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. 2014 Mar;52 Suppl 3(0 3):S118-25.
doi: 10.1097/MLR.0b013e3182a977da.

Healthcare task difficulty among older adults with multimorbidity

Cynthia M Boyd  1 , Jennifer L Wolff, Erin Giovannetti, Lisa Reider, Carlos Weiss, Qian-li Xue, Bruce Leff, Chad Boult, Travonia Hughes, Cynthia Rand
Affiliations

Healthcare task difficulty among older adults with multimorbidity

Cynthia M Boyd et al. Med Care. 2014 Mar.

Abstract

Background: Applying disease-specific guidelines to people with multimorbidity may result in complex regimens that impose treatment burden.

Objectives: To describe and validate a measure of healthcare task difficulty (HCTD) in a sample of older adults with multimorbidity.

Research design: Cross-sectional and longitudinal secondary data analysis.

Subjects: Multimorbid adults aged 65 years or older from primary care clinics.

Measures: We generated a scale (0-16) of self-reported difficulty with 8 HCTD and conducted factor analysis to assess its dimensionality and internal consistency. To assess predictive ability, cross-sectional associations of HCTD and number of chronic diseases, and conditions that add to health status complexity (falls, visual, and hearing impairment), patient activation, patient-reported quality of chronic illness care (Patient Assessment of Chronic Illness Care), mental and physical health (SF-36) were tested using statistical tests for trend (n=904). Longitudinal analyses of the effects of change in HCTD on changes in the outcomes were conducted among a subset (n=370) with ≥1 follow-up at 6 and/or 18 months. All models were adjusted for age, education, sex, race, and time.

Results: Greater HCTD was associated with worse mental and physical health [Cuzick test for trend (P<0.05)], and patient-reported quality of chronic illness care (P<0.05). In longitudinal analysis, increasing patient activation was associated with declining HCTD over time (P<0.01). Increasing HCTD over time was associated with declining mental (P<0.001) and physical health (P=0.001) and patient-reported quality of chronic illness care (P<0.05).

Conclusions: The findings of this study establish the construct validity of the HCTD scale.

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References

    1. Tinetti ME, Bogardus ST, Jr, Agostini JV. Potential pitfalls of disease-specific guidelines for patients with multiple conditions. N Engl J Med. 2004;351(27):2870–4. - PubMed
    1. Patient-centered care for older adults with multiple chronic conditions: a stepwise approach from the american geriatrics society: american geriatrics society expert panel on the care of older adults with multimorbidity. J Am Geriatr Soc. 2012;60(10):1957–68. - PMC - PubMed
    1. Anderson G, Horvath J. Chronic Conditions: Making the Case for Ongoing Care. 2002 Partnership for Solutions.
    1. Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu AW. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance. JAMA. 2005;294(6):716–24. - PubMed
    1. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924–6. - PMC - PubMed

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