Learnings from five controlled trials of person-centred care

Short Description of main results

The study examined the progression of research in person-centred care, specifically focusing on using complex interventions within intricate contexts. It aimed to explore how previous experiences can inform and shape subsequent projects. The review was based on five studies from our research group, encompassing 1099 patients, resulting in 41 peer-reviewed scientific publications. The study highlights how the cumulative experience from previous research in person-centred care informs the design and analyses of subsequent projects through an iterative learning process, particularly important for complex interventions in various health care contexts.

Project description

In the project we synthesized learnings from four randomized controlled trials and one quasi-experimental controlled trial examining effects and cost-effectiveness of introducing person-centred care in different patient populations, all conducted by the same research group. The group has conducted several controlled trials over the whole period GPCC has existed as a research centre.

The projects also illustrated a spectrum of methods for providing person-centred care, some face-to-face and some using channels for communicating over distance. The following projects were included:

• The PCC-HF study evaluated person-centred care for hospitalized patients with chronic heart failure. Lenth of hospitalization decreased by 30 %, activities of daily living remained more stable, there were less uncertainty about the disease and treatment, and lower healthcare costs, in the intervention group.
• The PAK study evaluated person-centred care for patients with acute coronary syndrome from hospitalization into outpatient care and primary care. The probability of improved self-efficacy combined with return to previous activity/work level increased in the intervention group, and the effects were most pronounced among patients with lower educational level. The intervention was cost-effective in a subgroup of the population. Furthermore, those who used the eHealth-platform improved more in self-efficay more than other patients in the intervention group.
• The C4 study evaluated person-centred care for patients with chronic heart failure and/or chronic obstructive pulmonary disease recruited during hospitalization due to deterioration in the disease. Participants in the intervention group had on average 3 phonecalls with staff. Self-efficacy worsened in the control group, while the intervention group to a higher degree remained stable. The intervention was cost-effective.
• In the PROTECT study, an eHealth platform was used as a complement to person-centred care provided over phone to patients with chronic heart failure and/or chronic obstructive pulmonary disease recruited in primary care. The platform was used by 70% of the intervention group, and 20% wrote their health plan themselves based on co-creation with healthcare staff. Self-efficacy increased at 3 months for those in the per protocol-population, but not at 6 months.
• In the PROMISE study, an eHealth platform was used as a complement to person-centred care provided over phone to people who are on sick leave for stress, depression or anxiety, recruited in primary care. Participants had on average 4 phonecalls with staff, while the most used function in the eHealth platform was symptoms evaluation, used by 70%. Effectiveness evaluation found no effect on self-reported sick leave, but self-efficacy improved in the intervention group at 3 months, and also at 6 months among people in the per protocol-population.