Sustainability of the integrated chronic disease management model at primary care clinics in South Africa

Mahomed, Ozayr; Asmall, Shaidah; Voce, Anna

doi:10.4102/phcfm.v8i1.1248

Cited by 36 publications

(45 citation statements)

References 11 publications

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“…Severe chronic conditions narrow treatment choices and are associated with poor quality of life and survival, especially in postmenopausal women . In South Africa chronic disease management is meant to be delivered using the integrated chronic disease management approach; however, this is yet to be achieved as people with multimorbidity receive fragmented and inefficient health care delivery . There is a need for an effective integrated and comprehensive array of health services spanning from primary to tertiary levels.…”

Section: Discussionmentioning

confidence: 99%

The multimorbidity profile of South African women newly diagnosed with breast cancer

Ayeni

Norris

Joffe

et al. 2019

Intl Journal of Cancer

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Multimorbidity in women with breast cancer may delay presentation, affect treatment decisions and outcomes. We described the multimorbidity profile of women with breast cancer, its determinants, associations with stage at diagnosis and treatments received. We collected self-reported data on five chronic conditions (hypertension, diabetes, cerebrovascular diseases, asthma/chronic obstructive pulmonary disease, tuberculosis), determined obesity using body mass index (BMI) and tested HIV status, in women newly diagnosed with breast cancer between January 2016 and April 2018 in five public hospitals in South Africa. We identified determinants of ≥2 of the seven above-mentioned conditions (defined as multimorbidity), multimorbidity itself with stage at diagnosis (advanced [III-IV] vs. early [0-II]) and multimorbidity with treatment modalities received. Among 2,281 women, 1,001 (44%) presented with multimorbidity. Obesity (52.8%), hypertension (41.3%), HIV (22.0%) and diabetes (13.7%) were the chronic conditions that occurred most frequently. Multimorbidity was more common Additional Supporting Information may be found in the online version of this article.with older age (OR = 1.02; 95% CI 1.01-1.03) and higher household socioeconomic status (HSES) (OR = 1.06; 95% CI 1.00-1.13). Multimorbidity was not associated with advanced-stage breast cancer at diagnosis, but for self-reported hypertension there was less likelihood of being diagnosed with advanced-stage disease in the adjusted model (OR 0.80; 95% CI 0.64-0.98). Multimorbidity was associated with first treatment received in those with early-stage disease, p = 0.003. The prevalence of multimorbidity is high among patients with breast cancer. Our findings suggest that multimorbidity had a significant impact on treatment received in those with early-stage disease. There is need to understand the impact of multimorbidity on breast cancer outcomes. What's new?Multimorbidity in women with breast cancer increases with age and may influence treatment decisions and outcome. The authors find that in South Africa 44%, of women newly diagnosed with breast cancer also suffered from other chronic conditions, most prevalently obesity, hypertension, HIV and diabetes. Asian and white women were less likely to present with multimorbidity when compared to black women, but multimorbidity was more common in women with higher socioeconomic status. The authors propose to evaluate the effect of multimorbidity on the South African health system and its impact on scarce health care resources.

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Section: Discussionmentioning

confidence: 99%

The multimorbidity profile of South African women newly diagnosed with breast cancer

Ayeni

Norris

Joffe

et al. 2019

Intl Journal of Cancer

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“…43 Some of these factors may have been responsible for these declines in the comparison facilities because these facilities were being managed by the same administrative and managerial structures in the municipality.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of an Integrated Approach to HIV and Hypertension Care in Rural South Africa: Controlled Interrupted Time-Series Analysis

Ameh

Klipstein‐Grobusch

Musenge

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…The various initiatives currently underway to re-engineer the primary healthcare system in SA to more effectively deal with NCDs, will go some way to meeting the identified needs of older diabetic patients and to addressing their barriers to care [58][59][60].However, as part of this re-modelling exercise, it is perhaps opportune for the health department to consult older chronic care patients and involve them in decision making and the planning of services. This study alerts policymakers and clinicians to some of the specific issues considered to be pertinent and important in the care and management of older persons with diabetes.…”

Section: Plos Onementioning

confidence: 99%

Does social support effect knowledge and diabetes self-management practices in older persons with Type 2 diabetes attending primary care clinics in Cape Town, South Africa?

Werfalli

Kalula²,

Manning

et al. 2020

PLoS ONE

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BackgroundIn South Africa with one of the most rapidly ageing populations in Africa despite the demographic impact of the HIV/AIDS epidemic, diabetes is a major cause of morbidity and mortality. Self-management is challenging for all those with the condition but is likely to create a higher demand for those who may have existing co-morbidities associated with age, and long-standing chronic diseases. ObjectiveTo determine the relationship of social support, especially that of family and friends with their self-management. MethodsThis cross-sectional study was undertaken in the Cape Town metropole primary care clinics. The sample comprised 406 people drawn from four community health centres (CHC) that are served by Groote Schuur Hospital at the tertiary level. ResultsOf the 406 participants, 68.5% were females, 60.5% were living with a family member, and almost half were married. The mean duration of diabetes from diagnosis was eight years. More than half (57.4%) had no or only primary education. Half the participants (50.2%) had poor knowledge level in relation to symptoms and complications of diabetes. Multivariable linear regression showed older age was associated with poor knowledge (®: -1.893, 95% CI-3.754; -0.031) and higher income was associated with self-management practice (®: PLOS ONEPLOS ONE | https://doi.

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Sustainability of the integrated chronic disease management model at primary care clinics in South Africa

Cited by 36 publications

References 11 publications

The multimorbidity profile of South African women newly diagnosed with breast cancer

The multimorbidity profile of South African women newly diagnosed with breast cancer

Effectiveness of an Integrated Approach to HIV and Hypertension Care in Rural South Africa: Controlled Interrupted Time-Series Analysis

Does social support effect knowledge and diabetes self-management practices in older persons with Type 2 diabetes attending primary care clinics in Cape Town, South Africa?

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