ArticleBMC health services research2016
Meaningful conversations in living with and treating chronic conditions: development of the ICAN discussion aid.
Article in BMC health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Decision aids for the care of patients with multimorbidity: a systematic review.BMC primary care · 2025Pooled it
- Training in communication skills for healthcare providers in chronic care: a systematic review.BMC medical education · 2025Pooled it
- A systematic literature review of the assessment of treatment burden experienced by patients and their caregivers.BMC geriatrics · 2019Pooled it
- Care for patients living with chronic conditions using the ICAN Discussion Aid: A mixed methods cluster-randomized trial.PloS one · 2024Trial
- Exploring Self-Management Behavior Profiles in Patients with Multimorbidity: A Sequential, Explanatory Mixed-Methods Study.Clinical interventions in aging · 2025Article
- Decisional Regret Surrounding Dialysis Initiation: A Comparative Analysis.Kidney medicine · 2024Article
- Shared decision-making as a method of care.BMJ evidence-based medicine · 2023Article
- Patient Work and Treatment Burden in Type 2 Diabetes: A Mixed-Methods Study.Mayo Clinic proceedings. Innovations, quality & outcomes · 2021Article
- Implementation and preliminary testing of a theory-guided nursing discharge teaching intervention for adult inpatients aged 50 and over with multimorbidity: a pragmatic feasibility study protocol.Pilot and feasibility studies · 2021Article
- Healthcare professionals' perspective on treatment burden and patient capacity in low-income rural populations: challenges and opportunities.BMC family practice · 2021Article
- Minimally disruptive medicine (MDM) in clinical practice: a qualitative case study of the human immunodeficiency virus (HIV) clinic care model.BMC health services research · 2021Article
- Capacity Coaching: A Focused Ethnographic Evaluation in Clinical Practice.Mayo Clinic proceedings. Innovations, quality & outcomes · 2020Article
- Crafting Care That Fits: Workload and Capacity Assessments Complementing Decision Aids in Implementing Shared Decision Making.Journal of participatory medicine · 2020Article
- The burden of treatment in people living with type 2 diabetes: A qualitative study of patients and their primary care clinicians.PloS one · 2020Article
- Article
- Capacity Coaching: A New Strategy for Coaching Patients Living With Multimorbidity and Organizing Their Care.Mayo Clinic proceedings · 2019Review
- The deprescribing rainbow: a conceptual framework highlighting the importance of patient context when stopping medication in older people.BMC geriatrics · 2018Article
- Patient capacity for self-care in the medical record of patients with chronic conditions: a mixed-methods retrospective study.BMC family practice · 2018Article
- The importance and challenges of shared decision making in older people with multimorbidity.PLoS medicine · 2018Article
- Shared Decision Making in Immigrant Patients.Cureus · 2017Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe needs of the growing population of complex patients with multiple chronic conditions calls for a different approach to care. Clinical teams need to acknowledge, respect, and support the work that patients do and the capacity they mobilize to enact this work, and to adapt and self-manage. Tools that enable this approach to care are needed.
methodsUsing user-centered design principles, we set out to create a discussion aid for use by patients, clinicians, and other health professionals during clinical encounters. We observed clinical encounters, visited patient homes, and dialogued with patient support groups. We then developed and tested prototypes in routine clinical practice. Then we refined a final prototype with extensive stakeholder feedback.
resultsFrom this process resulted the ICAN Discussion Aid, a tool completed by the patient and reviewed during the consultation in which patients classified domains that contribute to capacity as sources of burden or satisfaction; clinical demands were also classified as sources of help or burden. The clinical review facilitated by ICAN generates hypotheses regarding why some treatment plans may be problematic and may not be enacted in the patient's situation.
conclusionWe successfully created a discussion aid to elucidate and share insights about the capacity patients have to enact the treatment plan and hypotheses as to why this plan may or may not be enacted. Next steps involve the evaluation of the impact of the ICAN Discussion Aid on clinical encounters with a variety of health professionals and the impact of ICAN-informed treatment plans on patient-important outcomes.
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