Perceptions of patient-centered care among veterans with gastroesophageal reflux disease on proton pump inhibitor therapy

Salva N. Balbale, Center for Evaluation of Practices and Experiences of Patient-centered Care (CEPEP) & Center of Innovation for Complex Chronic Health Care (CINCCH), Edward Hines Jr. VA Hospital, Hines, IL, USA; Division of Gastroenterology and Hepatology, Department of Medicine, & Center for Healthcare Studies, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL USA Follow
Andrew Gawron, Salt Lake City Veterans Affairs Medical Center, Salt Lake City, UT, USA; Division of Gastroenterology, Hepatology, & Nutrition, University of Utah, Salt Lake City, UT, USAFollow
Sherri L. LaVela PhD, MPH, MBA, Center for Evaluation of Practices and Experiences of Patient-centered Care (CEPEP) & Center of Innovation for Complex Chronic Health Care (CINCCH), Edward Hines Jr. VA Hospital, Hines, IL, USA; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL USA Follow

Abstract

The aim of this study was to explore perceptions of patient-centered care (PCC) among Veterans with gastroesophageal reflux disease (GERD) on proton pump inhibitor (PPI) therapy using patient-reported outcome (PRO) measures. We used three validated surveys to measure PCC concepts in a national sample of Veterans with GERD on PPI therapy. The Combined Outcome Measure for Risk Communication and Treatment Decision Making Effectiveness (COMRADE) measures patient experiences with risk communication and decision-making. The Patient Activation Measure (PAM) evaluates confidence and knowledge needed for self-management. The Patient Assessment of Care for Chronic Conditions (PACIC) assesses views of chronic care received. We used descriptive statistics to describe patient characteristics and PCC outcomes. Respondents (n=444) were mostly male (95.1%) with a mean age of 67.7 years. The mean COMRADE score measuring patient experiences with risk communication was 55.3 (SD=19.0). The mean PAM score was 56.1 (SD=19.2); 47.8% of respondents were considered disengaged patients lacking confidence and knowledge for self-management. The mean PACIC summary score was 3.03 (SD=1.2), with highest scores in the Delivery System Design/Decision Support (3.38, SD=1.2) subscale, and lowest scores in the Follow-up/Coordination subscale (2.58, SD=1.3). Veterans with GERD reported that care was well-organized and supportive in enhancing decision-making. Potential gaps in patient experiences may exist in delivering follow-up care, enhancing patient activation, and informing patients about risks of available GERD treatments. This is the first study to evaluate patient perceptions of PCC in a national sample of Veterans with GERD on PPI therapy. Findings can inform further investigation and development of targeted interventions to enhance the experience of PCC for individuals with GERD.

Recommended Citation

Balbale SN, Gawron A, LaVela SL. Perceptions of patient-centered care among veterans with gastroesophageal reflux disease on proton pump inhibitor therapy. Patient Experience Journal. 2018; 5(3):149-159. doi: 10.35680/2372-0247.1232.