Multiple Chronic Conditions in the United States

10.7249/tl221 ◽  
2017 ◽  
Author(s):  
Christine Buttorff ◽  
Teague Ruder ◽  
Melissa Bauman
Keyword(s):  
United States ◽  
Chronic Conditions ◽  
The United States ◽  
Multiple Chronic Conditions

scholarly journals Regional Risk: Mapping Single and Multiple Chronic Conditions in the United States

SAGE Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 215824401882238 ◽  
Author(s):  
Alexandra C. H. Nowakowski ◽  
Jihyung Shin ◽  
Henry J. Carretta
Keyword(s):  
United States ◽  
Health Risk ◽  
Risk Behaviors ◽  
Chronic Conditions ◽  
Regional Differences ◽  
The United States ◽  
Health Risk Behaviors ◽  
Multiple Chronic Conditions ◽  
Average Risk ◽  
Odds Ratios

Prevalence of single and multiple chronic conditions continues to increase in the United States. Chronic conditions predict significant morbidity and health care costs, especially when complicated by additional conditions. Likewise, many conditions are linked to health risk behaviors, and thus amenable to prevention. We examine regional differences in prevalence of single and multiple chronic conditions. In the process, we examine the ability of health risk behaviors to predict condition prevalence in each region. We recommend national prevention strategies with targeted content for specific geographic regions. We used 2009 Behavioral Risk Factor Surveillance System (BRFSS) data ( N = 432,607) for all analyses. After grouping states into nine U.S. Census divisions, we fitted generalized linear mixed regression models and compared regional odds ratios with national averages. Analyses controlled for helpful and harmful behaviors, health insurance coverage, and demographic characteristics. Odds ratios for single and multiple chronic conditions deviated significantly from national averages in all nine regions. Health behaviors significantly predicted prevalence for both single and multiple conditions within regions, but differences in behaviors between regions did not fully account for observed disparities in prevalence. Significant regional differences in disease prevalence suggest priority areas for prevention efforts. Promoting healthy behaviors and mitigating harmful behaviors in high-risk regions may help to reduce overall chronic condition prevalence, but is unlikely to obviate disparities between regions. Targeted needs assessment should be conducted within each region with higher-than-average risk to determine intervention strategies with the greatest likelihood of near-term impact.

scholarly journals Data visualizations to support health practitioners� provision of personalized care for patients with cancer and multiple chronic conditions: A user-centered design study (Preprint)

2018 ◽  
Author(s):  
Uba Backonja ◽  
Sarah Haynes ◽  
Katherine Kim
Keyword(s):  
United States ◽  
Cancer Care ◽  
Chronic Conditions ◽  
The United States ◽  
Multiple Chronic Conditions ◽  
Line Graphs ◽  
User Centered Design ◽  
Care Providers ◽  
Personalized Care ◽  
User Centered

BACKGROUND About one out of every four people in the United States lives with multiple chronic conditions including cancer, hypertension, diabetes, and heart disease. Attempts to personalize care must take into account the individual’s comprehensive needs rather than focusing on one condition in isolation. Collection and presentation of person generated health data such as symptoms, medication use, physical activity, and health goals are important complements to clinical data in personalized care. There are challenges in integrating and making sense of these various data types in order for both patients and clinicians. User-centered design applied to data visualization has the potential to address this challenge by offering well-designed information displays that fit users’ needs and preferences. OBJECTIVE The aim of this study was to assess the perceptions of and feedback regarding visualizations developed to support care of individuals with multiple chronic conditions engaging in cancer care in one important user group, healthcare practitioners. METHODS Medical doctors (MDs; n=4) and Registered Nurses (RNs; n=4) providing cancer care at an academic medical center in the western United States provided feedback on visualization mockups. Mockup designs were guided by current health informatics and visualization literature and Munzner’s Nested Model for Visualization Design. Visualizations included: a four-week calendar view summarizing four measures; temporal line graphs of blood glucose, blood pressure, and weight; longitudinal symptom ratings. Visual encodings included color, lines or bands indicating expected normal ranges for various measures, and icons. User-centered design methods, a mock patient persona, and a scenario were used to elicit insights from participants. Directed content analysis was used to identify themes from session transcripts. Means and standard deviations were calculated for health care providers’ rankings of overview visualizations. RESULTS Themes identified were data elements, supportive elements, confusing elements, interpretation, and use of visualization. Overall, participants found the visualizations useful and with potential to provide personalized care. Use of color, reference lines, and familiar visual presentations (calendars, line graphs) were noted as helpful in interpreting data. Participants were confused by: the meaning of white spaces, the miniature line graphs indicating symptoms, and the different ways in which symptoms were quantified. Participants were able to see trends and spot recurrent issues using the calendar view and line graphs. The visualizations were perceived of as useful to: better understand the patient outside the clinic; empower patients engaging in self-management, and support provision of personalized care. CONCLUSIONS Visualizations guided by a framework and literature can support healthcare providers’ understanding of data for individuals with multiple chronic conditions engaged in cancer care. This understanding has the potential to support the provision of personalized care.

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