General practice and social service partnership for better clinical outcomes, patient self efficacy and lifestyle behaviours of diabetic care: randomised control trial of a chronic care model

Lee, Albert; Siu, Choi-Fong; Leung, Kam-Tao; Lau, L.; Chan, Cathy C M; Wong, Kin Yau

doi:10.1136/pgmj.2011.118885

Cited by 31 publications

(41 citation statements)

References 33 publications

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“…This has been previously shown in other populations, including patients with other chronic diseases, as well [11,18,43]. Two recently published randomized controlled trials by Shi et al in China, and Lee et al in Hong Kong, testing interventions to improve self-efficacy for diabetes have also reported improvement in glycemic control with increased self-efficacy [22,38].…”

Section: Discussionmentioning

confidence: 64%

“…The calculated BMI was categorised based on the WHO expert consultation recommendations, into below normal (\18), normal (18)(19)(20)(21)(22).99), high normal (23-24.99), overweight (25-29.99) and obese (30 and above) [2].…”

Section: Body Mass Index (Bmi)mentioning

confidence: 99%

“…Studies from other countries have identified several provider and patient-related factors which can influence outcome measures in people with diabetes [4,12,21,23,29]. In particular, several studies have identified self-efficacy, the belief in one's capabilities in a given situation or challenge, as an important factor in successful management of many chronic diseases, including diabetes [3,14,22,38,43]. It has also been demonstrated that improving patients' knowledge and skills results in better self-management and control of disease through effects on self-efficacy [1,19,31].…”

Section: Introductionmentioning

confidence: 97%

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Diabetes Self-Efficacy Strongly Influences Actual Control of Diabetes in Patients Attending a Tertiary Hospital in India

et al. 2011

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A cross-sectional survey of 507 in- and out-patients, with diagnosed Type 2 diabetes mellitus (T2DM) was undertaken to study the relationships between personal, disease and treatment-related factors and diabetes control in a tertiary care hospital. On multivariate logistic regression analysis, self-efficacy (odds ratio (OR) =2.94; 95% confidence interval (CI) =1.92-4.54); P<0.001) was the single most important determinant of current diabetes control (HbA1c ≤7%), along with absence of hyperglycemic symptoms in the past year (OR=1.83; 95% CI=1.15-2.93, P<0.01), current treatment with oral medication (OR=1.77; 95% CI=1.17-2.66; P<0.007), and adherence to dietary restrictions (OR=2.7; 95% CI=1.28-5.88; P<0.009). Self-efficacy was itself influenced by educational status, employment, availability of family support, and positive mental attitudes. Our findings suggest that health care delivery inputs, patients' personal characteristics including education and attitude, and family support for care are complexly processed to determine patients' ability to manage their disease, which ultimately influences disease outcomes.

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Section: Discussionmentioning

confidence: 64%

Section: Body Mass Index (Bmi)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

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Diabetes Self-Efficacy Strongly Influences Actual Control of Diabetes in Patients Attending a Tertiary Hospital in India

et al. 2011

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“…Characteristic of the included studies are presented in Table 1 . Only one study reported blinding of both patients and data collectors [ 13 ] and one other study [ 14 ] reported blinding of patients only.…”

Section: Reviewmentioning

confidence: 99%

The chronic care model for type 2 diabetes: a systematic review

Baptista

Wiens

Pontarolo

et al. 2016

Diabetol Metab Syndr

105

102

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The chronic care model (CCM) uses a systematic approach to restructure health care systems. The aim of this systematic review was to examine studies that evaluated different elements of the CCM in patients with type 2 diabetes mellitus (T2DM) and to assess the influence of the CCM on different clinical outcomes. There view was performed in the Medline and Cochrane Library electronic databases. The search was limited to randomized controlled trials conducted with T2DM patients. Studies were eligible for inclusion if they compared usual care with interventions that use done or more elements of the CCM and assessed the impact on clinical outcomes. After applying the eligibility criteria, 12 studies were included for data extraction. Of these, six showed evidence of effectiveness of the CCM for T2DM management in primary care as well as significant improvements in clinical outcomes. In the other six studies, no improvements regarding clinical outcomes were observed when comparing the intervention and control groups. Some limitations, such as a short follow-up period and a low number of patients, were observed. Some studies showed that the reorganization of health systems can improveT2DM care. However, it is possible that greater benefits could be obtained through combing all 6 elements of CCM.

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“…Self-management support is a broad concept stretching well beyond the medical domain, to a range of community resources (Fig 1, Supplementary data file Table S1); and broader partnerships providing input may for example improve care in diabetes [46]. Such multi-faceted data sources may lend themselves well to ontological exploration.…”

Section: Self-management Supportmentioning

confidence: 99%

The Evidence-base for Using Ontologies and Semantic Integration Methodologies to Support Integrated Chronic Disease Management in Primary and Ambulatory Care: Realist Review

et al. 2013

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SummaryBackground: Most chronic diseases are managed in primary and ambulatory care. The chronic care model (CCM) suggests a wide range of community, technological, team and patient factors contribute to effective chronic disease management. Ontologies have the capability to enable formalised linkage of heterogeneous data sources as might be found across the elements of the CCM. Objective: To describe the evidence base for using ontologies and other semantic integration methods to support chronic disease management. Method: We reviewed the evidence-base for the use of ontologies and other semantic integration methods within and across the elements of the CCM. We report them using a realist review describing the context in which the mechanism was applied, and any outcome measures. Results: Most evidence was descriptive with an almost complete absence of empirical research and important gaps in the evidence-base. We found some use of ontologies and semantic integration methods for community support of the medical home and for care in the community. Ubiquitous information technology (IT) and other IT tools were deployed to support self-management support, use of shared registries, health behavioural models and knowledge discovery tools to improve delivery system design. Data quality issues restricted the use of clinical data; however there was an increased use of interoperable data and health system integration. Conclusions: Ontologies and semantic integration methods are emergent with limited evidence-base for their implementation. However, they have the potential to integrate the disparate community wide data sources to provide the information necessary for effective chronic disease management.

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General practice and social service partnership for better clinical outcomes, patient self efficacy and lifestyle behaviours of diabetic care: randomised control trial of a chronic care model

Abstract: Current Controlled Trials ISRCTN78882965.

Cited by 31 publications

References 33 publications

Diabetes Self-Efficacy Strongly Influences Actual Control of Diabetes in Patients Attending a Tertiary Hospital in India

Diabetes Self-Efficacy Strongly Influences Actual Control of Diabetes in Patients Attending a Tertiary Hospital in India

The chronic care model for type 2 diabetes: a systematic review

The Evidence-base for Using Ontologies and Semantic Integration Methodologies to Support Integrated Chronic Disease Management in Primary and Ambulatory Care: Realist Review

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