Approaches to improve management of patients with multiple chronic non-communicable diseases (literature review)

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Abstract

A large fraction of adult patients has two or more chronic diseases (multiple chronic diseases, MCD). There are often questions about the quality and availability of medical care for patients with MCD, which could drastically be improved using information technologies (IT).

The purpose of this work was to study medical care management for MCD patients abroad using IT.

This study was carried out by searching the Google system and PubMed.

MCD patients are characterized by a high heterogeneity. Effective processing of the flow of medical information (electronic patient registers, digital medical records, scientific knowledge, etc.) is usually feasible with the help of artificial intelligence technologies and supercomputers. To improve health care delivery to adult MCD patients there are described three dimensions for the IT development including 1) development the algorithms to support clinical decision making; 2) coordination of medical care delivery; and 3) attainment of patient self-management.

The presented results confirm the important role of IT in medical care. The number of scientific reports devoted to this issue is growing. The use of IT in medicine demonstrates the promise of the principles of automated analysis and the provision of additional information directly at the point of care delivery. This can improve medical processes and, to some extent, clinical outcomes, including indicators of patients’ quality of life.

Conclusion. Additional studies based on data from real-life clinical settings are required to make a comprehensive assessment of the areas of IT applicability.

Contribution of the authors:
Kamynina N.N. — research concept and design, editing;
Andreev D.A. — material collection and processing, collection of literature data, compilation of the list of literature, writing the text;
Pakhuridze M.D. — material collection and processing, writing the text;
Sizov G.G. — material collection and processing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: June 22, 2023
Accepted: August 23, 2023
Published: November 3, 2023

About the authors

Natalya N. Kamynina

Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department

Author for correspondence.
Email: noemail@neicon.ru
ORCID iD: 0000-0002-0925-5822
Russian Federation

Dmitry A. Andreev

Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department

Email: andreevda@zdrav.mos.ru
ORCID iD: 0000-0003-0745-9474

MD, PhD, Leading researcher, Research Institute for Healthcare Organization and Medical Management of Moscow Health Department, Moscow, 115088, Russian Federation.

e-mail: andreevda@zdrav.mos.ru

Russian Federation

Mariam D. Pakhuridze

Centre of Medical prevention Department of Healthcare of Moscow

Email: noemail@neicon.ru
ORCID iD: 0009-0003-5913-3422
Russian Federation

Grigory G. Sizov

Information and Service Bureau of the Department of Healthcare of Moscow

Email: noemail@neicon.ru
ORCID iD: 0009-0009-3897-7144
Russian Federation

References

  1. WHO. Noncommunicable diseases; 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases (in Russian)
  2. National Center for Chronic Disease Prevention and Health Promotion. About the Center; 2023. Available at: https://www.cdc.gov/chronicdisease/center/index.htm
  3. Salisbury C., Man M.S., Bower P., Guthrie B., Chaplin K., Gaunt D.M., et al. Management of multimorbidity using a patient-centred care model: a pragmatic cluster-randomised trial of the 3D approach. Lancet. 2018; 392(10141): 41–50. https://doi.org/10.1016/s0140-6736(18)31308-4
  4. Boersma P., Black L.I., Ward B.W. Prevalence of multiple chronic conditions among US adults, 2018. Prev. Chronic Dis. 2020; 17: E106. https://doi.org/10.5888/pcd17.200130
  5. Management of individuals with multiple chronic conditions: a continuing challenge. Am. J. Manag. Care. 2021; 27(6): 256–60. https://doi.org/10.37765/ajmc.2021.88665
  6. Benjamin R.M. Multiple chronic conditions: a public health challenge. Public Health Rep. 2010; 125(5): 626–7. https://doi.org/10.1177/003335491012500502
  7. Wolff J.L., Starfield B., Anderson G. Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch. Intern. Med. 2002; 162(20): 2269–76. https://doi.org/10.1001/archinte.162.20.2269
  8. Agborsangaya C.B., Lau D., Lahtinen M., Cooke T., Johnson J.A. Health-related quality of life and healthcare utilization in multimorbidity: results of a cross-sectional survey. Qual. Life Res. 2013; 22(4): 791–9. https://doi.org/10.1007/s11136-012-0214-7
  9. Ward B.W. Barriers to health care for adults with multiple chronic conditions: United States, 2012–2015. NCHS Data Brief. 2017; (275): 1–8.
  10. Schiltz N.K. Prevalence of multimorbidity combinations and their association with medical costs and poor health: A population-based study of U.S. adults. Front. Public Heal. 2022; 10: 953886. https://doi.org/10.3389/fpubh.2022.953886
  11. Moscow Mayor official website. Digital polyclinic: the way technologies help doctors and patients; 2021. Available at: https://www.mos.ru/news/item/88866073/ (in Russian)
  12. Andreev D.A., Kashurnikov A.Yu., Zav’yalov A.A. Digital technologies in improving cancer care delivery to Muscovites. In: Research Institute for Healthcare Organization and Medical Management of Moscow Health Department. Collection of Scientific Articles [Trudy nauchno-issledovatel’skogo instituta organizatsii zdravookhraneniya i meditsinskogo menedzhmenta. Sbornik nauchnykh trudov]. Moscow; 2020: 27–37. https://elibrary.ru/vtkzrk (in Russian)
  13. TASS. Specialsts of the telemedicine center provided over 1 million consultations in Moscow during the year of work; 2021. Available at: https://tass.ru/moskva/11055261 (in Russian)
  14. Samal L., Fu H.N., Camara D.S., Wang J., Bierman A.S., Dorr D.A. Health information technology to improve care for people with multiple chronic conditions. Health Serv. Res. 2021; 56(Suppl. 1): 1006–36. https://doi.org/10.1111/1475-6773.13860
  15. Thorpe K., Jain S., Joski P. Prevalence and spending associated with patients who have a behavioral health disorder and other conditions. Health Aff. (Millwood). 2017; 36(1): 124–32. https://doi.org/10.1377/hlthaff.2016.0875
  16. Foo K.M., Sundram M., Legido-Quigley H. Facilitators and barriers of managing patients with multiple chronic conditions in the community: a qualitative study. BMC Public Health. 2020; 20(1): 273. https://doi.org/10.1186/s12889-020-8375-8
  17. Goldberg D.G., Gimm G., Burla S.R., Nichols L.M. Care experiences of patients with multiple chronic conditions in a payer-based patient-centered medical home. Popul. Health Manag. 2020; 23(4): 305–12. https://doi.org/10.1089/pop.2019.0189
  18. Atlas S.J., Grant R.W., Ferris T.G., Chang Y., Barry M.J. Patient-physician connectedness and quality of primary care. Ann. Intern. Med. 2009; 150(5): 325–35. https://doi.org/10.7326/0003-4819-150-5-200903030-00008
  19. Lim C.Y., Berry A.B.L., Hirsch T., Hartzler A.L., Wagner E.H., Ludman E.J., et al. Understanding what is most important to individuals with multiple chronic conditions: a qualitative study of patients’ perspectives. J. Gen. Intern. Med. 2017; 32(12): 1278–84. https://doi.org/10.1007/s11606-017-4154-3
  20. Loeb D.F., Bayliss E.A., Candrian C., DeGruy F.V., Binswanger I.A. Primary care providers’ experiences caring for complex patients in primary care: a qualitative study. BMC Fam. Pract. 2016; 17: 34. https://doi.org/10.1186/s12875-016-0433-z
  21. Giordano C., Brennan M., Mohamed B., Rashidi P., Modave F., Tighe P. Accessing artificial intelligence for clinical decision-making. Front. Digit. Health. 2021; 3: 645232. https://doi.org/10.3389/fdgth.2021.645232
  22. Allard J.P., Keller H., Jeejeebhoy K.N., Laporte M., Duerksen D.R., Gramlich L., et al. Decline in nutritional status is associated with prolonged length of stay in hospitalized patients admitted for 7 days or more: A prospective cohort study. Clin. Nutr. 2016; 35(1): 144–52. https://doi.org/10.1016/j.clnu.2015.01.009
  23. Barrett M., Boyne J., Brandts J., Brunner-La Rocca H.P., De Maesschalck L., De Wit K., et al. Artificial intelligence supported patient self-care in chronic heart failure: a paradigm shift from reactive to predictive, preventive and personalised care. EPMA J. 2019; 10(4): 445–64. https://doi.org/10.1007/s13167-019-00188-9
  24. Boers S.N., Jongsma K.R., Lucivero F., Aardoom J., Büchner F.L., de Vries M., et al. SERIES: eHealth in primary care. Part 2: Exploring the ethical implications of its application in primary care practice. Eur. J. Gen. Pract. 2020; 26(1): 26–32. https://doi.org/10.1080/13814788.2019.1678958
  25. Tarumi S., Takeuchi W., Chalkidis G., Rodriguez-Loya S., Kuwata J., Flynn M., et al. Leveraging artificial intelligence to improve chronic disease care: methods and application to pharmacotherapy decision support for type-2 diabetes mellitus. Methods. Inf. Med. 2021; 60(S01): e32–43. https://doi.org/10.1055/s-0041-1728757
  26. Labovitz D.L., Shafner L., Reyes Gil M., Virmani D., Hanina A. Using artificial intelligence to reduce the risk of nonadherence in patients on anticoagulation therapy. Stroke. 2017; 48(5): 1416–9. https://doi.org/10.1161/strokeaha.116.016281
  27. Ju H.H. Improving care coordination of patients with chronic diseases. J. Nurse Pract. 2022; 18(8): 833–6. https://doi.org/10.1016/j.nurpra.2022.06.011
  28. Bates D.W., Samal L. Interoperability: what is it, how can we make it work for clinicians, and how should we measure it in the future? Health Serv. Res. 2018; 53(5): 3270–7. https://doi.org/10.1111/1475-6773.12852
  29. Carey M., Noble N., Mansfield E., Waller A., Henskens F., Sanson-Fisher R. The role of eHealth in optimizing preventive care in the primary care setting. J. Med. Internet. Res. 2015; 17(5): e126. https://doi.org/10.2196/jmir.3817
  30. Hou C., Carter B., Hewitt J., Francisa T., Mayor S. Do mobile phone applications improve glycemic control (HbA1c) in the self-management of diabetes? A systematic review, meta-analysis, and GRADE of 14 randomized trials. Diabetes Care. 2016; 39(11): 2089–95. https://doi.org/10.2337/dc16-0346
  31. Dinsmore J., Hannigan C., Smith S., Murphy E., Kuiper J.M.L., O’Byrne E., et al. A digital health platform for integrated and proactive patient-centered multimorbidity self-management and care (ProACT): Protocol for an action research proof-of-concept trial. JMIR Res. Protoc. 2021; 10(12): e22125. https://doi.org/10.2196/22125

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Copyright (c) 2023 Kamynina N.N., Andreev D.A., Pakhuridze M.D., Sizov G.G.

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