Doos, L and Bradley, E and Rushton, CA and Satchithananda, D and Davies, SJ and Kadam, UT (2015) Heart failure and chronic obstructive pulmonary disease multimorbidity at hospital discharge transition: a study of patient and carer experience. Health Expectations, 18 (6). 2401 -2412. ISSN 1369-7625

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Abstract

BACKGROUND: Care for patients with multimorbidity represents a major challenge not only for patients and carers but to health-care systems. Hospital discharge transition is a critical point at which challenges for multimorbidity may amplify. OBJECTIVES: The main objective of the study was to explore the experiences of heart failure (HF) and chronic obstructive pulmonary disease (COPD) multimorbid patients and their carers on hospital discharge. Secondary objectives included identification of gaps in the health care of multimorbidity and optimal solutions from patients and carers' perspectives. DESIGN: Mixed methods were applied to collect data using patient self-completion questionnaire from an adapted version of the American Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and in-depth interviews. SETTING: Participants were recruited from two cardiology and respiratory wards at a large regional hospital in England, and all had a multimorbidity diagnosis of COPD and HF. RESULTS AND CONCLUSIONS: Findings revealed that patients experienced difficulties in their communication with health-care professionals and there were specific challenges with information about medication. Qualitative descriptions revealed that experiences fell into two main categories: (i) information transfer to patients with multimorbidity in terms of issues with medication and clarity of information on diagnosis and (ii) communication and continuity of care after discharge. Respondents highlighted gaps in the management of patients with multimorbidity of HF and COPD at the critical time of care transition. They suggested the need for a comprehensive, coordinated and integrated approach to incorporate patients, carers and staff preferences for treatment on discharge from hospital.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via Wiley at http://dx.doi.org/10.1111/hex.12208 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: Aged, Aged, 80 and over, Caregivers, Comorbidity, Continuity of Patient Care, England, Female, Heart Failure, Humans, Information Dissemination, Male, Middle Aged, Patient Discharge, Pulmonary Disease, Chronic Obstructive, Surveys and Questionnaires, communication, discharge planning, heart failure, medication, multimorbidity, obstructive lung disease
Subjects: R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
R Medicine > RC Internal medicine > RC705 Diseases of the respiratory system
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Depositing User: Symplectic
Date Deposited: 05 Apr 2017 09:34
Last Modified: 05 Apr 2017 10:29
URI: http://eprints.keele.ac.uk/id/eprint/3165

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