Four-year long-term follow-up of diabetes patients after implementation of the Chronic Care Model in primary care: a cross-sectional study

Chmiel, Corinne; Giewer, Irina; Frei, Anja; Rosemann, Thomas

doi:10.4414/smw.2017.14522

Cited by 8 publications

(14 citation statements)

References 36 publications

(47 reference statements)

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“…In this nested cross-sectional study, among others one outcome measure was perception of diabetes care. The authors proved significant differences between intervention and control group with a higher overall PACIC score for patients of the intervention group over the course of the study compared to those of the control group [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Shared decision making and patient-centeredness for patients with poorly controlled type 2 diabetes mellitus in primary care—results of the cluster-randomised controlled DEBATE trial

et al. 2021

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Background We investigate whether an educational intervention of GPs increases patient-centeredness and perceived shared decision making in the treatment of patients with poorly controlled type 2 diabetes mellitus? Methods We performed a cluster-randomized controlled trial in German primary care. Patients with type 2 diabetes mellitus defined as HbA1c levels ≥ 8.0% (64 mmol/mol) at the time of recruitment (n = 833) from general practitioners (n = 108) were included. Outcome measures included subjective shared decision making (SDM-Q-9; scale from 0 to 45 (high)) and patient-centeredness (PACIC-D; scale from 1 to 5 (high)) as secondary outcomes. Data collection was performed before intervention (baseline, T0), at 6 months (T1), at 12 months (T2), at 18 months (T3), and at 24 months (T4) after baseline. Results Subjective shared decision making decreased in both groups during the course of the study (intervention group: -3.17 between T0 and T4 (95% CI: -4.66, -1.69; p < 0.0001) control group: -2.80 (95% CI: -4.30, -1.30; p = 0.0003)). There were no significant differences between the two groups (-0.37; 95% CI: -2.20, 1.45; p = 0.6847). The intervention's impact on patient-centeredness was minor. Values increased in both groups, but the increase was not statistically significant, nor was the difference between the groups. Conclusions The intervention did not increase patient perceived subjective shared decision making and patient-centeredness in the intervention group as compared to the control group. Effects in both groups might be partially attributed to the Hawthorne-effect. Future trials should focus on patient-based intervention elements to investigate effects on shared decision making and patient-centeredness. Trial registration The trial was registered on March 10th, 2011 at ISRCTN registry under the reference ISRCTN70713571.

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Section: Discussionmentioning

confidence: 99%

Shared decision making and patient-centeredness for patients with poorly controlled type 2 diabetes mellitus in primary care—results of the cluster-randomised controlled DEBATE trial

et al. 2021

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“…As can be seen in Table S1 in the supplementary material, the sizes of the study groups differ significantly both among participants and among providers. Patient numbers ranged from 194 patients in Chmiel et al [ 18 ] to 8574 in Profili et al [ 13 ]. The number of care providers varied from one health center in Musacchio et al [ 12 ] to 483 providers in Profili et al [ 13 ].…”

Section: Resultsmentioning

confidence: 99%

“…The studies by Petersen et al [ 11 ] and Profili et al [ 13 ] have the collection of patient data beyond ACIC/PACIC in common. The remaining studies by Sunaert et al [ 10 ], Musacchio et al [ 12 ], Frei et al [ 17 ], Chmiel et al [ 18 ], and Samoutis et al [ 19 ] established target values before the study began or were based on specific guidelines. HbA1c as a distinctive parameter was measured in both intervention and control groups in the studies by Sunaert et al [ 10 ], Musacchio et al [ 12 ], Frei et al [ 17 ], Chmiel et al [ 18 ], and Samoutis et al [ 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…The remaining studies by Sunaert et al [ 10 ], Musacchio et al [ 12 ], Frei et al [ 17 ], Chmiel et al [ 18 ], and Samoutis et al [ 19 ] established target values before the study began or were based on specific guidelines. HbA1c as a distinctive parameter was measured in both intervention and control groups in the studies by Sunaert et al [ 10 ], Musacchio et al [ 12 ], Frei et al [ 17 ], Chmiel et al [ 18 ], and Samoutis et al [ 19 ]. In the intervention group, the HbA1c value decreased in all studies except in the studies of Samoutis et al [ 19 ] when the average value remained almost the same (increase in the value for intervention group after a follow-up of 0.01% over time).…”

Section: Resultsmentioning

confidence: 99%

“…In the intervention group, the HbA1c value decreased in all studies except in the studies of Samoutis et al [ 19 ] when the average value remained almost the same (increase in the value for intervention group after a follow-up of 0.01% over time). In the study of Sunaert et al [ 10 ], there was a significant decrease of HbA1c of 0.49% on average, followed by Musacchio et al [ 12 ] with 0.4% in the test group of patients with moderate blood glucose elevation, Chmiel et al [ 18 ] with 0.24%, and Frei et al [ 17 ] with a decrease of 0.2% in the average value. Considering the measured blood BP values, improvement was seen in the study of Frei et al [ 17 ] (intervention: baseline (mmHg) from 140.30 ± 18.40/83.10 ± 10.40 to 136.40 ± 17.50/79.60 ± 9.90 after follow-up).…”

Section: Resultsmentioning

confidence: 99%

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Chronic-Care-Management Programs for Multimorbid Patients with Diabetes in Europe: A Scoping Review with the Aim to Identify the Best Practice

Brettel

Manuwald

Hornstein

et al. 2021

Journal of Diabetes Research

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Aim. This scoping review is aimed at providing a current descriptive overview of care programs based on the chronic care model (CCM) according to E. H. Wagner. The evaluation is carried out within Europe and assesses the methodology and comparability of the studies. Methods. A systematic search in the databases PubMed, Embase, and MEDLINE via OVID was conducted. In the beginning, 2309 articles were found and 48 full texts were examined, 19 of which were incorporated. Included were CCM-based programs from Belgium, Cyprus, Germany, Italy, Switzerland, and the Netherlands. All 19 articles were presented descriptively whereof 11 articles were finally evaluated in a checklist by Rothe et al. (2020). In this paper, the studies were tabulated and evaluated conforming to the same criteria. Results. Due to the complexity of the CCM and the heterogeneity of the studies in terms of setting and implementation, a direct comparison proved difficult. Nevertheless, the review shows that CCM was successfully implemented in various care situations and also can be useful in single practices, which often dominate the primary care sector in many European health systems. The present review was able to provide a comprehensive overview of the current care situation of chronically ill patients with multimorbidities. Conclusions. A unified nomenclature concerning the distinction between disease management programs and CCM-based programs should be aimed for. Similarly, homogeneous quality standards and a Europe-wide evaluation strategy would be necessary to identify best practice models and to provide better care for the steadily growing number of chronically multimorbid patients.

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Improving Management of Non-communicable Chronic Diseases in Primary Healthcare Centres in The Saudi Health Care System

Hazazi

Wilson

2022

Health�Serv�Insights

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Evaluation of patient perceptions of quality and adequacy of care is a critical component of continuous improvement in chronic disease care. The purpose of this study was to ascertain how patients with non-communicable diseases (NCDs) assess their routine care in primary care centres in Saudi Arabia and to identify areas for improvement. This cross-sectional study used the PACIC questionnaire to assess the quality of care received by these patients in primary care centres in Saudi Arabia. Data collection took place between May 2019 and July 2019. The questionnaire was self-completed anonymously by 315 patients with NCD attending primary health care centres in Riyadh, Saudi Arabia. The results showed that the average overall PACIC score was 2.97 (SD = 0.65), the mean scores for the subscales ranged from 2.76 (SD = 0.78) for the subscale of goal settings/tailoring to 3.17 (SD = 0.78) for delivery system design/decision support. PACIC scores varied significantly with age, occupation, monthly income, type and duration of chronic illness and educational attainment. In conclusion, patients with NCDs prioritised improvements in organised care that; is comprehensive, focussed on their needs, helps them identify clear goals for their treatments and become more involved in their condition(s) management.

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Four-year long-term follow-up of diabetes patients after implementation of the Chronic Care Model in primary care: a cross-sectional study

Cited by 8 publications

References 36 publications

Shared decision making and patient-centeredness for patients with poorly controlled type 2 diabetes mellitus in primary care—results of the cluster-randomised controlled DEBATE trial

Shared decision making and patient-centeredness for patients with poorly controlled type 2 diabetes mellitus in primary care—results of the cluster-randomised controlled DEBATE trial

Chronic-Care-Management Programs for Multimorbid Patients with Diabetes in Europe: A Scoping Review with the Aim to Identify the Best Practice

Improving Management of Non-communicable Chronic Diseases in Primary Healthcare Centres in The Saudi Health Care System

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