Evidence map›Paper›PMID 34363205›Full record

ArticleHealth services research2021

Aligning care with the personal values of patients with complex care needs.

Leah Tuzzio, Andrew L Berry, Kathy Gleason, Jennifer Barrow, Elizabeth A Bayliss, Marlaine Figueroa Gray, Thomas Delate, Zoe Bermet, Connie S Uratsu, Richard W Grant and 1 more

Open access · greenAbstract read
In one paragraph

Article in Health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Leah TuzzioKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.ORCID 0000-0002-3298-904X
Andrew L BerryDepartment of Biomedical Informatics & Medical Education, University of Washington, Seattle, Washington, USA.
Kathy GleasonKaiser Permanente Colorado Institute for Health Research, Aurora, Colorado, USA.
Jennifer BarrowKaiser Permanente Colorado Institute for Health Research, Aurora, Colorado, USA.
Elizabeth A BaylissKaiser Permanente Colorado Institute for Health Research, Aurora, Colorado, USA.ORCID 0000-0002-5264-0670
Marlaine Figueroa GrayKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
Thomas DelatePharmacy Outcomes Research Group, Kaiser Permanente National Pharmacy, Aurora, Colorado, USA.
Zoe BermetKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
Connie S UratsuDivision of Research, Kaiser Permanente Northern California, Oakland, California, USA.ORCID 0000-0001-9870-138X
Richard W GrantDivision of Research, Kaiser Permanente Northern California, Oakland, California, USA.
James D RalstonKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
Kaiser Permanente · USKaiser Permanente Washington Health Research Institute · USUniversity of Washington Medical Center · US

Funding

University of Washington Biomedical Informatics and Data Science Research Training ProgramT15LM007442 · NLM · UNIVERSITY OF WASHINGTON · PI JOHN H. GENNARI, Andrea L. Hartzler · 2002 to 2026
$19.6M
Technology Enabled Services for Coordinated Care of Depression in Healthcare SettingsP50MH119029 · NIMH · NORTHWESTERN UNIVERSITY AT CHICAGO · PI DAVID CURTIS MOHR, Jessica Lee Schleider · 2020 to 2026
$10.7M
NIMH NIH HHS P50 MH119029NLM NIH HHS T15 LM007442
6 · The paper itself

Abstract

objectiveTo identify opportunities to align care with the personal values of patients from three distinct groups with complex medical, behavioral, and social needs. DATA SOURCES/STUDY

settingBetween June and August 2019, we conducted semi-structured interviews with individuals with complex care needs in two integrated health care delivery systems. STUDY

designQualitative study using semi-structured interviews. DATA COLLECTION

methodsWe interviewed three groups of patients at Kaiser Permanente Washington and Kaiser Permanente Colorado representing three distinct profiles of complex care needs: Group A ("obesity, opioid prescription, and low-resourced neighborhood"), Group B ("older, high medical morbidity, emergency department, and hospital use"), and Group C ("older, mental and physical health concerns, and low-resourced neighborhood"). These profiles were identified based on prior work and prioritized by internal primary care stakeholders. Interview transcripts were analyzed using thematic analysis. PRINCIPAL

findingsTwenty-four patients participated; eight from each complex needs profile. Mean age across groups was 71 (range 48-86) years. We identified five themes common across the three groups that captured patients' views regarding values-aligned care. These themes focused on the importance of care teams exploring and acknowledging a patient's values, providing access to nonphysician providers who have different perspectives on care delivery, offering values-aligned mental health care, ensuring connection to community-based resources that support values and address needs, and providing care that supports the patient plus their family and caregivers.

conclusionsOur results suggest several opportunities to improve how care is delivered to patients with different complex medical, behavioral, and social needs. Future research is needed to better understand how to incorporate these opportunities into health care.

Indexed as

Practice Guidelines as TopicAgedAged, 80 and overChronic DiseaseColoradoDelivery of Health Care, IntegratedFemaleHumansMaleMiddle AgedPatient-Centered CarePatientsQualitative ResearchSocial Determinants of HealthWashingtonchronic diseasehealth prioritiesprimary carequalitative researchsocial determinants of health

Identifiers

PMID34363205
PMCPMC8515216
OpenAlexW3190553133

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.