AbstractText Label="STUDY SELECTION" NlmCategory="METHODS">We identified the most recent guidelines for adults with 1 of 6 prevalent chronic conditions in primary care (ie hypertension, diabetes, coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD), osteoarthritis and depression).</AbstractText>
<AbstractText Label="DATA EXTRACTION" NlmCategory="METHODS">From the guidelines, we extracted all recommended health-related activities (HRAs) such as drug management, self-monitoring, visits to the doctor, laboratory tests and changes of lifestyle for a patient aged 45-64 years with moderate severity of conditions.</AbstractText>
<AbstractText Label="SIMULATION MODELLING APPROACH" NlmCategory="UNASSIGNED">For each HRA identified, we performed a literature review to determine the potential workload in terms of time spent on this HRA. Then, we used a simulation modelling approach to estimate the potential workload needed to comply with these recommended HRAs for patients with several of these chronic conditions.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Depending on the concomitant chronic condition, patients with 3 chronic conditions complying with all the guidelines would have to take a minimum of 6 to a maximum of 13 medications per day, visit a health caregiver a minimum of 1.2 to a maximum of 5.9 times per month and spend a mean (SD) of 49.6 (27.3) to 71.0 (34.5) h/month in HRAs. The potential workload increased greatly with increasing number of concomitant conditions, rising to 18 medications per day, 6.6 visits per month and 80.7 (35.8) h/month in HRAs for patients with 6 chronic conditions.</AbstractText>
<CopyrightInformation>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Buffel du Vaure</LastName>
<ForeName>Céline</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Département de Médecine Générale, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France METHODS Team, Epidemiology and Statistics Sorbonne Paris Cité, Research Center UMR 1153, INSERM, Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ravaud</LastName>
<ForeName>Philippe</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France METHODS Team, Epidemiology and Statistics Sorbonne Paris Cité, Research Center UMR 1153, INSERM, Paris, France Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Epidémiologie Clinique, Paris, France Centre de Médecine Fondée sur les Preuves (EHESP, HAS, INSERM, AP-HP), Paris, France Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Baron</LastName>
<ForeName>Gabriel</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France METHODS Team, Epidemiology and Statistics Sorbonne Paris Cité, Research Center UMR 1153, INSERM, Paris, France Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Epidémiologie Clinique, Paris, France Centre de Médecine Fondée sur les Preuves (EHESP, HAS, INSERM, AP-HP), Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Barnes</LastName>
<ForeName>Caroline</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France METHODS Team, Epidemiology and Statistics Sorbonne Paris Cité, Research Center UMR 1153, INSERM, Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Gilberg</LastName>
<ForeName>Serge</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Département de Médecine Générale, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Boutron</LastName>
<ForeName>Isabelle</ForeName>
<Initials>I</Initials>
<AffiliationInfo><Affiliation>Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France METHODS Team, Epidemiology and Statistics Sorbonne Paris Cité, Research Center UMR 1153, INSERM, Paris, France Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Epidémiologie Clinique, Paris, France Centre de Médecine Fondée sur les Preuves (EHESP, HAS, INSERM, AP-HP), Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016454">Review</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2016</Year>
<Month>03</Month>
<Day>22</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>England</Country>
<MedlineTA>BMJ Open</MedlineTA>
<NlmUniqueID>101552874</NlmUniqueID>
<ISSNLinking>2044-6055</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D002908" MajorTopicYN="Y">Chronic Disease</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015897" MajorTopicYN="Y">Comorbidity</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D010349" MajorTopicYN="N">Patient Compliance</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D019338" MajorTopicYN="N">Polypharmacy</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017410" MajorTopicYN="N">Practice Guidelines as Topic</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011320" MajorTopicYN="N">Primary Health Care</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012648" MajorTopicYN="N">Self Care</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D014481" MajorTopicYN="N">United States</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016526" MajorTopicYN="Y">Workload</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Chronic disease</Keyword>
<Keyword MajorTopicYN="N">Multimorbidity</Keyword>
<Keyword MajorTopicYN="N">PRIMARY CARE</Keyword>
<Keyword MajorTopicYN="N">Practice guidelines</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2016</Year>
<Month>3</Month>
<Day>24</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed"><Year>2016</Year>
<Month>3</Month>
<Day>24</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2016</Year>
<Month>12</Month>
<Day>29</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>epublish</PublicationStatus>
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<ArticleId IdType="doi">10.1136/bmjopen-2015-010119</ArticleId>
<ArticleId IdType="pmc">PMC4809109</ArticleId>
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<affiliations><list><country><li>France</li>
<li>États-Unis</li>
</country>
<region><li>État de New York</li>
<li>Île-de-France</li>
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<tree><country name="France"><region name="Île-de-France"><name sortKey="Buffel Du Vaure, Celine" sort="Buffel Du Vaure, Celine" uniqKey="Buffel Du Vaure C" first="Céline" last="Buffel Du Vaure">Céline Buffel Du Vaure</name>
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<name sortKey="Gilberg, Serge" sort="Gilberg, Serge" uniqKey="Gilberg S" first="Serge" last="Gilberg">Serge Gilberg</name>
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<country name="États-Unis"><region name="État de New York"><name sortKey="Ravaud, Philippe" sort="Ravaud, Philippe" uniqKey="Ravaud P" first="Philippe" last="Ravaud">Philippe Ravaud</name>
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Potential workload in applying clinical practice guidelines for patients with chronic conditions and multimorbidity: a systematic analysis.

Potential workload in applying clinical practice guidelines for patients with chronic conditions and multimorbidity: a systematic analysis.

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