Effectiveness of interventions for managing multiple high-burden chronic diseases in older adults: a systematic review and meta-analysis

Kastner, Monika; Cardoso, Roberta; Lai, Yonda; Treister, Victoria; Hamid, Jemila S.; Hayden, Leigh; Wong, Geoff; Ivers, Noah; Liu, Barbara; Marr, Sharon; Holroyd‐Leduc, Jayna; Straus, Sharon E.

doi:10.1503/cmaj.171391

Cited by 113 publications

(107 citation statements)

References 65 publications

(87 reference statements)

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“…46 Although findings are mixed, Health TAPESTRY is aligned with accepted guidance for personal care planning, 47,48 providing patient-centred or goal-directed care for older adults who are managing multiple chronic conditions 49 and Starfield principles of primary care, [50][51][52] and, for people with chronic diseases, care-coordination strategies that improve health and outcomes. 53 The intervention is well aligned with redesigns of the health care system underway in Canada and elsewhere 21,[54][55][56][57] and incorporates key elements recommended by the World Health Organization for integrated health care for older people. 24 Volunteers showed great enthusiasm for and a sense of purpose regarding their role.…”

Section: Discussionmentioning

confidence: 99%

Combining volunteers and primary care teamwork to support health goals and needs of older adults: a pragmatic randomized controlled trial

Dolovich

Oliver

Lamarche

et al. 2019

CMAJ

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Section: Discussionmentioning

confidence: 99%

Combining volunteers and primary care teamwork to support health goals and needs of older adults: a pragmatic randomized controlled trial

Dolovich

Oliver

Lamarche

et al. 2019

CMAJ

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“…Nursing administrators can conduct special geriatric survey conduct various programmes related to the welfare of the old age people and develop necessary educational material [14]. Similar study may be replicated on large sample and comparative study may be conducted between urban and rural community [15,16].…”

Section: Association Of Knowledge Scores Of Elderly Population With Smentioning

confidence: 99%

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2024

IJBP

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Introduction:Aging is a universal process. In the words of Seneca -"old age is an incurable disease". Sir James Sterling Ross Commented "you do not heal old age, you protect it, you promote it and you extend it". The number of old age people indwelling in the world is increasing rapidly. Some of them tackle the situation in a more pleasant way. But the majority of the geriatric clients are seeing it in negative manner. Here comes the importance of the self-care activities.According to the Oxford English Dictionary, old age is the time of life when you are old, above the age group of 60 years.Objective: The Objectives of the study were to assess the knowledge of self-care capabilities among geriatric population in Handignur village in Belagavi district of Karnataka state in India, to find out the practices of self-care capabilities among geriatric population in Handignur village and to find an association between knowledge and practices regarding self-care capabilities among geriatric population in Handignur village.Methodology: Descriptive survey design was used for the study. A total of 252 study subjects above 60 years were selected for the study by using purposive sampling technique. The setting selected for the present study was Handignur village in Belagavi district, Karnataka state, India. Data collection was done using items assessing knowledge regarding self-care capabilities and check list; related to items assessing practice. Results:Out of 252 subjects surveyed, 105(41%) were having good knowledge, 90(35.7%) were having average knowledge and only 57(22.6%) were having poor knowledge regarding self-care capability. Among practices, majority gave their feedback in terms of not following the practices mentioned in the checklist. There was a strong association between knowledge and variables like age, occupation, monthly income, gender, type of family, diet, education, habits, health conditions, but religion did not show any statistically significant association regarding self care capability. Conclusion:The study aids as a milestone to provide optimal care for the growing number of elderly people. It also reflects the attitude practiced in the past and modified in the future by the nurses. The study also enhances the impact of the age, gender, occupation, socio-economic status, health condition and activity for the daily living in the health care system of geriatric population.

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“…18 A recent systematic review and metaanalysis concluded that multidisciplinary care coordination interventions for patients with MCCs appear to have the potential for improving primary and secondary outcomes, including care utilization. 19 The effects of such care programs are different for each type of model and disease. Further evidence is needed to establish if multidisciplinary care interventions affect health-care utilization patterns in patients with specific disease combinations.…”

Section: Introductionmentioning

confidence: 99%

<p>Extreme Consumers of Health Care: Patterns of Care Utilization in Patients with Multiple Chronic Conditions Admitted to a Novel Integrated Clinic</p>

Rafiq¹,

Keel²,

Mazzocato³

et al. 2019

JMDH

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Purpose: Patients with multiple chronic conditions (MCC) of diabetes, cardiovascular and kidney diseases; hereafter referred to as HND (heart/cardiac-, nephrology-, diabetes mellitus-) patients, are high utilizers of health care. However, the care received is often insufficiently coordinated between different specialties and health-care providers. This study aims to describe the characteristics of HND patients and to explore the initial effects of a multidisciplinary and person-centered care on total care utilization. Patients and Methods: We conducted a sub-study of HND patients recruited in an ongoing randomized trial CareHND (NCT03362983). Descriptive statistics of patient characteristics, including diagnostic data and Charlson Comorbidity Index scores, informed a comparison of care utilization patterns between HND patient care and traditional care. Diagnostic and care utilization data were collected from a regional database. Wilcoxon signed ranked sum tests were performed to compare care utilization frequencies between the two groups. Results: Patients included in the study were care-intensive with several diagnoses and experienced a high level of variation in care utilization and diagnoses profiles. HND patients were sicker than their counterparts in the control group. Utilization indicators were similar between the two arms. There was some indication that the HND center is beginning to perform as expected, but no results were statistically significant. Conclusion: This study sits among many studies reporting difficulties obtaining statistically significant findings for MCC patients. However, previous research has shown that the key components of this intervention, such as integrated, multidisciplinary, inter-professional collaboration within patient-centered care have had a positive effect on health-care outcomes. More innovative methods beyond the RCT, such as machine learning should be explored to evaluate the impact of integrated care interventions on care utilization.

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Effectiveness of interventions for managing multiple high-burden chronic diseases in older adults: a systematic review and meta-analysis

Abstract: PROSPERO-CRD42014014489.

Cited by 113 publications

References 65 publications

Combining volunteers and primary care teamwork to support health goals and needs of older adults: a pragmatic randomized controlled trial

Combining volunteers and primary care teamwork to support health goals and needs of older adults: a pragmatic randomized controlled trial

Untitled

<p>Extreme Consumers of Health Care: Patterns of Care Utilization in Patients with Multiple Chronic Conditions Admitted to a Novel Integrated Clinic</p>

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