Abstract
Background: Management of diabetes may be uniquely challenging for older individuals with multiple chronic conditions. Health systems and policymakers have attempted to reduce barriers to chronic care management (CCM) through incentives to provide non-face-to-face care. This qualitative study aimed to investigate and present views on non-face-to-face care management held by elderly patients with diabetes and other chronic conditions in order to contribute to improved programming for this population.
Materials and methods: Semi-structured interviews were conducted with patients over the age of 64 who have been diagnosed with diabetes and at least one other chronic health condition. Interview recordings were transcribed and analyzed by experienced researchers using a thematic analytic approach, and an illustrative case study was developed.
Results: Thirty individuals participated in this study. Participants were drawn from three health systems in south Louisiana, an area with high rates of morbidity and mortality related to chronic diseases. We identified themes related to lived experiences with diabetes and other medical conditions, perception of personal health status, perceived value of non-face-to-face programs, and support needs for future programming. Additionally, we present one case study describing in detail an individual patient’s experience with non-face-to-face CCM.
Conclusion: Health systems should consider intentionally recruiting participants who would benefit most from non-face-to-face care, including higher-need, less self-sufficient patients with resource constraints, while continuing to offer in-person services. Future research should examine whether tailoring non-face-to-face programming and support to address unique barriers can further enhance diabetes care at the population level.
Acknowledgments
This work was supported through a Patient-Centered Outcomes Research Institute (PCORI) Program Award (NEN-1508-32257). All statements in this poster, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its Board of Governors or Methodology Committee. The LEAD Study would like to acknowledge the contributions of our partners. The success of this study depended on their ongoing support and expertise. These partners include Ochsner Health System and the Ochsner Patient Research Advisory Board; Tulane Medical Center; Louisiana State University (LSU); Research Action for Health Network (REACHnet, a PCORnet CDRN) and their multi-stakeholder Diabetes Advisory Groups; Pennington Biomedical Research Center; Blue Cross and Blue Shield of Louisiana; and our patient and community partners Patricia Dominick, Cathy Glover, and Peggy Malone. We are grateful to Heather Sandoval for her participation in data collection and analysis and to Jewel Harden-Barrios for her support throughout the study.
Disclosure
The authors have no conflicts of interest to disclose in this work.
Supplementary material
Box S1 Case study