When does nonadherence indicate a deviation from patient-centered care?

Area of Science:

• Health Services Research
• Medical Quality Improvement
• Patient-Centered Outcomes Research

Background:

• Patient-centered care is crucial but difficult to measure accurately and feasibly.
• It is defined as care respectful of patient preferences, needs, and values, guiding clinical decisions.
• Patient-centered care is incentivized in various healthcare settings, including medical homes.

Purpose of the Study:

• To propose an improved method for assessing patient-centered care.
• To identify indicators of probable patient-centered care absence.
• To suggest flagging discordance between patient preferences and treatment plans.

Main Methods:

• Focus on identifying circumstances indicating probable absence of patient-centered care.
• Propose using persistent lack of control of easily manageable comorbid conditions as a marker.
• Suggest using conditions with diverse, preference-compatible therapies (e.g., hypertension, type 2 diabetes).

Main Results:

• Persistent lack of control in easily manageable comorbid conditions may indicate patient-centered care absence.
• This approach could serve as a feasible and scalable assessment marker.
• The proposed method can be tested, validated, and integrated with quality improvement efforts.

Conclusions:

• Assessing patient-centered care can be enhanced by identifying probable discordance between patient preferences and treatment.
• Uncontrolled, easily manageable comorbid conditions can serve as a potential marker for this discordance.
• This approach offers a practical strategy for quality improvement in patient-centered care.