Adapting the Bipolar Care Model for Chronic Care Management in Community-based Health Care Sites

Diabesity could be defined as a new global epidemic of obesity and being overweight with many complications and chronic conditions. The financial direct and indirect burden of diabesity is a real challenge in many Western health-care systems. Even if multidisciplinary protocols have been implemented, significant limitations in the chronic care management of obesity with type 2 diabetes concern costs and long-term adherence and efficacy. mHealth approach could overcome limitations linked with the traditional, restricted and highly expensive in-patient treatment of diabesity. The mHealth approach could help clinicians by motivating patients in remote settings to develop healthier lifestyles and could be implemented in the Chronic Care Model. A practical stepped-care model for diabesity, including mhealth approach and psychological treatments with different intensity, is discussed.

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A Stepped Care mHealth-Based Approach for Promoting Patient Engagement in Chronic Care Management of Obesity with Type 2 Diabetes

Transformative Healthcare Practice through Patient Engagement - Advances in Medical Diagnosis, Treatment, and Care ◽

10.4018/978-1-5225-0663-8.ch008 ◽

2017 ◽

pp. 192-214

Author(s):

Gianluca Castelnuovo ◽

Giada Pietrabissa ◽

Gian Mauro Manzoni ◽

Stefania Corti ◽

Margherita Novelli ◽

...

Keyword(s):

Type 2 Diabetes ◽

Care Management ◽

Chronic Care ◽

Stepped Care ◽

Patient Treatment ◽

Care Model ◽

Global Epidemic ◽

Chronic Care Management ◽

Care Systems

Diabesity could be defined as a new global epidemic of obesity and being overweight with many complications and chronic conditions. The financial direct and indirect burden of diabesity is a real challenge in many Western health-care systems. Even if multidisciplinary protocols have been implemented, significant limitations in the chronic care management of obesity with type 2 diabetes concern costs and long-term adherence and efficacy. mHealth approach could overcome limitations linked with the traditional, restricted and highly expensive in-patient treatment of diabesity. The mHealth approach could help clinicians by motivating patients in remote settings to develop healthier lifestyles and could be implemented in the Chronic Care Model. A practical stepped-care model for diabesity, including mhealth approach and psychological treatments with different intensity, is discussed.

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Facilitators and Barriers of a Chronic Care Management Intervention Addressing Diabetes Among Mexican-Origin Adults

Health Education & Behavior ◽

10.1177/10901981211014431 ◽

2021 ◽

pp. 109019812110144

Author(s):

Valerie L. Polletta ◽

Alana M. W. LeBrón ◽

Maribel R. Sifuentes ◽

Lisa A. Mitchell-Bennett ◽

Ciara Ayala ◽

...

Keyword(s):

Care Management ◽

Chronic Care ◽

Mexican Origin ◽

Community Based ◽

Building Relationships ◽

Program Staff ◽

Clinic Staff ◽

Chronic Care Management ◽

Facilitators And Barriers ◽

Communication And Coordination

Background Chronic care management (CCM) and community health worker (CHW) interventions hold promise for managing complex chronic conditions such as diabetes and related comorbidities. This qualitative study examines facilitators and barriers to the implementation of an expanded CCM intervention that explicitly incorporated program staff, clinic staff, CHWs, and partnerships with community-based organizations to enhance diabetes management among Mexican-origin adults. Method Grounded theory was used to analyze interviews conducted in 2018 with 24 members of the CCM team, including program staff, clinic staff, and community-based program partner staff. Results Three themes emerged that characterize perceived facilitators and barriers to CCM implementation, based on analysis of interviews: (1) understanding roles and responsibilities across organizations, (2) building relationships across organizations, and (3) coordinating delivery of the model among different organizations. First, structured meetings and colocated workspaces enhanced understanding of CCM roles for each team member and across organizations. Barriers to understanding CCM roles were more common during the early stages of CCM implementation and amongst staff who did not participate in regular meetings. Second, regular meetings facilitated development of relationships across organizations to enhance implementation of the CCM model. In contrast, limited relationship building among some CCM team members served as a barrier to implementation. Third, CHWs and case review meetings fostered communication and coordination across the CCM model. Conclusions Results suggest the importance of understanding roles and building relationships among multidisciplinary teams to ensure effective communication and coordination of care.

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How People with Parkinson's Disease and Health Care Professionals Wish to Partner in Care Using eHealth: Co-Design Study

Journal of Medical Internet Research ◽

10.2196/19195 ◽

2020 ◽

Vol 22 (9) ◽

pp. e19195

Author(s):

Carolina Wannheden ◽

Åsa Revenäs

Keyword(s):

Parkinson’S Disease ◽

Health Care ◽

Parkinson's Disease ◽

Health Care Professionals ◽

Care Management ◽

Chronic Care ◽

Self Care ◽

Chronic Care Management ◽

Organizational Constraints ◽

Ehealth Service

Background Worldwide, the number of people with Parkinson’s disease (PD) is predicted to double between the years 2005 and 2030. Chronic care management requires active collaboration and knowledge exchange between patients and health care professionals (HCPs) for best possible health outcomes, which we describe as co-care. eHealth services have the potential to support the realization of co-care between people with PD (PwP) and HCPs. Objective This study aimed to explore how co-care could be operationalized in PD care, supported by eHealth. More specifically, this study explores PwP's and HCPs' expectations and desired eHealth functionalities to achieve co-care. Methods Principles of participatory design were used to enable the identification of co-care needs and design ideas, in a series of 4 half-day co-design workshops. The sample included 7 (4 women) PwP and 9 (4 women) HCPs, including 4 neurologists, 3 nurses, and 2 physiotherapists. The co-design process resulted in a functional prototype that was evaluated by the co-design participants in the last workshop. Data were collected through note cards produced by the participants during the first 3 workshops and focus group discussions during the 3rd and 4th workshops. The data were analyzed using qualitative thematic analysis. After the workshop series, the prototype was demonstrated at a Mini Fair for ongoing PD research and evaluated using a self-developed questionnaire with 37 respondents: 31 PwP (14 women) and 6 informal caregivers (3 women). Descriptive statistics are reported. Results The qualitative analysis of data resulted in 2 main themes. The first theme, core eHealth functionalities and their expected values, describes 6 desired eHealth functionalities for supporting PD co-care between PwP and HCPs: (1) self-tracking, (2) previsit forms, (3) graphical visualization, (4) clinical decision support, (5) self-care recommendations, and (6) asynchronous communication. The second theme, individual and organizational constraints, describes constraints that need to be addressed to succeed with an eHealth service for co-care. Individual constraints include eHealth literacy and acceptance; organizational constraints include teamwork and administrative workload. The majority of the questionnaire respondents (31/37, 84%) perceived that they would benefit from an eHealth service similar to the demonstrated prototype. All prototype functionalities were rated as very important or important by the majority of respondents (ranging from 86% to 97% per functionality). Conclusions This study adds to our knowledge on how PD co-care could be operationalized. Co-care implies a shift from episodic routine-driven care to more flexible care management that is driven by the mutual needs of patients and HCPs and supported by active information exchange between them, as well as automated information processing to generate patient-specific advice. More research is needed to further explore the concept of co-care in chronic care management and what it means for self-care and health care. International Registered Report Identifier (IRRID) RR2-10.2196/11278

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How People with Parkinson's Disease and Health Care Professionals Wish to Partner in Care Using eHealth: Co-Design Study (Preprint)

10.2196/preprints.19195 ◽

2020 ◽

Author(s):

Carolina Wannheden ◽

Åsa Revenäs

Keyword(s):

Parkinson’S Disease ◽

Health Care ◽

Parkinson's Disease ◽

Health Care Professionals ◽

Care Management ◽

Chronic Care ◽

Self Care ◽

Chronic Care Management ◽

Organizational Constraints ◽

Ehealth Service

BACKGROUND Worldwide, the number of people with Parkinson’s disease (PD) is predicted to double between the years 2005 and 2030. Chronic care management requires active collaboration and knowledge exchange between patients and health care professionals (HCPs) for best possible health outcomes, which we describe as co-care. eHealth services have the potential to support the realization of co-care between people with PD (PwP) and HCPs. OBJECTIVE This study aimed to explore how co-care could be operationalized in PD care, supported by eHealth. More specifically, this study explores PwP's and HCPs' expectations and desired eHealth functionalities to achieve co-care. METHODS Principles of participatory design were used to enable the identification of co-care needs and design ideas, in a series of 4 half-day co-design workshops. The sample included 7 (4 women) PwP and 9 (4 women) HCPs, including 4 neurologists, 3 nurses, and 2 physiotherapists. The co-design process resulted in a functional prototype that was evaluated by the co-design participants in the last workshop. Data were collected through note cards produced by the participants during the first 3 workshops and focus group discussions during the 3rd and 4th workshops. The data were analyzed using qualitative thematic analysis. After the workshop series, the prototype was demonstrated at a Mini Fair for ongoing PD research and evaluated using a self-developed questionnaire with 37 respondents: 31 PwP (14 women) and 6 informal caregivers (3 women). Descriptive statistics are reported. RESULTS The qualitative analysis of data resulted in 2 main themes. The first theme, core eHealth functionalities and their expected values, describes 6 desired eHealth functionalities for supporting PD co-care between PwP and HCPs: (1) self-tracking, (2) previsit forms, (3) graphical visualization, (4) clinical decision support, (5) self-care recommendations, and (6) asynchronous communication. The second theme, individual and organizational constraints, describes constraints that need to be addressed to succeed with an eHealth service for co-care. Individual constraints include eHealth literacy and acceptance; organizational constraints include teamwork and administrative workload. The majority of the questionnaire respondents (31/37, 84%) perceived that they would benefit from an eHealth service similar to the demonstrated prototype. All prototype functionalities were rated as very important or important by the majority of respondents (ranging from 86% to 97% per functionality). CONCLUSIONS This study adds to our knowledge on how PD co-care could be operationalized. Co-care implies a shift from episodic routine-driven care to more flexible care management that is driven by the mutual needs of patients and HCPs and supported by active information exchange between them, as well as automated information processing to generate patient-specific advice. More research is needed to further explore the concept of co-care in chronic care management and what it means for self-care and health care. INTERNATIONAL REGISTERED REPORT RR2-10.2196/11278

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