Primary Care Physicians' Prevention Counseling With Patients With Multiple Morbidity

被引:17
作者
Bardach, Shoshana H. [1 ]
Schoenberg, Nancy E. [1 ]
机构
[1] Univ Kentucky, Grad Ctr Gerontol, KY Clin J525, Lexington, KY 40536 USA
基金
美国国家卫生研究院;
关键词
health care; primary; illness and disease; chronic; prevention; interviews; semistructured; research; qualitative; COLORECTAL-CANCER; HEALTH-CARE; MANAGEMENT; BARRIERS; ADVICE; MODEL; PREVALENCE; EXERCISE; OBESITY; ATTITUDES;
D O I
10.1177/1049732312458183
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
The prevalence of multiple health conditions, or multiple morbidity (MM), is increasing. Providing medical care for adults with MM presents challenges, including balancing disease management with prevention. We conducted in-depth semistructured interviews with 12 primary care physicians to explore their perspectives on prevention counseling among patients with MM. Participants described the complex relationship between disease management and prevention, highlighted the importance of patient motivation, and discussed various strategies to promote receptivity to prevention recommendations. The perceived potential benefits of prevention recommendations encouraged physicians to persist with such counseling, despite challenges presented by visit time constraints, reimbursement procedures, and concerns over futility. Physicians recommended the development of alternate care delivery and reimbursement models to overcome challenges of the existing health care system and to meet the prevention needs of patients with MM. We explore the implications of these findings for maximizing the health and quality of life of adults with MM.
引用
收藏
页码:1599 / 1611
页数:13
相关论文
共 54 条
[1]  
American Academy of Family Physicians, 2011, SUMM REC CLIN PREV S
[2]  
[Anonymous], CHRON CAR MAK CAS ON
[3]  
[Anonymous], HLTH US 2005 CHARTB
[4]  
Bernard H.R., 1998, HDB METHODS CULTURAL, DOI DOI 10.5860/CHOICE.36-4846
[5]   The "Meaningful Use" Regulation for Electronic Health Records [J].
Blumenthal, David ;
Tavenner, Marilyn .
NEW ENGLAND JOURNAL OF MEDICINE, 2010, 363 (06) :501-504
[6]   Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases - Implications for pay for performance [J].
Boyd, CM ;
Darer, J ;
Boult, C ;
Fried, LP ;
Boult, L ;
Wu, AW .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 294 (06) :716-724
[7]   Physicians' attitudes towards prevention: importance of intervention-specific barriers and physicians' health habits [J].
Cornuz, J ;
Ghali, WA ;
Di Carlantonio, D ;
Pecoud, A ;
Paccaud, F .
FAMILY PRACTICE, 2000, 17 (06) :535-540
[8]   Delivery of clinical preventive services in family medicine offices [J].
Crabtree, BF ;
Miller, WL ;
Tallia, AF ;
Coben, DJ ;
DiCicco-Bloom, B ;
McIlvain, HE ;
Aita, VA ;
Scott, JG ;
Gregory, PB ;
Stange, KC ;
McDaniel, RR .
ANNALS OF FAMILY MEDICINE, 2005, 3 (05) :430-435
[9]   Trends in care by nonphysician clinicians in the United States. [J].
Druss, BG ;
Marcus, SC ;
Olfson, M ;
Tanielian, T ;
Pincus, HA .
NEW ENGLAND JOURNAL OF MEDICINE, 2003, 348 (02) :130-137
[10]   Direct observation of counseling on colorectal cancer in rural primary care practices [J].
Ellerbeck, EF ;
Engelman, KK ;
Gladden, J ;
Mosier, MC ;
Raju, GS ;
Ahluwalia, JS .
JOURNAL OF GENERAL INTERNAL MEDICINE, 2001, 16 (10) :697-700