Collaborative Self-Management Support in Chronic Conditions - Qualitative Study

NCT ID: NCT03262428

Last Updated: 2019-08-30

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 109 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2018-04-14
• Study Completion Date: 2019-06-27

Brief Summary

The management of chronic conditions is a challenge for health systems worldwide, particularly in the context of an aging population, and requires urgent improvement of health services. Integrated care and patient empowerment represent promising solutions: offering tailored self-management support in a collaborative framework led to good results in several clinical contexts. Yet, large scale implementation remains a challenge. An important limitation of existing solutions is a lack of utilization of behavioural and communication theory for identifying the dynamics of pluridisciplinary collaboration and the interactive effects of the activities performed by several actors involved in self-management support in a given chronic condition. A second limitation is not involving all relevant actors in the development of health service improvement solutions, which leads to limited programme adoption and sustainability in routine care.

This study is part of a project that proposes to address these limitations and develop and interdisciplinary model of collaborative care in the self-management of chronic conditions (CoSMaS) that adopts a community-based participative approach. CoSMaS-ql is a qualitative study that will consist of semi-structured interviews with several types of stakeholders: patients, caregivers, and health care professionals of different specialties (e.g. general practitioners, nurses, specialist consultants, pharmacists). The main objective of the study is to explore the experiences and of patients, caregivers, and HCPs on how self-management support is currently delivered in asthma, cancer and stroke (content, communication, organisation of care), their needs related to self-management support provision, and envisaged solutions for improving current practice. Three different chronic conditions will be targeted: asthma, breast cancer and stroke. The qualitative data will be analysed via grounded-theory and template analysis. It will inform the development of a theoretical model of collaborative self-management support in chronic conditions. It will also result in three profiles describing 'real' versus 'ideal' care processes, which will represent needs assessment stages for future health services improvement interventions in the three conditions.

Conditions

Asthma; Breast Cancer; Stroke

Study Design

• Observational Model Type: OTHER
• Study Time Perspective: PROSPECTIVE

Study Groups

Patients

Patients with asthma, breast cancer, and stroke living in the Rhône Alpes region

Semi-structured interviews

Intervention Type: OTHER

Patients, caregivers and health care professionals involved in self-management support will be sought via patient organizations and professional organizations in the region. Study information materials will be provided to these organizations for dissemination to their members, providing also contact details of the study team for interested individuals to register their interest and provide basic eligibility and screening information. Selected participants will be invited to take part in a face-to-face or telephone interview about (supporting) self-management. Data collection will consist of semi-structured interviews conducted either face-to-face or by telephone.

Caregivers

Caregivers of patients with asthma, breast cancer, and stroke living in the Rhône Alpes region

Semi-structured interviews

Intervention Type: OTHER

Patients, caregivers and health care professionals involved in self-management support will be sought via patient organizations and professional organizations in the region. Study information materials will be provided to these organizations for dissemination to their members, providing also contact details of the study team for interested individuals to register their interest and provide basic eligibility and screening information. Selected participants will be invited to take part in a face-to-face or telephone interview about (supporting) self-management. Data collection will consist of semi-structured interviews conducted either face-to-face or by telephone.

Health care professionals

Health care professionals involved in the care of patients with asthma, breast cancer, and stroke living in the Rhône Alpes region

Semi-structured interviews

Intervention Type: OTHER

Patients, caregivers and health care professionals involved in self-management support will be sought via patient organizations and professional organizations in the region. Study information materials will be provided to these organizations for dissemination to their members, providing also contact details of the study team for interested individuals to register their interest and provide basic eligibility and screening information. Selected participants will be invited to take part in a face-to-face or telephone interview about (supporting) self-management. Data collection will consist of semi-structured interviews conducted either face-to-face or by telephone.

Interventions

Semi-structured interviews

Patients, caregivers and health care professionals involved in self-management support will be sought via patient organizations and professional organizations in the region. Study information materials will be provided to these organizations for dissemination to their members, providing also contact details of the study team for interested individuals to register their interest and provide basic eligibility and screening information. Selected participants will be invited to take part in a face-to-face or telephone interview about (supporting) self-management. Data collection will consist of semi-structured interviews conducted either face-to-face or by telephone.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• having (had) one of the health conditions targeted.
• age >18 years (in order to have had the opportunity to achieve full transition from parent/caregiver-managed to self-managed care),
• at least 1 year since diagnosis (in order to have had sufficient time to experience adjustments to their condition on the long term), and
• at least 1 consultation with an HCP of any specialty in the past year (in order to ensure minimum 1 recent experience of care they could reflect on).

• nominated by a participating patients as principal caregiver

• at least 1 year of experience working in one of the 3 chronic conditions targeted (irrespective of the number of patients consulted)

Exclusion Criteria

• unable to communicate in French
• level of severity of health condition or comorbidities making participation in the study too burdensome

CAREGIVERS:

• none

HEALTH CARE PROFESSIONALS :

• none

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Hospices Civils de Lyon

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

EA 7425 HESPER - Health Services and Performance Research, Université Claude Bernard Lyon 1

Lyon, , France

Countries

France

Other Identifiers

69HCL17_0480

Identifier Type: -

Identifier Source: org_study_id