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Distinct care trajectories among persons living with arthritic conditions: A two-year state sequence analysis.
Nguena Nguefack, Hermine Lore; Pagé, M Gabrielle; Choinière, Manon; Vanasse, Alain; Deslauriers, Simon; Angarita-Fonseca, Adriana; Blanchette, Marc-André; Lacasse, Anaïs.
Affiliation
  • Nguena Nguefack HL; Department of Health Sciences, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC, Canada.
  • Pagé MG; Research Centre, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
  • Choinière M; Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
  • Vanasse A; Research Centre, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
  • Deslauriers S; Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
  • Angarita-Fonseca A; Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.
  • Blanchette MA; Research Centre, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.
  • Lacasse A; VITAM - Centre de recherche en santé durable, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec, QC, Canada.
Front Pain Res (Lausanne) ; 3: 1014793, 2022.
Article in En | MEDLINE | ID: mdl-36444387
Objectives: Developing solutions to optimize care trajectories (CareTs) requires examining patient journeys through the health care system. This study aimed to describe CareTs among people living with arthritis and evaluate their association with self-reported health outcomes. Methods: Analyses were conducted using the TorSaDE Cohort (n = 102,148), which connects the 2007 to 2016 Canadian Community Health Surveys (CCHS) with Quebec administrative databases (longitudinal claims). CareTs of participants living with arthritis according to CCHS (n = 16,631), over the two years before CCHS completion, were clustered using state sequence analysis (months as a time unit). CareT group membership was then put in association with self-reported outcomes (pain intensity and interference, self-perceived general and mental health). Results: The analysis revealed five CareT groups characterized predominantly by: (1) arthritis-related visits to a specialist (n = 2,756; 16.6%), (2) arthritis-related emergency department visits (n = 2,928; 17.6%), (3) very high all-cause health care utilization and arthritis-related hospitalizations (n = 1,570; 9.4%), (4) arthritis-related medical visits to general practitioners and specialists (n = 2,708; 16.3%), (5) low all-cause health care utilization (n = 6,669; 40.1%). Multivariable results revealed that CareT group membership was associated with higher levels of pain interference (CareT group #3 vs. #5: OR: 1.4, 95%CI: 1.1-1.8) and fair/poor self-perceived general health (CareT group #1 vs. #5: OR: 1.551, 95%CI: 1.319-1.824; #2 vs. #5: OR: 1.244, 95%CI: 1.062-1.457; #3 vs. #5: OR: 1.771, 95%CI: 1.451-2.162; #4 vs. #5: OR: 1.481, 95%CI: 1.265-1.735). Discussion: Sate sequence analysis is an innovative method of studying CareTs and valuable for making evidence-based decisions taking into account inter- and intra-individual variability.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Front Pain Res (Lausanne) Year: 2022 Document type: Article Affiliation country: Canada Country of publication: Switzerland

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Front Pain Res (Lausanne) Year: 2022 Document type: Article Affiliation country: Canada Country of publication: Switzerland