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

Yin, K; Jung, J; Coiera, E; Ho, KWK; Vagholkar, S; Blandford, A; Rapport, F; (2021) How Patient Work Changes Over Time for People With Multimorbid Type 2 Diabetes: Qualitative Study. Journal of Medical Internet Research , 23 (7) , Article e25992. 10.2196/25992. Green open access

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Abstract

BACKGROUND: The experiences of patients change throughout their illness trajectory and differ according to their medical history, but digital support tools are often designed for one specific moment in time and do not change with the patient as their health state changes. This presents a fragmented support pattern where patients have to move from one app to another as they move between health states, and some subpopulations of patients do not have their needs addressed at all. OBJECTIVE: This study aims to investigate how patient work evolves over time for those living with type 2 diabetes mellitus and chronic multimorbidity, and explore the implications for digital support system design. METHODS: In total, 26 patients with type 2 diabetes mellitus and chronic multimorbidity were recruited. Each interview was conducted twice, and interviews were transcribed and analyzed according to the Chronic Illness Trajectory Model. RESULTS: Four unique illness trajectories were identified with different patient work goals and needs: living with stable chronic conditions involves patients seeking to make patient work as routinized and invisible as possible; dealing with cycles of acute or crisis episodes included heavily multimorbid patients who sought support with therapy adherence; responding to unstable changes described patients currently experiencing rapid health changes and increasing patient work intensity; and coming back from crisis focused on patients coping with a loss of normalcy. CONCLUSIONS: Patient work changes over time based on the experiences of the individual, and its timing and trajectory need to be considered when designing digital support interventions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2018-022163.

Type: Article
Title: How Patient Work Changes Over Time for People With Multimorbid Type 2 Diabetes: Qualitative Study.
Location: Canada
Open access status: An open access version is available from UCL Discovery
DOI: 10.2196/25992
Publisher version: https://doi.org/10.2196/25992
Language: English
Additional information: © Kathleen Yin, Joshua Jung, Enrico Coiera, Kenneth W K Ho, Sanjyot Vagholkar, Ann Blandford, Frances Rapport, Annie Y S Lau. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 15.07.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.
Keywords: Chronic conditions, chronic illness trajectory, consumer informatics, diabetes, patient work, self-management
UCL classification: UCL
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Computer Science
URI: https://discovery.ucl.ac.uk/id/eprint/10128699
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