PhD student: Antoine BRACONNIER
Title: DEVELOPMENT OF A TOOL TO MAP THE CARE JOURNEY OF PATIENTS WITH CHRONIC CONDITIONS AND MULTIMORBIDITY
Supervisor(s): Pr Viet-Thi Tran
Doctoral school : Ecole Doctorale 393
Promotion: 2024
Funding : _
Thesis abstract
The aim of this PhD project is to study the care journey of patients with chronic conditions and multimorbidity. The project is performed within the context of a larger European project (Digital-CACTUS), which is coordinated by Pr Tran. This PhD project aims at:
- Describing the existing methods measurement tools to evaluate the journey of patients with chronic conditions (P1).
- Developing a novel patient-reported measurement tool to describe the journey of patients with chronic conditions and multimorbidity (P2 & P3).
Project 1: Description of the methods and measurement tools used to evaluate the journeys of patients with chronic conditions and multimorbidity
The project will rely on a systematic review of studies assessing the journey of patients with chronic conditions and/or with multimorbidity. Literature search will involve multiple databases (PubMed & EMBASE) over the last 5 years. Study selection will be performed by 2 independent reviewers. Data extraction will be performed by 2 independent reviewers and will focus on the methods and measurement tools used to assess the journey of patients. Analysis will focus on appraising the domains covered by the tools, whether the tools are fit for multimorbidity, and their measurement properties.
Project 2: Development of a novel validated patient-reported tool to retrace the patient’s care journey
The project will involve the development of an interactive and visual patient reported tool, inspired by the “metro mapping” initiative (6,7), to retrace the patient’s care journey during the last 6 months. The tool should be able to 1) capture all interactions between patients and care-providers: consultations, hospitalizations, exams, pharmacy refills, care tasks (arranging appointments, administrative tasks etc.); 2) describe each interaction; 3) assess whether these interactions are associated with treatment burden. Within this project, we will work on the definition of the data captured by the tool, and the elaboration of the user interface. This work will be supported by both the results from project 1, and by several stakeholder meetings with patients, health professionals and hospital directors. Elaboration of the tool will use cycles of prototyping and testing, following the methods described by Agoritsas et al. (8). The actual development of the interactive tool will be performed by a private company (SKEZI), in the context of the European project Digital CACTUS.
Project 3: Assessment of the psychometric properties of the novel validated patient-reported tool developed in project 2 in a sample of patients with chronic conditions recruited in the ComPaRe cohort.
The preliminary tool developed in Project 2 will be validated with a sample of patients with chronic conditions and multimorbidity, recruited in the ComPaRe e-cohort, a nationwide cohort of 50000 patients with chronic conditions in France. Validation will follow a standard multi-step approach to validate PROMs and PREMs. In short, we aim to assess the tool’s construct validity by studying the 1) correlation between the number of interactions reported by patients, and patients’ assessment of their burden of treatment, assessed using the Treatment Burden Questionnaire (TBQ) (9); 2) correlation between the number of interactions with high burden and patients’ assessment of their quality of life, assessed using the EQ-5D-5L scale (10). Reliability will be assessed by using a test-retest method with a 1-month interval.
