The impact of a multidisciplinary, integrated approach on improving the health and quality of care for individuals dealing with multiple chronic conditions.

Krause, Christina M.; Jones, Christopher S.; Joyce, Stephen; Kuhn, Maria E. J.; Curtin, Karen; Murphy, Lee; Krause, Chad M. J.; Boan, Brandi; Lucas, Donald R.

doi:10.1037/0002-9432.76.1.109

Cited by 17 publications

(24 citation statements)

References 29 publications

(30 reference statements)

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“…exercise and cognitive symptom management) [77]. The studies that did not compare comprehensive care with usual care found a (significant) improvement of behavior towards, diet, exercise, immunization or medication but not towards cognitive symptom management [40,64,78]. Considering these findings, there is moderate evidence for a beneficial effect of comprehensive care on health behavior.…”

Section: Functional Statusmentioning

confidence: 87%

“…significantly slower deterioration than in the usual care group). Four studies did not compare comprehensive care with usual care [55,60,64,78], with two studies observing an improvement in quality of life over time due to comprehensive care [55,64]. Considering the inconsistent findings across studies, there is insufficient evidence for a beneficial effect of comprehensive care on quality of life in terms of mental functioning.…”

Section: Functional Statusmentioning

confidence: 93%

“…Two studies did not specify costs for inpatient and outpatient healthcare services [58,64]. One study compared healthcare costs of the comprehensive care group with these of the usual care group, and found no effect of comprehensive care [58].…”

Section: Mortality Mortality Was Evaluated In Six Studiesmentioning

confidence: 96%

“…One study compared healthcare costs of the comprehensive care group with these of the usual care group, and found no effect of comprehensive care [58]. The other study reported only healthcare costs for the comprehensive care group and observed that the actual healthcare costs were significantly lower than the projected healthcare costs [64].…”

Section: Mortality Mortality Was Evaluated In Six Studiesmentioning

confidence: 97%

“…Patients found the comprehensive care program helpful and user-friendly, and appreciated the holistic approach. They further believed that the program helped them to manage their disease, had improved their health, and made it easier to get access to healthcare services [11,[40][41][42]60,62,64,76,77]. Considering the fact that two studies with relatively high quality sum-scores reported positive effects of comprehensive care on quality of care and satisfaction and that these findings were supported by qualitative findings, there is moderate evidence for a beneficial effect of comprehensive care on quality of care and patient satisfaction.…”

Section: Mortality Mortality Was Evaluated In Six Studiesmentioning

confidence: 99%

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Comprehensive care programs for patients with multiple chronic conditions: A systematic literature review

et al. 2012

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Section: Functional Statusmentioning

confidence: 87%

Section: Functional Statusmentioning

confidence: 93%

Section: Mortality Mortality Was Evaluated In Six Studiesmentioning

confidence: 96%

Section: Mortality Mortality Was Evaluated In Six Studiesmentioning

confidence: 97%

Section: Mortality Mortality Was Evaluated In Six Studiesmentioning

confidence: 99%

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Comprehensive care programs for patients with multiple chronic conditions: A systematic literature review

et al. 2012

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The Hidden Curriculum and Integrating Cure- and Care-Based Approaches to Medicine

Choudhury

Nortjé

2020

HEC Forum

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Although current literature about the "cure versus care" issue tends to promote a patient-centered approach, the disease-centered approach remains the prevailing model in practice. The perceived dichotomy between the two approaches has created a barrier that could make it difficult for medical students and physicians to integrate psychosocial aspects of patient care into the prevailing disease-based model. This article examines the influence of the formal and hidden curricula on the perception of these two approaches and finds that the hidden curriculum perpetuates the notion that "cure" and "care" based approaches are dichotomous despite significant changes in formal curricula that promote a more integrated approach. The authors argue that it is detrimental for clinicians to view the two approaches as oppositional rather than complementary and attempt to give recommendations on how the influence of the hidden curriculum can be reduced to get a both-cure-and-care-approach, rather than an either-cure-or-care-approach.

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The Impact of Balanced Counseling on Contraceptive Method Choice and Determinants of Long Acting and Reversible Contraceptive Continuation in Nepal

Sapkota

Rajbhandary

Lohani

2016

Matern Child Health J

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Introduction Long-acting reversible contraceptives (LARCs) reduce rates of unintended pregnancies and repeat abortion. Uptake and continuation rates of LARCs are very low in Nepal, despite free provision from most health facilities. We sought to establish the effectiveness of a new approach to LARC promotion in Nepal. Methods We examined change in contraceptive method mix in Nepal using service data resulting from introduction of a balanced counseling (BC) approach to family planning (FP). All staff located at nine randomly selected FP sites were trained and began applying BC in April and May 2014. Women who accepted LARCs from a participating facility were re-contacted at 1, 3, 6 and 12 months. We estimated the LARC continuation rate and assessed determinants of continuation using descriptive analysis, Kaplan-Meier survival curves and univariate and multivariate Cox proportional hazard analysis. Results A total of 5744 women received BC between April and July 2014. 1580 women (27.5 %) took up LARCs, raising its contribution to contraceptive method mix at [organization] to 40 %, significantly higher than the 15 % recorded in 2013. 913 women were followed-up, and the LARC continuation rate at 12 months was 82 %. Women's reported satisfaction with LARC [AHR 0.23; 95 % CI 0.14-0.39, p = 0.000] was the single strongest determinant of LARC continuation after adjusting for all background characteristics. Discussion The findings suggest BC is an effective approach for increasing LARC uptake in Nepal. The rate of LARC continuation and its determinants are important inputs to strategies for improved delivery of FP services.

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The impact of a multidisciplinary, integrated approach on improving the health and quality of care for individuals dealing with multiple chronic conditions.

Cited by 17 publications

References 29 publications

Comprehensive care programs for patients with multiple chronic conditions: A systematic literature review

Comprehensive care programs for patients with multiple chronic conditions: A systematic literature review

The Hidden Curriculum and Integrating Cure- and Care-Based Approaches to Medicine

The Impact of Balanced Counseling on Contraceptive Method Choice and Determinants of Long Acting and Reversible Contraceptive Continuation in Nepal

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