Tele-Nursing in Chronic Disease Care: A Systematic Review

Abstract Background Although pay-for-performance (P4P) among primary care physicians for enhanced chronic disease management is increasingly common, the evidence base is fragmented in terms of socially equitable impacts in achieving the quadruple aim for healthcare improvement: better population health, reduced healthcare costs, and enhanced patient and provider experiences. This study aimed to assess the literature from a systematic review on how P4P for diabetes services impacts on gender equity in patient outcomes and the physician workforce. Methods A gender-based analysis was performed of studies retrieved through a systematic search of 10 abstract and citation databases plus grey literature sources for P4P impact assessments in multiple languages over the period January 2000 to April 2018, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study was restricted to single-payer national health systems to minimize the risk of physicians sorting out of health organizations with a strong performance pay component. Two reviewers scored and synthesized the integration of sex and gender in assessing patient- and provider-oriented outcomes as well as the quality of the evidence. Findings Of the 2218 identified records, 39 studies covering eight P4P interventions in seven countries were included for analysis. Most (79%) of the studies reported having considered sex/gender in the design, but only 28% presented sex-disaggregated patient data in the results of the P4P assessment models, and none (0%) assessed the interaction of patients’ sex with the policy intervention. Few (15%) of the studies controlled for the provider’s sex, and none (0%) discussed impacts of P4P on the work life of providers from a gender perspective (e.g., pay equity). Conclusions There is a dearth of evidence on gender-based outcomes of publicly funded incentivizing physician payment schemes for chronic disease care. As the popularity of P4P to achieve health system goals continues to grow, so does the risk of unintended consequences. There is a critical need for research integrating gender concerns to help inform performance-based health workforce financing policy options in the era of the Sustainable Development Goals.

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Positive influence of short message service and voice call interventions on adherence and health outcomes in case of chronic disease care: a systematic review

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-016-0286-3 ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 24

Author(s):

F. Yasmin ◽

B. Banu ◽

S. M. Zakir ◽

R. Sauerborn ◽

L. Ali ◽

...

Keyword(s):

Systematic Review ◽

Chronic Disease ◽

Health Outcomes ◽

Short Message Service ◽

Positive Influence ◽

Short Message ◽

Voice Call ◽

Chronic Disease Care ◽

Message Service

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Integrated chronic disease care delivery at a primary care level in sub-Saharan Africa: A systematic review, best fit framework synthesis, and new conceptual model

10.1101/2021.11.30.21267057 ◽

2021 ◽

Author(s):

Simon R Harrison ◽

Aileen M Jordan

Keyword(s):

Systematic Review ◽

Primary Care ◽

Chronic Disease ◽

Conceptual Model ◽

Conceptual Models ◽

A Priori ◽

Sub Saharan Africa ◽

Chronic Disease Care ◽

African Context ◽

Sub Saharan

Background: Existing chronic care conceptual models were not designed for sub-Saharan Africa, where there is a growing burden of chronic disease. This review provides a qualitative synthesis and new conceptual model for primary care approaches to the integration of chronic communicable and non-communicable disease care in a sub-Saharan African context. Methods: A best fit framework synthesis comprising two systematic reviews, with information retrieved from PubMed, Embase, CINAHL plus, Global Health, and Global Index Medicus databases between 1st and 30th April 2020. Articles on chronic care conceptual models were included if they were developed for application in a primary care context and described a framework for long-term management of chronic disease care, and themes extracted to construct an a priori framework. A second systematic review included articles focussing on integrated HIV and diabetes care at a primary care level in sub-Saharan Africa, with thematic analysis carried out against the a priori framework. A new conceptual model was constructed from a priori themes and new themes. Risk of bias of included studies was assessed using CASP and MMAT. Results: Two conceptual models of chronic disease care, comprising 6 themes, were used to build the a priori framework. The systematic review of primary research identified 12 articles, with all 6 of the a priori framework themes, and 5 new themes identified. A new patient-centred conceptual model for integrated HIV and diabetes care was constructed, specific to a sub-Saharan African context. Discussion: Improving patient access to chronic disease care through implementing decentralised, integrated, affordable and efficient primary care services should be prioritised in sub-Saharan Africa. Services must be acceptable to patients, viewing them as partners, addressing their concerns, and seeking to safeguard confidentiality. Limitations of this study include potential publication bias, and impact of policy environment and economic factors in sub-Saharan Africa.

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