Is degree of chronic illness management in heart transplant centers associated with better patient survival? Findings from the intercontinental BRIGHT study

Purpose To explore the association between the degree of Chronic illness management and survival rates at 1-, 3-, 5-years post heart transplantation. Methods Exploratory secondary analysis of a cross-sectional, international study (Building Research Initiative Group study). Latent profile analysis was performed to classify 36 heart transplant centers according to the degree of chronic illness management. Results The analysis resulted in 2 classes with 29 centers classified as “low-degree chronic illness management” and 7 centers as “high-degree chronic illness management”. After 1-year posttransplantation, the high-degree chronic illness management class had a significantly greater mean survival rate compared to the low-degree chronic illness management class (88.4% vs 84.2%, p = 0.045) and the difference had a medium effect size (η2 = .06). No difference in survival for the other time points was observed. Patients in high-degree chronic illness management centers had 52% lower odds of moderate to severe drinking (95% confidence interval .30–.78, p = 0.003). No significant associations between degree of chronic illness management and the other recommended health behaviors were observed. Conclusions The findings from this exploratory study offer preliminary insight into a system-level pathway (chronic illness management) for improving outcomes for heart transplant recipients. The signals observed in our data support further investigation into the effectiveness of chronic illness management-based interventions in heart transplant follow-up care.

Chronic Illness Management: Indian Workplace Perspective

The present study aims to understand the perspectives of the employer representatives in Indian organizations about the management of chronic illnesses and the resultant disability. Legislative framework and Government of India initiatives were also visited upon to understand the environment prevailing for the Indian organizations in the context of employment of people with chronic illnesses. Qualitative research methodology of thematic analysis was preferred to capture various concerns and challenges faced by employer representatives in employing and maintaining employment of individuals with chronic illness and resultant disability. A total of 20 employer representatives were contacted, out of which 12 agreed to participate. The findings suggest that though visible disability has begun to be acknowledged and embraced in Indian organizations, the invisible and episodic disability caused by various chronic illnesses is still struggling to gather enough accommodation as a distinct diversity group in Indian organizations.

Informal care of older adults with chronic life-limiting illness in Africa: An integrative review

Informal care is recognised as a significant resource in the care of older adults living with a chronic life-limiting illness. This review aims to assess the existing literature on how informal care can support older people living with chronic life-limiting illness in Africa. An integrative review framework was used. Three themes emerged to focus on chronic illness management as a social and clinical matter; cultural obligations contingent on the availability of people and resources; and burden of care relieved by connection with the church. Social policies should be structured to support caregivers and older adults to strengthen the ties between community social organisations and their families.