Mieke Rijken1, Nienke Bekkema, Pauline Boeckxstaens, François G Schellevis, Jan M De Maeseneer, Peter P Groenewegen. 1. Head of research programmePhD student, Netherlands Institute for Health Services Research (NIVEL), Utrecht, the NetherlandsPhD student, Department of Family Medicine and Primary Health Care, Ghent University, Ghent, BelgiumProfessor, Department of General Practice, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the NetherlandsHead of research department, Netherlands Institute for Health Services Research (NIVEL), Utrecht, the NetherlandsProfessor, Department of Family Medicine and Primary Health Care, Ghent University, Ghent, BelgiumProfessor, Department of Family Medicine and Primary Health Care, Ghent University, Ghent, BelgiumDirector, Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands.
Abstract
BACKGROUND: Inspired by American examples, several European countries are now developing disease management programmes (DMPs) to improve the quality of care for patients with chronic diseases. Recently, questions have been raised whether the disease management approach is appropriate to respond to patient-defined needs. OBJECTIVE: In this article we consider the responsiveness of current European DMPs to patients' needs defined in terms of multimorbidity, functional and participation problems, and self-management. METHOD: Information about existing DMPs was derived from a survey among country-experts. In addition, we made use of international scientific literature. RESULTS: Most European DMPs do not have a solid answer yet to the problem of multimorbidity. Methods of linking DMPs, building extra modules to deal with the most prevalent comorbidities and integration of case management principles are introduced. Rehabilitation, psychosocial and reintegration support are not included in all DMPs, and the involvement of the social environment of the patient is uncommon. Interventions tailored to the needs of specific social or cultural patient groups are mostly not available. Few DMPs provide access to individualized patient information to strengthen self-management, including active engagement in decision making. CONCLUSION: To further improve the responsiveness of DMPs to patients' needs, we suggest to monitor 'patient relevant outcomes' that might be based on the ICF-model. To address the needs of patients with multimorbidity, we propose a generic comprehensive model, embedded in primary care. A goal-oriented approach provides the opportunity to prioritize goals that really matter to patients.
BACKGROUND: Inspired by American examples, several European countries are now developing disease management programmes (DMPs) to improve the quality of care for patients with chronic diseases. Recently, questions have been raised whether the disease management approach is appropriate to respond to patient-defined needs. OBJECTIVE: In this article we consider the responsiveness of current European DMPs to patients' needs defined in terms of multimorbidity, functional and participation problems, and self-management. METHOD: Information about existing DMPs was derived from a survey among country-experts. In addition, we made use of international scientific literature. RESULTS: Most European DMPs do not have a solid answer yet to the problem of multimorbidity. Methods of linking DMPs, building extra modules to deal with the most prevalent comorbidities and integration of case management principles are introduced. Rehabilitation, psychosocial and reintegration support are not included in all DMPs, and the involvement of the social environment of the patient is uncommon. Interventions tailored to the needs of specific social or cultural patient groups are mostly not available. Few DMPs provide access to individualized patient information to strengthen self-management, including active engagement in decision making. CONCLUSION: To further improve the responsiveness of DMPs to patients' needs, we suggest to monitor 'patient relevant outcomes' that might be based on the ICF-model. To address the needs of patients with multimorbidity, we propose a generic comprehensive model, embedded in primary care. A goal-oriented approach provides the opportunity to prioritize goals that really matter to patients.
Authors: Russell E Glasgow; Edward H Wagner; Judith Schaefer; Lisa D Mahoney; Robert J Reid; Sarah M Greene Journal: Med Care Date: 2005-05 Impact factor: 2.983
Authors: Michel Wensing; Jan van Lieshout; Hans Peter Jung; Jan Hermsen; Thomas Rosemann Journal: BMC Health Serv Res Date: 2008-09-01 Impact factor: 2.655
Authors: Mieke Rijken; James Close; Juliane Menting; Manon Lette; Annerieke Stoop; Nick Zonneveld; Simone R de Bruin; Helen Lloyd; Monique Heijmans Journal: Health Expect Date: 2022-03-23 Impact factor: 3.318
Authors: Pauline Boeckxstaens; Sara Willems; Mieke Lanssens; Charlotte Decuypere; Guy Brusselle; Thomas Kühlein; Jan De Maeseneer; An De Sutter Journal: J Comorb Date: 2016-11-14
Authors: Stephanie Anna Lenzen; Ramon Daniëls; Marloes Amantia van Bokhoven; Trudy van der Weijden; Anna Beurskens Journal: PLoS One Date: 2017-11-27 Impact factor: 3.240
Authors: Stephanie Anna Lenzen; Ramon Daniëls; Marloes Amantia van Bokhoven; Trudy van der Weijden; Anna Beurskens Journal: BMC Health Serv Res Date: 2018-11-26 Impact factor: 2.655
Authors: Lidwien C Lemmens; Simone R de Bruin; Jeroen N Struijs; Mieke Rijken; Giel Nijpels; Caroline A Baan Journal: Int J Integr Care Date: 2015-12-15 Impact factor: 5.120