Engagement With the Plan of Care Among Older Adults With Multiple Cardiac Diagnoses

Abstract

Aging adults depend on complex treatment plans to manage chronic conditions, yet little is known about their ability to perform the sophisticated behaviors required of technologically engaged patients. This qualitative descriptive study describes engagement with the plan of care. Forty chronically ill adults participated in this study, which involved an observation of the clinical encounter and an interview. Data were collected and analyzed simultaneously in keeping with principles of qualitative research. Multiple techniques were used to test conclusions and findings were constructed as thematic sentences, including the following: I act in ways that support my health, I manage my health-related information, I make visits with my doctor part of my routine, I participate in treatment planning. Older adults work to achieve self-management to the best of their ability, shunning the use of health information technology (HIT) and demonstrating a preference for provider-created treatment plans.

A Systematic Review of Patient Engagement Experiences in Brain Disorders

“…Clorafi 24 showed that there are numerous initiatives underway to use health information technology to support patient engagement. However, the use of health information technology and other factors such as health literacy may be significant barriers to actually engage older adults.…”

“…The literature reveals some important insights as concerns specific age groups. For example, Clorafi 24 showed that older adults need to have a positive relationship with the provider meeting the patient’s needs, and the distribution of a meaningful summary at the end of the provider visit in order to have clear take-away messages. Menichetti et al 59 examined the design, development and optimization of a theoretically driven intervention program (PHEinAction) to increase patient engagement in older chronic populations, and showed that it is important to consider emotional, psychological, and behavioral processes to support patient engagement among older patients.…”

“…In order to make effective use of new health-related technological developments, it is essential to involve and engage all stakeholders continuously in developing and testing potential solutions and clinical guidelines, and working in a multidisciplinary way with all stakeholders to ensure that people with brain diseases are included in shared decision-making and disease management. 21 , 22 Moreover, patient engagement has been labelled as the ‘blockbuster drug of the century’ 23 for upcoming and rapidly developing methodologies like health information technology 24 and personal health records. 17 , 25 Rationales for patient engagement in developing clinical guidelines include recognizing patients as expert in their experience and perception of the disease, with important contributions, thereby empowering them in well-informed healthcare decisions and respecting the rights of citizens in healthcare policy.…”

The role of phone-based triage nurses in supporting older adults with multimorbidity to digitally self-manage – Findings from the ProACT proof-of-concept study

“…These same participants did not engage in the use of technology to manage their care, perhaps preferring human support. 25 …”

“…These same participants did not engage in the use of technology to manage their care, perhaps preferring human support. 25 HCPs also experience numerous challenges in caring for PwMs, often reporting limited time to interact with patients, create formal integrated care plans or conduct medication reviews, as well as feeling burdened by having to monitor patient data. 7,12,[26][27][28] There is frequently dissonance between what patients' desire and what HCPs typically can, or are willing to, provide in terms of support for managing conditions.…”