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Chronic care programme

C Teljeur, P S Moran, S Walshe, S M Smith, F Cianci, L Murphy, P Harrington, M Ryan
AIMS: To systematically review the evidence on the costs and cost-effectiveness of self-management support interventions for people with diabetes. BACKGROUND: Self-management support is the provision of education and supportive interventions to increase patients' skills and confidence in managing their health problems, potentially leading to improvements in HbA1c levels in people with diabetes. METHODS: Randomized controlled trials, observational studies or economic modelling studies were eligible for inclusion in the review...
October 22, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
Chantal Arditi, Bernard Burnand, Isabelle Peytremann-Bridevaux
BACKGROUND: To reduce the burden of asthma, chronic disease management (CDM) programmes have been widely implemented and evaluated. Reviews including randomised controlled trials (RCTs) suggest that CDM programmes for asthma are effective. Other study designs are however often used for pragmatic reasons, but excluded from these reviews because of their design. We aimed to examine what complementary information could be retrieved from the addition of non-randomised studies to the studies included in a published Cochrane review on asthma CDM programmes, for healthcare stakeholders involved in the development, implementation, conduct or long-term sustainability of such programmes...
October 21, 2016: BMC Health Services Research
Edwin Wouters, Frederik le Roux Booysen, Caroline Masquillier
Reviews of impact evaluations of community-based health workers and peer support groups highlight the considerable variability in the effectiveness of such support in improving antiretroviral treatment (ART) outcomes. Evidence indicates that community-based support interventions targeting patients known to be at risk will probably display better results than generic interventions aimed at the entire population of people living with HIV. It is however difficult to identify these at-risk populations, rendering knowledge on the characteristics of patients groups who are in need of community-based support a clear research priority...
2016: PloS One
Signe Hanghøj, Kirsten A Boisen, Kjeld Schmiegelow, Bibi Hølge-Hazelton
BACKGROUND: International guidelines recommend planned and structured transition programmes for adolescents with chronic illness because inadequate transition may lead to poor disease control and risk of lacking outpatient follow-up. OBJECTIVE: To investigate the feasibility of a transition intervention aimed at adolescents with chronic illness focusing on declines, drop-outs, no-shows and advantages and disadvantages of participating. METHODS: We invited 236 adolescents (12-20 years) with juvenile idiopathic arthritis (JIA) to participate in a randomised controlled trial (RCT) transition intervention...
October 14, 2016: International Journal of Adolescent Medicine and Health
Kate Button, Fiona Morgan, Helen Hodgson, Alison L Weightman, Steve Jones
BACKGROUND: Musculoskeletal (MSK) conditions are the most frequently reported chronic conditions and one of the biggest causes of disability in the UK. Given the ageing population and the impact of these problems, the demand for MSK treatment will rise. Despite reduced waiting times, MSK pathways have remained variable and inconsistent and need to be improved to meet patient needs. The aim of this systematic review is to understand the evidence for the effectiveness of current models of service delivery and care pathways for adult hip/knee pain patients accessing secondary care for specialist opinions...
August 1, 2016: Systematic Reviews
Elena Longhi, Lynne Murray, Rachael Hunter, David Wellsted, Samantha Taylor-Colls, Kathryn MacKenzie, Gwynne Rayns, Richard Cotmore, Peter Fonagy, Richard M Pasco Fearon
BACKGROUND: Young mothers living in low-income urban settings often are exposed to significant and chronic environmental difficulties including poverty, social isolation and poor education and typically also have to cope with personal histories of abuse and depression. Minding the Baby® (MTB) is an interdisciplinary home-visiting programme developed to support first-time young mothers, which integrates primary care and mental health approaches into a single intensive intervention from the last trimester of pregnancy until the child's second birthday...
October 7, 2016: Trials
Kaushik Guha, Christopher J Allen, Sumir Chawla, Hayley Pryse-Hawkins, Laura Fallon, Vicki Chambers, Ali Vazir, Alex R Lyon, Martin R Cowie, Rakesh Sharma
The National Institute for Health and Care Excellence (NICE) updated its guidelines for chronic heart failure (HF) in 2010. This re-audit assessed interim improvement as compared with an audit in 2011. Patients with HF (preserved and reduced ejection fraction) attending a tertiary cardiac centre over a 2-year period (January 2013-December 2014) were audited. The data collected included demographics, HF aetiology, medications, clinical parameters and cardiac rehabilitation. In total, 513 patients were audited...
October 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
J Crowley, S O'Connell, A Kavka, L Ball, C A Nowson
BACKGROUND: The prevalence of chronic disease is considerable, and dietary behaviours influence the progression of many chronic diseases. Practice guidelines recommend that general practitioners (GPs) promote healthy dietary behaviours in relevant consultations with patients in order to improve health outcomes at a population level. OBJECTIVE: To describe GPs' perceived interest, confidence and barriers to support patients to have a healthy diet. METHOD: A 24-item online and written survey was distributed in a national weekly newsletter to GPs in Australia...
September 28, 2016: Public Health
A Santoro, N Abu-Rmeileh, A Khader, A Seita, M McKee
Palestinian refugees served by the United Nation Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) are experiencing increasing rates of diagnosis of non-communicable diseases. In response, in 2011 UNRWA initiated an Agency-wide programme of primary healthcare reform, informed by the Chronic Care Model framework. Health services were reorganized following a family-centred approach, with delivery by multidisciplinary family health teams supported by updated technical advice. An inclusive clinical information system, termed e-Health, was implemented to collect a wide range of health information, with a focus on continuity of treatment...
2016: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
János Sándor, Karolina Kósa, Magor Papp, Gergő Fürjes, László Kőrösi, Mihajlo Jakovljevic, Róza Ádány
Mortality caused by non-communicable diseases has been extremely high in Hungary, which can largely be attributed to not performed preventive examinations (PEs) at the level of primary health care (PHC). Both structures and financial incentives are lacking, which could support the provision of legally defined PEs. A Model Programme was launched in Hungary in 2012 to adapt the recommendations for PHC of the World Health Organization. A baseline survey was carried out to describe the occurrence of not performed PEs...
2016: Frontiers in Public Health
Lisa C Martial, Ruud H J Verstegen, Elisabeth A M Cornelissen, Rob E Aarnoutse, Michiel F Schreuder, Roger J M Brüggemann
OBJECTIVES: The Radboudumc Amalia Children's hospital in the Netherlands has a programme for renal transplantation in children aged ≤4 years. Children receive chronic corticosteroid sparing immunosuppressive therapy that consists of tacrolimus and mycophenolate mofetil. This work aimed to describe the PK of tacrolimus in children ≤4 years with renal transplants. METHODS: Paediatric renal transplant patients aged ≤4 years were included in this analysis. A PK curve of tacrolimus recorded ≤3 weeks after transplantation has been standard of care in our institution and aided in adjusting the dose in each patient to attain a target AUC0-12h of 210 μg h/l early after transplantation...
September 27, 2016: Journal of Pharmacy and Pharmacology
Annette Hanson
Due to the growing number of ageing prisoners in the American correctional system, penal institutions are increasingly caring for patients with chronic and potentially terminal medical conditions. To address this problem states have attempted sentencing reform initiatives and adopted compassionate release programmes; however, these efforts have failed to significantly reduce the number of elderly or seriously ill inmates. Correctional mental health services are now called upon to aid in the care of prisoners at the end of life...
September 26, 2016: International Review of Psychiatry
Justin R Ortiz, Marc Perut, Laure Dumolard, Pushpa Ranjan Wijesinghe, Pernille Jorgensen, Alba Maria Ropero, M Carolina Danovaro-Holliday, James D Heffelfinger, Carol Tevi-Benissan, Nadia A Teleb, Philipp Lambach, Joachim Hombach
INTRODUCTION: The WHO recommends annual influenza vaccination to prevent influenza illness in high-risk groups. Little is known about national influenza immunization policies globally. MATERIAL AND METHODS: The 2014 WHO/UNICEF Joint Reporting Form (JRF) on Immunization was adapted to capture data on influenza immunization policies. We combined this dataset with additional JRF information on new vaccine introductions and strength of immunization programmes, as well as publicly available data on country economic status...
October 26, 2016: Vaccine
R M A van Erp, I P J Huijnen, A J A Köke, F E Abbink, M den Hollander, R J E M Smeets
: Biopsychosocial interventions provided in multidisciplinary settings are promising for improving functional disability levels in patients with chronic low back pain (CLBP). These multidisciplinary biopsychosocial interventions mainly focus on cognitive-behavioural approaches that aim to change negative cognitions, emotions, behaviour, work and social factors. As some patients with CLBP treated in primary care settings also experience psychosocial factors that influence their level of disability, these patients may benefit from the provision of a biopsychosocial intervention in primary care...
May 11, 2016: Physiotherapy
Raymond A Tetteh, Edmund T Nartey, Margaret Lartey, Aukje K Mantel-Teeuwisse, Hubert G M Leufkens, Barbara A Yankey, Alexander N O Dodoo
INTRODUCTION: Patients initiated on highly active antiretroviral therapy (HAART) generally remain on medication indefinitely. A modification in the HAART regimen may become necessary because of possible acute or chronic toxicities, concomitant clinical conditions, development of virological failure or the advent of adverse drug events. The study documents adverse drug events of HIV-positive Ghanaian patients with HAART modifications. It also investigates the association between documented adverse drug events and HAART modification using an unmatched case-control study design...
November 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
K Mergenthal, C Güthlin, M Beyer, F M Gerlach, A Siebenhofer
Background: In recent years, models for the delegation of GP tasks to non-physician medical staff have been tested, implemented in a general practice setting and, to some extent, funded by health insurance companies. Aim: How were changes in the spectrum of tasks performed by non-physician staff viewed and accepted by patients? Methods: Between October 2014 and January 2015, a written survey was conducted among chronically ill patients (≥ 65 years of age) receiving health care from health care assistants (HCA) with or without the additional "health care assistant in the family practice", or VERAH qualification...
September 16, 2016: Das Gesundheitswesen
Andrea M de Silva, Shalika Hegde, Bridget Akudo Nwagbara, Hanny Calache, Mark G Gussy, Mona Nasser, Hannah R Morrice, Elisha Riggs, Pamela M Leong, Lisa K Meyenn, Reza Yousefi-Nooraie
BACKGROUND: Dental caries and gingival and periodontal disease are commonly occurring, preventable chronic conditions. Even though much is known about how to treat oral disease, currently we do not know which community-based population-level interventions are most effective and equitable in preventing poor oral health. OBJECTIVES: Primary • To determine the effectiveness of community-based population-level oral health promotion interventions in preventing dental caries and gingival and periodontal disease among children from birth to 18 years of age...
September 15, 2016: Cochrane Database of Systematic Reviews
David Font, Joan Escarrabill, Mónica Gómez, Rafael Ruiz, Belén Enfedaque, Xavier Altimiras
The Integrated Health Area "Barcelona Esquerra" (Área Integral de Salud de Barcelona Esquerra - AIS-BE), which covers a population of 524,000 residents in Barcelona city, is running a project to improve healthcare quality and efficiency based on co-ordination between the different suppliers in its area through the participation of their professionals. Endowed with an Organisational Model that seeks decision-taking that starts out from clinical knowledge and from Information Systems tools that facilitate this co-ordination (an interoperability platform and a website) it presents important results in its structured programmes that have been implemented such as the Reorganisation of Emergency Care, Screening for Colorectal Cancer, the Onset of type 2 Diabetes Mellitus, Teledermatology and the Development of Cross-sectional Healthcare Policies for Care in Chronicity...
2016: International Journal of Integrated Care
Joshua Robert Zadro, Debra Shirley, Milena Simic, Seyed Javad Mousavi, Dragana Ceprnja, Katherine Maka, Paulo Ferreira
OBJECTIVES: To investigate the feasibility of implementing a video-game exercise programme for older people with chronic low back pain (LBP). DESIGN: Single-centred single-blinded randomised controlled trial (RCT). SETTING: Physiotherapy outpatient department in a public hospital in Western Sydney, Australia. PARTICIPANTS: We will recruit 60 participants over 55 years old with chronic LBP from the waiting list. INTERVENTIONS: Participants will be randomised to receive video-game exercise (n=30) or to remain on the waiting list (n=30) for 8 weeks, with follow up at 3 and 6 months...
June 4, 2016: Physiotherapy
Chantal F Ski, David R Thompson, David J Castle
Population ageing is a worldwide phenomenon, most advanced in developed countries and expected to continue over the next few decades. As people are surviving longer with age-associated disease and disability, there is an imperative to identify innovative solutions for an already overburdened health care system. Such innovations need to be focused on disease management, taking into consideration the strong associations that have been established between psychosocial factors and pathophysiological mechanisms associated with chronic disease...
2016: Trials
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