Catherine Hudon|Maud?Christine Chouinard|Marie?France Dubois|Pasquale Roberge|Christine Loignon|Éric Tchouaket|Mireille Lambert|Émilie Hudon|Fatoumata Diadiou|Danielle Bouliane
Case Management in Primary Care for Frequent Users of Health Care Services: A Mixed Methods Study
Université de Sherbrooke|Centre Hospitalier Universitaire de Sherbrooke|Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay–Lac-Saint-Jean|Hôpital Charles-Le Moyne|Université du Québec à Chicoutimi|Université de Sherbrooke|Université de Sherbrooke|Centre Hospitalier Universitaire de Sherbrooke|Université de Sherbrooke|Université du Québec en Outaouais|Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay–Lac-Saint-Jean|Université du Québec à Chicoutimi|Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay–Lac-Saint-Jean|Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay–Lac-Saint-Jean|Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay–Lac-Saint-Jean
study aimed evaluate effects v1sages case management intervention vulnerable patients primary care nurse case management selfmanagement support frequent users health care services chronic disease complex care needs psychological distress patient activationwe used 2phase sequential mixed methods design first phase pragmatic randomized controlled trial intentiontotreat analysis measured effects intervention compared usual care psychological distress patient activation 6 months second phase qualitative descriptive design entailed thematic analysis indepth interviews 25 patients 6 case management nurses 9 health managers focus groups 8 patients spouses 21 family physicians understand stakeholders perceived effects intervention patientsa total 247 patients randomized intervention group n 126 control group n 121 compared usual care intervention reduced psychological distress odds ratio 043 95 ci 019095 p 04 significant effect patient activation p 43 qualitative results suggested patients spouses benefitted case management intervention gaining sense security stakeholders noted better patient selfmanagement healthtogether studys quantitative qualitative results suggest case management reduces psychological distress making patients caregivers feel secure whereas impact selfmanagement unclear case management promising avenue improve outcomes among frequent users health care complex needs