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. 2015 Dec;18(6):2401-12.
doi: 10.1111/hex.12208. Epub 2014 May 16.

Heart failure and chronic obstructive pulmonary disease multimorbidity at hospital discharge transition: a study of patient and carer experience

Lucy Doos  1 , Eleanor Bradley  2 , Claire A Rushton  3 , Duwarakan Satchithananda  4 , Simon J Davies  3 , Umesh T Kadam  3
Affiliations

Heart failure and chronic obstructive pulmonary disease multimorbidity at hospital discharge transition: a study of patient and carer experience

Lucy Doos et al. Health Expect. 2015 Dec.

Abstract

Background: Care for patients with multimorbidity represents a major challenge not only for patients and carers but to health-care systems. Hospital discharge transition is a critical point at which challenges for multimorbidity may amplify.

Objectives: The main objective of the study was to explore the experiences of heart failure (HF) and chronic obstructive pulmonary disease (COPD) multimorbid patients and their carers on hospital discharge. Secondary objectives included identification of gaps in the health care of multimorbidity and optimal solutions from patients and carers' perspectives.

Design: Mixed methods were applied to collect data using patient self-completion questionnaire from an adapted version of the American Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and in-depth interviews.

Setting: Participants were recruited from two cardiology and respiratory wards at a large regional hospital in England, and all had a multimorbidity diagnosis of COPD and HF.

Results and conclusions: Findings revealed that patients experienced difficulties in their communication with health-care professionals and there were specific challenges with information about medication. Qualitative descriptions revealed that experiences fell into two main categories: (i) information transfer to patients with multimorbidity in terms of issues with medication and clarity of information on diagnosis and (ii) communication and continuity of care after discharge. Respondents highlighted gaps in the management of patients with multimorbidity of HF and COPD at the critical time of care transition. They suggested the need for a comprehensive, coordinated and integrated approach to incorporate patients, carers and staff preferences for treatment on discharge from hospital.

Keywords: communication; discharge planning; heart failure; medication; multimorbidity; obstructive lung disease.

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References

    1. Bayliss EA, Edwards AE, Steiner JF, Main DS. Processes of care desired by elderly patients with multimorbidities. Family Practice, 2008; 25: 287–293. - PMC - PubMed
    1. Fortin M, Soubhi H, Hudon C, Bayliss AE, van den Akker M. Multimorbidity's many challenges: time to focus on the needs of this vulnerable and growing population. British Medical Journal, 2007; 334: 1016–1017. - PMC - PubMed
    1. van Walraven C, Taljaard M, Bell CM et al Information exchange among physicians caring for the same patient in the community. Canadian Medical Association Journal, 2008; 179: 1013–1018. - PMC - PubMed
    1. Vyas A, Pan X, Sambamoothi U. Chronic condition clusters and polypharmacy among Adults. International Journal of Family Medicine, 2012; 2012: 193168. - PMC - PubMed
    1. Fried TR, McGraw S, Agostini JV, Tinetti ME. Views of older persons with multiple morbidities on competing outcomes and clinical decision‐making. Journal of the American Geriatrics Society, 2008; 56: 1839–1844. - PMC - PubMed

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