Development and acceptability of PETS-Now, an electronic point-of-care tool to monitor treatment burden in patients with multiple chronic conditions: a multi-method study.

Publication date: Mar 01, 2024

The aim of this study was to develop a web-based tool for patients with multiple chronic conditions (MCC) to communicate concerns about treatment burden to their healthcare providers. Patients and providers from primary-care clinics participated. We conducted focus groups to identify content for a prototype clinical tool to screen for treatment burden by reviewing domains and items from a previously validated measure, the Patient Experience with Treatment and Self-management (PETS). Following review of the prototype, a quasi-experimental pilot study determined acceptability of using the tool in clinical practice. The study protocol was modified to accommodate limitations due to the Covid-19 pandemic. Fifteen patients with MCC and 18 providers participated in focus groups to review existing PETS content. The pilot tool (named PETS-Now) consisted of eight domains (Living Healthy, Health Costs, Monitoring Health, Medicine, Personal Relationships, Getting Healthcare, Health Information, and Medical Equipment) with each domain represented by a checklist of potential concerns. Administrative burden was minimized by limiting patients to selection of one domain. To test acceptability, 17 primary-care providers first saw 92 patients under standard care (control) conditions followed by another 90 patients using the PETS-Now tool (intervention). Each treatment burden domain was selected at least once by patients in the intervention. No significant differences were observed in overall care quality between patients in the control and intervention conditions with mean care quality rated high in both groups (9. 3 and 9. 2, respectively, out of 10). There were no differences in provider impressions of patient encounters under the two conditions with providers reporting that patient concerns were addressed in 95% of the visits in both conditions. Most intervention group patients (94%) found that the PETS-Now was easy to use and helped focus the conversation with the provider on their biggest concern (98%). Most providers (81%) felt they had learned something new about the patient from the PETS-Now. The PETS-Now holds promise for quickly screening and monitoring treatment burden in people with MCC and may provide information for care planning. While acceptable to patients and clinicians, integration of information into the electronic medical record should be prioritized.

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Concepts Keywords
Healthcare Multimorbidity
Pandemic Patient-reported experience
Pets Patient-reported outcomes
Pilot Primary health care
Quality of life
Self-management
Telehealth

Semantics

Type Source Name
disease MESH multiple chronic conditions
drug DRUGBANK MCC
disease VO protocol
disease MESH Covid-19 pandemic
disease IDO intervention
disease IDO quality
pathway REACTOME Reproduction
drug DRUGBANK Ethionamide
disease VO USA
disease MESH chronic conditions
disease VO report
drug DRUGBANK Trestolone
disease VO device
drug DRUGBANK Cysteamine
disease VO efficient
disease VO time
disease MESH arthritis
disease MESH COPD
disease MESH cancer
disease IDO site
drug DRUGBANK Etoperidone
drug DRUGBANK Coenzyme M
disease VO Canada
disease VO IpaD
drug DRUGBANK Aspartame
disease IDO history
drug DRUGBANK Pirenzepine
disease MESH Education level
drug DRUGBANK Hyaluronic acid
disease VO effective
disease IDO host
disease MESH symptom cluster
disease MESH Anxiety Disorder
disease IDO process
drug DRUGBANK Methionine
disease MESH burnout
disease VO population
disease MESH morbidity
disease MESH diabetes mellitus
disease MESH heart failure

Original Article

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