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Development of a Person-Centred Integrated Care Approach for Chronic Disease Management in Dutch Primary Care: A Mixed-Method Study

Author

Listed:
  • Lena H. A. Raaijmakers

    (Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands)

  • Tjard R. Schermer

    (Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
    Science Support Office, Gelre Hospitals, P.O. Box 9014, 7300 DS Apeldoorn, The Netherlands)

  • Mandy Wijnen

    (Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands)

  • Hester E. van Bommel

    (Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
    Pharos, Dutch Centre of Expertise on Health Disparities, P.O. Box 13318, 3507 LH Utrecht, The Netherlands)

  • Leslie Michielsen

    (Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
    Research Group Innovation of Care and Services, HAN University of Applied Sciences, Kapittelweg 33, 6525 EN Nijmegen, The Netherlands)

  • Floris Boone

    (Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands)

  • Jan H. Vercoulen

    (Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands)

  • Erik W. M. A. Bischoff

    (Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands)

Abstract

To reduce the burden of chronic diseases on society and individuals, European countries implemented chronic Disease Management Programs (DMPs) that focus on the management of a single chronic disease. However, due to the fact that the scientific evidence that DMPs reduce the burden of chronic diseases is not convincing, patients with multimorbidity may receive overlapping or conflicting treatment advice, and a single disease approach may be conflicting with the core competencies of primary care. In addition, in the Netherlands, care is shifting from DMPs to person-centred integrated care (PC-IC) approaches. This paper describes a mixed-method development of a PC-IC approach for the management of patients with one or more chronic diseases in Dutch primary care, executed from March 2019 to July 2020. In Phase 1, we conducted a scoping review and document analysis to identify key elements to construct a conceptual model for delivering PC-IC care. In Phase 2, national experts on Diabetes Mellitus type 2, cardiovascular diseases, and chronic obstructive pulmonary disease and local healthcare providers (HCP) commented on the conceptual model using online qualitative surveys. In Phase 3, patients with chronic conditions commented on the conceptual model in individual interviews, and in Phase 4 the conceptual model was presented to the local primary care cooperatives and finalized after processing their comments. Based on the scientific literature, current practice guidelines, and input from a variety of stakeholders, we developed a holistic, person-centred, integrated approach for the management of patients with (multiple) chronic diseases in primary care. Future evaluation of the PC-IC approach will show if this approach leads to more favourable outcomes and should replace the current single-disease approach in the management of chronic conditions and multimorbidity in Dutch primary care.

Suggested Citation

  • Lena H. A. Raaijmakers & Tjard R. Schermer & Mandy Wijnen & Hester E. van Bommel & Leslie Michielsen & Floris Boone & Jan H. Vercoulen & Erik W. M. A. Bischoff, 2023. "Development of a Person-Centred Integrated Care Approach for Chronic Disease Management in Dutch Primary Care: A Mixed-Method Study," IJERPH, MDPI, vol. 20(5), pages 1-27, February.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:5:p:3824-:d:1075761
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    References listed on IDEAS

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    1. Leijten, Fenna R.M. & Struckmann, Verena & van Ginneken, Ewout & Czypionka, Thomas & Kraus, Markus & Reiss, Miriam & Tsiachristas, Apostolos & Boland, Melinde & de Bont, Antoinette & Bal, Roland & Bus, 2018. "The SELFIE framework for integrated care for multi-morbidity: Development and description," Health Policy, Elsevier, vol. 122(1), pages 12-22.
    2. Hopman, Petra & de Bruin, Simone R. & Forjaz, Maria João & Rodriguez-Blazquez, Carmen & Tonnara, Giuseppe & Lemmens, Lidwien C. & Onder, Graziano & Baan, Caroline A. & Rijken, Mieke, 2016. "Effectiveness of comprehensive care programs for patients with multiple chronic conditions or frailty: A systematic literature review," Health Policy, Elsevier, vol. 120(7), pages 818-832.
    3. Sterre S. Bour & Lena H. A. Raaijmakers & Erik W. M. A. Bischoff & Lucas M. A. Goossens & Maureen P. M. H. Rutten-van Mölken, 2023. "How Can a Bundled Payment Model Incentivize the Transition from Single-Disease Management to Person-Centred and Integrated Care for Chronic Diseases in the Netherlands?," IJERPH, MDPI, vol. 20(5), pages 1-20, February.
    4. Palmer, Katie & Marengoni, Alessandra & Forjaz, Maria João & Jureviciene, Elena & Laatikainen, Tiina & Mammarella, Federica & Muth, Christiane & Navickas, Rokas & Prados-Torres, Alexandra & Rijken, Mi, 2018. "Multimorbidity care model: Recommendations from the consensus meeting of the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS)," Health Policy, Elsevier, vol. 122(1), pages 4-11.
    5. Kasey R Boehmer & Abd Moain Abu Dabrh & Michael R Gionfriddo & Patricia Erwin & Victor M Montori, 2018. "Does the chronic care model meet the emerging needs of people living with multimorbidity? A systematic review and thematic synthesis," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-17, February.
    6. de Bruin, Simone R. & Versnel, Nathalie & Lemmens, Lidwien C. & Molema, Claudia C.M. & Schellevis, François G. & Nijpels, Giel & Baan, Caroline A., 2012. "Comprehensive care programs for patients with multiple chronic conditions: A systematic literature review," Health Policy, Elsevier, vol. 107(2), pages 108-145.
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    1. Sterre S. Bour & Lena H. A. Raaijmakers & Erik W. M. A. Bischoff & Lucas M. A. Goossens & Maureen P. M. H. Rutten-van Mölken, 2023. "How Can a Bundled Payment Model Incentivize the Transition from Single-Disease Management to Person-Centred and Integrated Care for Chronic Diseases in the Netherlands?," IJERPH, MDPI, vol. 20(5), pages 1-20, February.

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