Patient Experience Journal (Nov 2018)

Perceptions of patient-centered care among veterans with gastroesophageal reflux disease on proton pump inhibitor therapy

  • Salva Balbale,
  • Andrew Gawron,
  • Sherri LaVela

Abstract

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The aim of this study was to explore perceptions of patient-centered care (PCC) among Veterans with gastroesophageal reflux disease (GERD) on proton pump inhibitor (PPI) therapy using patient-reported outcome (PRO) measures. We used three validated surveys to measure PCC concepts in a national sample of Veterans with GERD on PPI therapy. The Combined Outcome Measure for Risk Communication and Treatment Decision Making Effectiveness (COMRADE) measures patient experiences with risk communication and decision-making. The Patient Activation Measure (PAM) evaluates confidence and knowledge needed for self-management. The Patient Assessment of Care for Chronic Conditions (PACIC) assesses views of chronic care received. We used descriptive statistics to describe patient characteristics and PCC outcomes. Respondents (n=444) were mostly male (95.1%) with a mean age of 67.7 years. The mean COMRADE score measuring patient experiences with risk communication was 55.3 (SD=19.0). The mean PAM score was 56.1 (SD=19.2); 47.8% of respondents were considered disengaged patients lacking confidence and knowledge for self-management. The mean PACIC summary score was 3.03 (SD=1.2), with highest scores in the Delivery System Design/Decision Support (3.38, SD=1.2) subscale, and lowest scores in the Follow-up/Coordination subscale (2.58, SD=1.3). Veterans with GERD reported that care was well-organized and supportive in enhancing decision-making. Potential gaps in patient experiences may exist in delivering follow-up care, enhancing patient activation, and informing patients about risks of available GERD treatments. This is the first study to evaluate patient perceptions of PCC in a national sample of Veterans with GERD on PPI therapy. Findings can inform further investigation and development of targeted interventions to enhance the experience of PCC for individuals with GERD.

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