What are the patients' preferences for the Chronic Care Model? An application to the obstructive sleep apnoea syndrome

CONTEXT: The Chronic Care Model (CCM) has been developed to improve the quality of medical care delivered by general practitioners to patients with multiple chronic conditions. Despite an increasing use of this model, it remains unclear to what extent the different recommendations are valued by the patients.

OBJECTIVE: This study aims to identify the preferences of patients with multiple chronic conditions for recommendations of the Chronic Care Model.

METHODS: The patients' preferences were identified with a discrete choice experiment. The hypothetical general practice cares were described using 10 recommendations of the Chronic Care Model (i.e. shared decision making; informational continuity (INF); regular follow-up; planned care; communication; collaboration with a nurse; advices on health habits; patient empowerment; psychological support; coordination). Respondents were consecutively recruited in a hospital setting during routine follow-up visits to their pulmonary specialist. The sample of respondents included 150 patients with multiple chronic conditions in addition to an obstructive sleep apnoea syndrome.

RESULTS: The INF is highly valued by the patients. At the opposite, patients do not appear to value collaboration between nurses and GPs. To a large extent, the patients' preferences for the recommendations of the CCM depend on their gender, number of chronic conditions and self-perceived health condition.

DISCUSSION: The INF appeared to be a minimal requirement to ensure high-quality general practice care. The significant interactions between the patients' socio-demographic characteristics and their preferences for the CCM highlighted the necessity to deliver personalized services.