Engaging patients in population-based chronic disease management: A qualitative study of barriers and intervention opportunities.
Anya Fang, Dana Abdelgadir, Anjali Gopalan and 5 others
PMID 33975772WHAT IT FOUND
Patients struggling with chronic disease control said skills sessions gave them ways to speak up, but dismissive, rushed, or judgmental care and shame or cost still made them avoid their care team.
Key findings
01Many patients initially did not know how to be assertive with providers, and some used the group sessions to speak up about medication and lifestyle choices.
02Patients said dismissive, rushed, judgmental, or cookie-cutter care made them feel unsupported, less trusting, and reluctant to engage.
03Shame, guilt, hopelessness, and cost barriers led some patients to avoid their care team rather than disclose problems.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Participants were already engaged enough to join a trial and attend group sessions, so people who avoid care teams entirely may be underrepresented. Session observations may have emphasized patients who spoke more often. Secure messages and clinical notes were not available for all participants. The study was in Kaiser Permanente Northern California and required English consent, so findings may not apply elsewhere. Qualitative data cannot show whether CREATE Wellness or these strategies improved clinical outcomes.
Declared interests
The work was listed as supported by NIH extramural research. The supplied text does not report author conflicts of interest.
The easy way to misread this
Do not read this as proof that CREATE Wellness improved cardiovascular risk control. The CREATE Wellness trial increased participants' activation and engagement behaviors but did not improve clinical CVD risk factor control outcomes, and this qualitative analysis only describes patients' reported barriers.