Constellation, le dépôt institutionnel de l'Université du Québec à Chicoutimi

Résumé

Background: The purpose of this research was to explore the predictive factors (patient-related and intervention-related) of effects of an interdisciplinary and patient-centered chronic disease prevention and management (CDPM) intervention in an adult population with chronic diseases seen in primary healthcare (PHC).

Methods: This work presents the secondary analysis of data from the PR1MaC project, a pragmatic randomized controlled trial of an intervention involving the integration of canadian CDPM services in PHC. The main outcomes were dichotomic substantive improvement in the eight domains of the Health Education Impact Questionnaire (heiQ) measured at baseline and three months. Included in the multivariate analysis were the independent variables related to patient characteristics: age, gender, education, family income, marital status, multimorbidity, having healthy eating habits at baseline, doing sufficient physical activity at baseline; and those related to the intervention: duration of intervention, number of health professionals involved, health professionals working in consensus and number of risk factors aimed by the intervention objectives.

Results: A group of 160 patients (84 male; mean age 52.7 ± 11.5 years) from the intervention arm was considered. Multivariate logistic regression analysis showed that being younger, being single and having a higher family income is associated with improvement in Emotional Wellbeing. Having healthy eating habits and a limited number of patient-fixed objectives is associated with improvement in the Constructive Attitudes and Approaches. Also, being younger, longer intervention duration and consensus of the professionals is associated with improvement in the Health Services Navigation. An increasing intervention duration is associated with improvement in the Positive and Active Engagement in Life. Finally, increasing number of professionals is associated with improvement in the Skills and Techniques Acquisition.

Conclusion: The results showed specific associations that could lead in improvements in CDPM delivery, contributing to the understanding of the complex mechanisms of chronic disease management and support.