scholarly journals The pros and cons of the implementation of a chronic care model in European rural primary care: the points of view of European rural general practitioners

2021 ◽  
Author(s):  
Kurpas ◽  
Petrazzuoli ◽  
Szwamel ◽  
Randall-Smith ◽  
Blahova ◽  
...  
2016 ◽  
Vol 16 (6) ◽  
pp. 78 ◽  
Author(s):  
Geert Goderis ◽  
Gunther D'hanis ◽  
Gert Merckx ◽  
Wim Verhoevven ◽  
Pierre Sijbers ◽  
...  

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Shantanu Nundy ◽  
Jonathan J. Dick ◽  
Anna P. Goddu ◽  
Patrick Hogan ◽  
Chen-Yuan E. Lu ◽  
...  

Background. Self-management support and team-based care are essential elements of the Chronic Care Model but are often limited by staff availability and reimbursement. Mobile phones are a promising platform for improving chronic care but there are few examples of successful health system implementation.Program Development. An iterative process of program design was built upon a pilot study and engaged multiple institutional stakeholders. Patients identified having a “human face” to the pilot program as essential. Stakeholders recognized the need to integrate the program with primary and specialty care but voiced concerns about competing demands on clinician time.Program Description. Nurse administrators at a university-affiliated health plan use automated text messaging to provide personalized self-management support for member patients with diabetes and facilitate care coordination with the primary care team. For example, when a patient texts a request to meet with a dietitian, a nurse-administrator coordinates with the primary care team to provide a referral.Conclusion. Our innovative program enables the existing health system to support ade novocare management program by leveraging mobile technology. The program supports self-management and team-based care in a way that we believe engages patients yet meets the limited availability of providers and needs of health plan administrators.


2010 ◽  
Vol 23 (3) ◽  
pp. 295-305 ◽  
Author(s):  
P. A. O. Strickland ◽  
S. V. Hudson ◽  
A. Piasecki ◽  
K. Hahn ◽  
D. Cohen ◽  
...  

2005 ◽  
Vol 31 (2) ◽  
pp. 225-234 ◽  
Author(s):  
Linda M. Siminerio ◽  
Gretchen Piatt ◽  
Janice C. Zgibor

Purpose The purpose of this pilot study was to determine the impact of implementing elements of the chronic care model (CCM; decision support, self-management, and delivery system redesign) on providers' diabetes care practices and patient outcomes in a rural practice setting. Methods In this pilot study, 104 patients with type 2 diabetes and 6 providers in a rural primary care practice were involved in an intervention that included a certified diabetes educator (CDE) who educated and supported providers on diabetes management and adherence to the American Diabetes Association (ADA) Standards of Care over the year of the project. The CDE also provided diabetes self-management education (DSME) at the office site for 29 of the 104 patients who received their care in the practice. The following variables were evaluated: provider perceived barriers to care and adherence to ADA standards of care and patient A1C, blood pressure, cholesterol, knowledge, and empowerment levels. Results Provider adherence to ADA Standards of Care increased significantly across all process measures. Patients who received DSME at point of service in the primary care practice setting gained improvements in knowledge, empowerment, A1C, and high-density lipoprotein cholesterol levels. Conclusions Implementing systems to support decision support, selfmanagement education, and delivery system redesign has a positive influence on practices and patient outcomes in outlying rural communities.


2018 ◽  
Vol 258 ◽  
pp. 279-288 ◽  
Author(s):  
E.K. Yeoh ◽  
Martin C.S. Wong ◽  
Eliza L.Y. Wong ◽  
Carrie Yam ◽  
C.M. Poon ◽  
...  

2016 ◽  
pp. 89-96 ◽  
Author(s):  
Thomas Bodenheimer ◽  
Rachel Willard-Grace

2011 ◽  
Vol 4 (4) ◽  
pp. 87-98 ◽  
Author(s):  
Andrea C Ely ◽  
Christie A Befort ◽  
Angela Banitt Duncan ◽  
Jianghua He ◽  
Cheryl Gibson ◽  
...  

Background. Obesity is a chronic disease of epidemic proportions. Primary care providers are on the front line of diagnosing and treating obesity and need better tools to deliver top-notch obesity care. Methods. A pilot randomized trial was conducted to test a chronic care model (CCM) program for obesity compared to usual care. Primary care patients, 18 years and older, with a body mass index (BMI) between 27 and 45 were enrolled. Sixteen weekly 90-minute group office visits were structured with the first 30 minutes encompassing individualized clinical assessments and the final 60 minutes containing the group-based standardized intensive lifestyle training. The primary outcome was weight change at 16 weeks. Secondary outcomes were weight change at 24 weeks, change in diet and physical activity behaviors, self-efficacy for weight control behaviors, and physiologic markers of cardiovascular risk at 16 and 24 weeks. Results. The participants (19 in the active arm and 10 in the control arm) were 49.8 ± 11.5 years old (mean ± SD), 97% women, 55% white, and 41% black. Weight change in the control arm at week 16 was 0.25+ 2.21 kg (mean + SD) and that for the active arm was -5.74 + 4.50 kg (n=16). The difference between the two arms was significant (p = 0.0002). Both the intent-to-treat analysis using the last observation carried forward approach and the analysis including completers only provided similar siginificant results. Conclusions. This study demonstrated that a CCM program incorporating group office visits was feasible and effective for obesity treatment in primary care settings.


2019 ◽  
Vol 33 (1) ◽  
pp. 13-23
Author(s):  
Sara Barsanti ◽  
Francesca Guarneri

The aim of this paper is to provide an overview of general practitioners’ perspectives across key criteria for effective chronic disease management. The study setting is the Tuscany Region in Italy that implemented the Chronic Care Model in 2010 with multidisciplinary team to assist chronic patients. We used the results of a web-based survey of general practitioners (N = 1136) conducted in 2015 to compare the experiences and satisfaction of general practitioners involved (group 1) and not involved (group 2) in the Chronic Care Model. The analysis included all general practitioners, and compared the two groups’ perspectives of the different core aspects of Chronic Care Model through conducting an ANOVA analysis and Bonferroni test. General practitioners involved in the Chronic Care Model are found to be more favourably disposed toward measurement and benchmarking, and more satisfied in terms of decision support system. Conversely, no significant differences were found in terms of collaboration with specialists, which remains weak and in terms of community collaboration and involvement. This study provides a detailed investigation of the implementation of Disease Management Programs, by considering the professional point of view.


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