q uali t a ti v e expl o r a ti o n :
DESCRIPTION
Q uali t a ti v e Expl o r a ti o n : M inneso t a P a tie n ts ’ R espons e t o T ak i n g a n I n c r e a se d R o l e i n He a l th c a r e. M e thod. W e c onduc t ed t w o Online Digi t al Bulletin Boa r ds (ODBBs) Al l o w ed us t o r ecruit participa n ts s tat e w i de - PowerPoint PPT PresentationTRANSCRIPT
Qualitative Exploration:Minnesota Patients’ Response to Taking an Increased Role in Healthcare
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Method• We conducted two Online Digital Bulletin Boards (ODBBs)
• Allowed us to recruit participants statewide• Offered financial and logistical advantages over traditional
research methods• Allowed us to capture reactions to communication themes on an
individual basis prior to group discussion• Took place over 5 days 5 hours of input x
~100 respondents• Discussion guide could evolve as we learned
• Separating boards by gender similarities and differences between women and men could be observed
Sample
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• All respondents:• Expressed a willingness to explore new ideas• Had seen a doctor in the last 12 months about chronic condition
or ongoing health issue• Equal gender representation• Between ages 21 to 85 (sample skewed older due to health-
relatedrequirements)
• No past 6 month qualitative research work• Had access to computer for personal use• Passed a technology screen
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Limitations
• Sample size for this project was 100+ respondents• Samples of this size are more likely to yield results that are more
reliable, precise, and representative of the population than sample sizes of traditional qualitative research
• Sample was chosen randomly according to defined quotas (for patient behavior and types of illnesses as well as demographics)
• Please keep in mind that this is qualitative research to inform the development of a patient outreach campaign. It provides a more rich contextual type of qualitative feedback than most quantitative surveys can, but it does not have the predictability of a statistically significant random sample quantitative survey
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Executive Summary
Men and women agree that they have the primary responsibility for their own treatment and care with respect to their medical issues
Key is to inform them of what that responsibility entails• Most believe it includes acting on next steps (making
appointments, getting tests done, filling prescriptions) and watching for warning signs• Fewer believe that it is their responsibility to
document information (warning signs, next steps, prescriptions taken)• Men and women are least likely to take responsibility
for bringing test results with them to appointments
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Executive Summary (cont’d)In general, patients tended to take a more active
role in their medical care if:1. they had more serious and/or chronic diseases2. they saw multiple providers (especially if
from different clinics/networks)3. they were older4. they had experienced medical mishaps (first-
or second-hand)
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Executive Summary (cont’d)Barriers that MAPS will need to address include
these attitudes and behaviors:“My provider has all my information in my charts”
“My providers belong to the same network and they share my information”
“My pharmacist provides information when I get my prescriptions”
“I can (still) remember – I don’t need to write anything down”
“I don’t think about documenting anything”“I don’t know the questions to ask (my doctor)”“My spouse/mom/child takes care of that for me”
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Executive Summary (cont’d)Nearly everyone claimed to keep a list of some
kind (if only a grocery list)Post-it Notes, calendars, and messages posted on
refrigerators with magnets were also commonly used reminder methods
Younger patients were more likely to be “paper- free,” relying on electronic reminders and filing systems
Older patients were more likely to keep hardcopies, sometimes in (elaborate) filing systems
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Executive Summary (cont’d)Patients responded well to a to-do list: the steps
were clear, six steps the correct number• They had no suggestions for additions
Presenting the To-do list as in the Theme O radio ad was the most appealing overall:• Women found this approach compelling, supportive,
empowering, and “not preachy”• Men liked the direct approach of this theme and agreed with
the philosophy “You are Your Own Best Medicine”
Taking a serious approach in presenting the To-do list was endorsed by both men and women (although many acknowledged that they preferred – and were more likely to recall - humorous executions in general)
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Executive Summary (cont’d)Among the reminder product concepts reviewed, the refrigerator
magnet and note pads were most likely to be used (although perhaps not as effective as actual reminder tools)
Younger patients also liked the electronic options (Smartphone app, USB device), but older/less computer savvy patients were less positive: for them, a pre-loaded file folder or organizer had more appeal
Web videos and one-page information that came from providers were likely to get viewed at least once (and especially in the waiting room or if handed to respondents after an office visit)
Few thought the wallet card would get used or viewed
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Detailed Findings
Women’s Organizational Charts:Healthcare Functions
1st place is me (doctor was next most often mentioned in 1st position)
My job is to maintain my well being/to see to it that I take my medications, eat the correct foods, get exercise but be careful not to overdo, and to seek out help when it's needed
It's my husband’s job to emotionally support me and go to doctor's visits if I want him to… go to the grocery store and get something for me if I need it, if I'm sick, etc.
He diagnosed the condition, provided treatment, and instructions for ongoing procedures that I can conduct at home to help relieve the condition and prevent it from worsening.
Usually a spouse/significant other (but also relatives, pharmacists or physical therapists – or no one)
Usually no one
My doctor (or self, if not in first position)
Q. Thinking in terms of the chronic disease or illness you are living with, please tell me: who are the various participants in your treatment and care of your disease/illness and what is the responsibility of each?
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Men’s Organizational Charts:Healthcare Functions
1st place is me (doctor was next most often mentioned in 1st position)
I make all my food, blood testing, physical activity and medication schedule decisions. Others can make suggestions but I am the one to make the final decision
She is an integral part of my health team…knows my feelings…can accompany me to visits, listen, can ask clarifying questions, and convey to me things… Without her, I would not be as healthy.
He takes the time to explain things as well as reviewing my diagnostic tests and taking appropriate action.
Usually a spouse/significant other (but also relatives, pharmacists or physical therapists – or no one)
No one (or sometimes friend or relative)
My doctor (or self, if not placed in firstposition)
Friends - they help me keep sane along with bouncing ideas and suggestions off
Q. Thinking in terms of the chronic disease or illness you are living with, please tell me: who are the various participants in your treatment and care of your disease/illness and what is the responsibility of each?
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Reactions to To-do List
Number of items on List is right• Most women and men thought that the list contained the
right number of tasks (6)
Too many Too many
Too few
Right number
Women’s Response
Too fewRight number
Men's ResponseThis is a good number. It's thorough
without being overwhelming, and it's also divided into three easy to read
and understand sections.
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To-do steps are clear
Clear
Not clear
Women’s Response
I can tell that this check list would
be good to get me to be a little more
aware of my health and maybe
be able to ask more questions.
Clear
NotClear
Men's ResponseIt's clear what whoever wrote that list thinks you should do. What is written is clearly stated.
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Patients are polarized in terms of likelihood to bring a medication list (many count on their providers to have)
0 10 20 30 40 50
EXTREMELY UNLIKELY TO DO
SOMEWHAT UNLIKELY TO DO
NEITHER LIKELY NOR UNLIKELY TO DO
SOMEWHAT LIKELY TO DO
EXTREMELY LIKELY TO DO
Medication List
Women Men Combined
I have all this info in my
chart already.
It's too much work to bring with to your Dr appt no matter what your ailment is…It's not gonna get done.
I expect the doctor to do this, not me
This is most important to
me because of the large # ofmed's I take.
A must, as you may see multiple providers, and they may not be aware
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of the actions of another doctor.
Most patients also expect their providersto have test results
My doctor already has
access to this on the
computer.
I go to the same network of clinics that
have access to the records.
I do not routinely keep test records, as
the ratios and numbers they contain mean nothing to me.
These medical records I expect to be
kept on file by my clinic, where they
won't get lost, and where people with access to medical
desk reference books and pharmocopiae can decipher the meaning of the
cryptic numbers of the test results.
If this a serious condition I bring the information, if not a major problem or
condition I default to their record keeping.
I always carry my latest tests, because sometimes
they have not received results from another provider that may be necessary for them to
diagnose and treat you correctly.
0 10 20 30 40 50
EXTREMELY UNLIKELY TO DO
SOMEWHAT UNLIKELY TO DO
NEITHER LIKELY NOR UNLIKELY TO DO
SOMEWHAT LIKELY TO DO
EXTREMELY LIKELY TO DO
Test Results
Combined Women Men
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Patients with progressive conditions seemmore likely to keep a warning signs list
too many warning
signs for the meds I take
A list is already provided with any prescription… it
would be a waste of time.
If I have paper/pen, and my doc doesn't
give me a printed list, Iwill write it down.
0 5 10
WomenMen
15 20 25 30 35
EXTREMELY UNLIKELY TO DO
SOMEWHAT UNLIKELY TO DO
NEITHER LIKELY NOR UNLIKELY TO DO
SOMEWHAT LIKELY TO DO
EXTREMELY LIKELY TO DO
Write Warning Signs List
Combined
If the doctor would warn me to watch for a
symptom that would indicate a possible
medical condition you better believe it would
be documented
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Patients claim that next steps arenoted (if not always documented by
I feel like so far I can remember what I'm
told about any future steps there may be,
so I don't feel the need to write them
down.
0 5 10
WomenMen
15 20 25 30 35
EXTREMELY UNLIKELY TO DO
SOMEWHAT UNLIKELY TO DO
NEITHER LIKELY NOR UNLIKELY TO DO
SOMEWHAT LIKELY TO DO
EXTREMELY LIKELY TO DO
Combined
I go to the same network so I would just listen to the doctor and do what she said. My
condition is not so complex that I need to write it down. I leave the doctors office with steps and recommendations on a print out
anyway--I could refer to that if need be.
I would not think to ask.
them)You should always ask 'where do we go from here'. Good chance to ask if meds should be added,
Write a Next Steps List
reduced, or stopped. Also, what behavioral modifications are
necessary to improve your physical condition
If my doctor gave me next steps verbally, I
would definitely write them down. I would
assume, that this would be printed out for me by
the provider.
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Acting on next steps is the step thatmost patients (say they) comply with
Because I have so many appointments,
meds, tests at different clinics I
keep a daily planner which I have with me
at all times.
I care about my well being and my care begins with me. If I don't comply with
treatment I would only harm myself.
0 10 20 30 40
women
50 60 70 80 90
EXTREMELY UNLIKELY TO DO
SOMEWHAT UNLIKELY TO DO
NEITHER LIKELY NOR UNLIKELY TO DO
SOMEWHAT LIKELY TO DO
EXTREMELY LIKELY TO DO
Act on Next Steps
men combined
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Patients also claim to watch forwarning signs
I always do this so definitely this one,
even if hypochondriac-ish :)
I probably wouldn't make a list, but if I have concerns I would alert
the doctor
0 10 20 30 40 50 60 70
EXTREMELY UNLIKELY TO DO
SOMEWHAT UNLIKELY TO DO
NEITHER LIKELY NOR UNLIKELY TO DO
SOMEWHAT LIKELY TO DO
EXTREMELY LIKELY TO DO
Watch for Warning Signs
Combined Women Men
For me this is very important because if I don't care about my body who will. AFTER my last surgery I ended up with a staff infection which thanks to me I pushed the panic button
and lucky caught it early before it got out of control.
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Reactions to Themes
Themes P and O
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Themes H and M
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Most Persuasive Theme
O 30%
H 11%
M 4%
P 55%
O 30%
H 28%
M 15%
• An equal number of women picked Themes O, H, and P as “most persuasive”; men preferred P overall, followed by O
Women’s Response Men's Response
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P27%
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Why Theme “O”
For women:• Compelling (talks directly
to YOU)• Empowering, supportive• “Doesn’t talk down to me”
•For men:
• Many agreed philosophically with “you are your own best medicine”
• Puts patient in charge (appealed to Warriors)
• Addresses the problem (“you need to get involved”) more than other themes
Roughly half claim they would use a prepared folder (visual shown)• Great organizational
aid
• More likely to be maintained
0 10 20 30 40
Extremely unlikely to use
Somewhat unlikely to use
Might or might not be likely to use
Somewhat likely to use
Extremely likely to use
Likelihood to Use Folder
combined men women
This is the best idea ever -
everything can be kept in one
spot - divided for appointments,
blood work, prescriptions, allergies, tests
and so on - It can be carried to
every appointment
also
I love to be organized, but usually don't have the time
to set up something like this for me or
my family. Love it!
This seems way too
clunky and overbearing.
I expect the doctor to be connected
electronically. I don't want to drag all this
around
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Both men and women like “Lifesaving”option; less agreement on preferencesfor other options
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5
10
15
20
25
A B C D E F
G
H I J
Preferred Magnet Design
Women Men Combined
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