Why Hypotheses Informed by Observation Are Often Wrong: Results of Randomized Controlled Trials Challenge Chronic Disease Management Strategies Based on Epidemiological Evidence

2011 ◽  
Vol 17 (3) ◽  
pp. 224-231 ◽  
Author(s):  
Kathleen A. Fairman
2020 ◽  
Vol 41 (spe) ◽  
Author(s):  
Viviane Maria Osmarin ◽  
Fernanda Guarilha Boni ◽  
Taline Bavaresco ◽  
Amália de Fátima Lucena ◽  
Isabel Cristina Echer

Abstract Objective: To evaluate the knowledge of patients with venous ulcers (VU) on their chronic disease, treatment, and prevention of complications, according to the Nursing Outcomes Classification-NOC. Methods: This is a cross-sectional study conducted between 2017 and 2018 in a Brazilian hospital. The sample consisted of 38 patients with VU attended in outpatient nursing consultations. The study analyzed sociodemographic, clinical and nine indexes from the Knowledge: Chronic Disease Management (1847) of the NOC, assessed using a five-point Likert scale, analyzed using descriptive statistics. Results: The mean of the result Knowledge: Chronic Disease Management (1847) was 3.56±1.42. The clinical index Procedures involved in treatment regimen had the highest mean 4.18±0.21, followed by Pain management strategies with 3.92±0.27. In the association between knowledge and healing, the best scores were in patients with at least one healed VU. Conclusion: The knowledge of the patients was moderate and it was necessary to promote educational actions according to individual demands.


2018 ◽  
Vol 33 (9) ◽  
pp. 1634-1640 ◽  
Author(s):  
Alan J Wigg ◽  
Jong K Chin ◽  
Kate R Muller ◽  
Jeyamani Ramachandran ◽  
Richard J Woodman ◽  
...  

Author(s):  
Anne-Marie Nicol ◽  
Corlann Gee Bush ◽  
Ellen Balka

Abstract:Background and Objectives: The advent of the Internet has made in-home monitoring a possibility for patients suffering from chronic disease, although few studies have examined this phenomena across different disease states. The goal of this review is to identify and evaluate studies where randomized control trials were used to evaluate Internet-mediated home monitoring systems designed to manage and support patients with chronic diseases.Methods and Results: We reviewed 454 abstracts of articles describing computerbased health interventions and read forty-three articles in depth. Seventeen articles met inclusion criteria and were selected for this review. Only completed randomized, controlled trials that reported physiological health outcomes of the intervention were included. Other results reviewed included the populations studied, the short and long term effectiveness of the interventions, costs and technology-related issues and health care provider communication. Internet-mediated home monitoring interventions appear to have some benefit for specific chronic diseases in specific circumstances. Few studies documented cost savings; none of those that did used consistent measures. Studies seldom addressed the challenges of introducing sophisticated interactive-monitoring systems into patients’ homes, the reasons for attrition from trials, or the effects of the intervention on the work of care providers or interprofessional practices.Conclusions: The interventions reviewed showed potential to enhance chronic disease management in some cases. However, the short duration of the studies made it difficult to generalize the results to wider home care settings or predict the effectiveness of such systems over the long and complicated courses of chronic diseases. Thus, despite hopes for significant cost and labour savings, Internet-mediated systems for monitoring chronic diseases in patients’ homes will likely complement rather than replace usual care.


2021 ◽  
pp. 089011712110125
Author(s):  
Jacob B. Mirsky ◽  
Anne N. Thorndike

As health care systems respond to the COVID-19 pandemic, new virtual care approaches are emerging for health promotion and chronic disease management. Virtual group visits (VGVs) supporting a healthy lifestyle, adapted from the well-established shared medical appointment (SMA) model, hold promise as a primary care delivery tool for preventing and managing chronic disease. In order to establish VGVs as standard of care, evidence for clinical effectiveness, financial sustainability, and access for vulnerable populations is needed. In the future, VGVs could improve the quality and reach of chronic disease prevention and management strategies.


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