How Patient Work Changes Over Time for People With Multimorbid Type 2 Diabetes: Qualitative Study

Area of Science:

• Digital health interventions
• Chronic illness management
• Patient-centered care

Background:

• Current digital health tools offer fragmented support, failing to adapt to patients' changing needs throughout their illness trajectory.
• This static approach leads to disjointed patient experiences and unmet needs, particularly for vulnerable subpopulations.
• Digital support often does not evolve with the patient's health state, creating a gap in continuous care.

Purpose of the Study:

• To investigate the evolving nature of patient work in individuals with type 2 diabetes mellitus and chronic multimorbidity.
• To explore the implications of these evolving patient work dynamics for the design of digital support systems.
• To identify how digital health tools can better align with the dynamic needs of patients with complex chronic conditions.

Main Methods:

• Study involved 26 patients diagnosed with type 2 diabetes mellitus and chronic multimorbidity.
• Each participant underwent two in-depth interviews.
• Interview transcripts were analyzed using the established Chronic Illness Trajectory Model.

Main Results:

• Four distinct illness trajectories emerged, each with unique patient work goals and needs.
• Patients with stable conditions aimed to routinize and minimize patient work.
• Those experiencing acute episodes required support for therapy adherence, while others navigated rapid health changes or post-crisis recovery.

Conclusions:

• Patient work is dynamic and context-dependent, significantly influenced by individual experiences.
• The timing and trajectory of patient work must be integral to the design of digital support interventions.
• Adaptive digital tools that evolve with the patient are essential for effective chronic illness management.