Purpose of Review

Many countries prioritise the implementation of person-centred care. This study examines the progression of research in person-centred care, specifically focusing on using complex interventions within intricate contexts. It aims 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. Most studies focused on patients suffering from chronic heart failure, as well as patients with chronic obstructive pulmonary disease. Additionally, interventions for acute coronary syndrome and common mental disorders were also considered. Analyses included the development of a logical model for person-centred care, an overview of partnership operationalisation, and the establishment of evaluation criteria for the trials. The analyses involved creating a coherent model for person-centred care, examining partnership operationalisation, and establishing trial evaluation criteria.

Recent Findings

Sequential trials build upon their predecessors and add new elements. The studies conducted by clinicians in usual care and in-house by research staff were complementary, providing a deeper understanding of the efficacy and effectiveness of person-centred care. Initiating, working, and safeguarding a partnership between patient and staff was possible, whether through in-person or remote communication. Evaluations followed modern research standards and incorporated past study insights for a more thorough approach.

Summary

This 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.

Abstract Aims This study aims to explore possible associations between self‐efficacy and healthcare and drug expenditures (i.e. direct costs) in patients with chronic heart failure (CHF) or chronic obstructive pulmonary disease (COPD) in a study investigating the effects of person‐centred care delivered by telephone. Methods and results This exploratory analysis uses data from an open randomized controlled trial conducted between January 2015 and November 2016, providing remote person‐centred care by phone to patients with CHF, COPD, or both. Patients hospitalized due to worsening of CHF or COPD were eligible for the study. Randomization was based on a computer‐generated list, stratified for age ≥ 75 and diagnosis. At a 6 month follow‐up, 118 persons remained in a control group and 103 in an intervention group. The intervention group received person‐centred care by phone as an addition to usual care. Trial data were linked to register data on healthcare and drug use. Group‐based trajectory modelling was applied to identify trajectories for general self‐efficacy and direct costs. Next, associations between self‐efficacy trajectories and costs were assessed using regression analysis. Five trajectories were identified for general self‐efficacy, of which three indicated different levels of increasing or stable self‐efficacy, while two showed a decrease over time in self‐efficacy. Three trajectories were identified for costs, indicating a gradient from lower to higher accumulated costs. Increasing or stable self‐efficacy was associated with lower direct costs ( P  = 0.0013). Conclusions The findings show that an increased or sustained self‐efficacy is associated with lower direct costs in patients with CHF or COPD. Person‐centred phone contacts used as an add‐on to usual care could result in lower direct costs for those with stable or increasing self‐efficacy.

Informal carers have an important role in society through their care and support of their long-term ill relatives. Providing informal care is challenging and can lead to caregiver burden

To evaluate the effects of person-centred support via telephone in two chronically ill patient groups, chronic obstructive pulmonary disease (COPD) and/or chronic heart failure (CHF). 221 patients ≥ 50 years with COPD and/or CHF were randomized to usual care vs. usual care plus a person-centred telephone-support intervention and followed for six months. Patients in the intervention group were telephoned by a registered nurse initially to co-create a person-centred health plan with the patient and subsequently to discuss and evaluate the plan. The primary outcome measure was a composite score comprising General Self-Efficacy (GSE), re-hospitalization and death. Patients were classified as deteriorated if GSE had decreased by ≥ 5 points, or if they had been re-admitted to hospital for unscheduled reasons related to COPD and/or CHF or if they had died. At six-month follow-up no difference in the composite score was found between the two study groups (57.6%, n = 68 vs. 46.6%, n = 48