Case Management in Primary Care for Frequent Users of Health Care Services: A Mixed Methods Study

Catherine Hudon
Maud-Christine Chouinard
Marie-France Dubois
Pasquale Roberge
Christine Loignon
Eric Tchouaket
Mirielle Lambert
Emilie Hudon
Fatoumata Diadiou
Danielle Bouliane
Journal Article
May 2018

This resource describes a randomized controlled trial to evaluate the effects of a case management intervention called V1SAGES (Vulnerable Patients in Primary Care: Nurse Case Management and Self-management Support) on psychological distress and patient activation among patients with chronic disease and complex care needs.

  • The intervention consisted of evaluation of patient needs and resources; an individualized service plan; care coordination among the health care and community partners; and self-management support for patients and their families.
  • According to the quantitative results, compared with usual care, the intervention reduced psychological distress, but did not have any significant effect on patient activation.
  • Subsequent in-depth interviews suggested that patients and their spouses gained a sense of security, and stakeholders noted better patient self-management of health.
  • Together, the study’s quantitative and qualitative results suggest that case management reduces psychological distress, making patients and caregivers feel more secure, whereas impact on self-management is unclear.
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Population Addressed
Adults Under 65 with Disabilities
People with Advanced Illness
Frail Older Adults
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Key Questions Answered
  • Can a case management intervention reduce psychological distress and increase patient activation among individuals with complex needs?
  • What are the components of the intervention?
Level of Evidence
What does this mean?