A systematic review of impact of person-centred interventions for serious physical illness in terms of outcomes and costs
Background Person-centred care (PCC) is being internationally recognised as a critical attribute of high-quality healthcare. The International Alliance of Patients Organisations defines PCC as care that is focused and organised around people, rather than disease. Focusing on delivery, we aimed to re...
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e054386.full |
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| author | Richard Harding Sridhar Venkatapuram Alessandra Giusti Ruwayda Petrus Liz Gwyther Lindsay Farrant I Petersen Amelia Cook Kennedy Bashan Nkhoma |
| author_facet | Richard Harding Sridhar Venkatapuram Alessandra Giusti Ruwayda Petrus Liz Gwyther Lindsay Farrant I Petersen Amelia Cook Kennedy Bashan Nkhoma |
| author_sort | Richard Harding |
| collection | DOAJ |
| description | Background Person-centred care (PCC) is being internationally recognised as a critical attribute of high-quality healthcare. The International Alliance of Patients Organisations defines PCC as care that is focused and organised around people, rather than disease. Focusing on delivery, we aimed to review and evaluate the evidence from interventions that aimed to deliver PCC for people with serious physical illness and identify models of PCC interventions.Methods Systematic review of literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched AMED, CINAHL, Cochrane Library, Embase, Medline, PsycINFO, using the following key concepts: patient/person-centred care, family centred care, family based care, individualised care, holistic care, serious illness, chronic illness, long-term conditions from inception to April 2022. Due to heterogeneity of interventions and populations studied, narrative synthesis was conducted. Study quality was appraised using the Joanna Briggs checklist.Results We screened n=6156 papers. Seventy-two papers (reporting n=55 different studies) were retained in the review. Most of these studies (n=47) were randomised controlled trials. Our search yielded two main types of interventions: (1) studies with self-management components and (2) technology-based interventions. We synthesised findings across these two models:Self-management component: the interventions consisted of training of patients and/or caregivers or staff. Some studies reported that interventions had effect in reduction hospital admissions, improving quality of life and reducing costs of care.Technology-based interventions: consisted of mobile phone, mobile app, tablet/computer and video. Although some interventions showed improvements for self-efficacy, hospitalisations and length of stay, quality of life did not improve across most studies.Discussion PCC interventions using self-management have some effects in reducing costs of care and improving quality of life. Technology-based interventions improves self-efficacy but has no effect on quality of life. However, very few studies used self-management and technology approaches. Further work is needed to identify how self-management and technology approaches can be used to manage serious illness.PROSPERO registration number CRD42018108302. |
| format | Article |
| id | doaj-art-972dc5a9974a46d7bda616c7b42e9bbb |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-972dc5a9974a46d7bda616c7b42e9bbb2025-01-31T06:10:10ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-054386A systematic review of impact of person-centred interventions for serious physical illness in terms of outcomes and costsRichard Harding0Sridhar Venkatapuram1Alessandra Giusti2Ruwayda Petrus3Liz Gwyther4Lindsay Farrant5I Petersen6Amelia Cook7Kennedy Bashan Nkhoma8Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, King`s College London, London, UKKing`s College London, London, UKCicely Saunders Institute for Palliative Care, Policy and Rehabilitation, King`s College London, London, UKSchool of Applied Human Sciences, University of KwaZulu-Natal College of Humanities, Durban, South AfricaSchool of Public Health and Family Medicine, University of Cape Town Faculty of Health Sciences, Cape Town, South AfricaSchool of Public Health and Family Medicine, University of Cape Town, Cape Town, Western Cape, South AfricaCentre for Rural Health, University of KwaZulu-Natal, Durban, South AfricaCicely Saunders Institute for Palliative Care, Policy and Rehabilitation, King`s College London, London, UKFlorence Nightingale Faculty of Nursing Midwifery and Palliative Care, King`s College London, London, UKBackground Person-centred care (PCC) is being internationally recognised as a critical attribute of high-quality healthcare. The International Alliance of Patients Organisations defines PCC as care that is focused and organised around people, rather than disease. Focusing on delivery, we aimed to review and evaluate the evidence from interventions that aimed to deliver PCC for people with serious physical illness and identify models of PCC interventions.Methods Systematic review of literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched AMED, CINAHL, Cochrane Library, Embase, Medline, PsycINFO, using the following key concepts: patient/person-centred care, family centred care, family based care, individualised care, holistic care, serious illness, chronic illness, long-term conditions from inception to April 2022. Due to heterogeneity of interventions and populations studied, narrative synthesis was conducted. Study quality was appraised using the Joanna Briggs checklist.Results We screened n=6156 papers. Seventy-two papers (reporting n=55 different studies) were retained in the review. Most of these studies (n=47) were randomised controlled trials. Our search yielded two main types of interventions: (1) studies with self-management components and (2) technology-based interventions. We synthesised findings across these two models:Self-management component: the interventions consisted of training of patients and/or caregivers or staff. Some studies reported that interventions had effect in reduction hospital admissions, improving quality of life and reducing costs of care.Technology-based interventions: consisted of mobile phone, mobile app, tablet/computer and video. Although some interventions showed improvements for self-efficacy, hospitalisations and length of stay, quality of life did not improve across most studies.Discussion PCC interventions using self-management have some effects in reducing costs of care and improving quality of life. Technology-based interventions improves self-efficacy but has no effect on quality of life. However, very few studies used self-management and technology approaches. Further work is needed to identify how self-management and technology approaches can be used to manage serious illness.PROSPERO registration number CRD42018108302.https://bmjopen.bmj.com/content/12/7/e054386.full |
| spellingShingle | Richard Harding Sridhar Venkatapuram Alessandra Giusti Ruwayda Petrus Liz Gwyther Lindsay Farrant I Petersen Amelia Cook Kennedy Bashan Nkhoma A systematic review of impact of person-centred interventions for serious physical illness in terms of outcomes and costs BMJ Open |
| title | A systematic review of impact of person-centred interventions for serious physical illness in terms of outcomes and costs |
| title_full | A systematic review of impact of person-centred interventions for serious physical illness in terms of outcomes and costs |
| title_fullStr | A systematic review of impact of person-centred interventions for serious physical illness in terms of outcomes and costs |
| title_full_unstemmed | A systematic review of impact of person-centred interventions for serious physical illness in terms of outcomes and costs |
| title_short | A systematic review of impact of person-centred interventions for serious physical illness in terms of outcomes and costs |
| title_sort | systematic review of impact of person centred interventions for serious physical illness in terms of outcomes and costs |
| url | https://bmjopen.bmj.com/content/12/7/e054386.full |
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