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chronic diseases, community trials, health systems, primary health care

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https://www.readbyqxmd.com/read/27612446/design-and-protocol-for-the-dialysis-optimal-health-program-dohp-randomised-controlled-trial
#1
Simon R Knowles, Chantal F Ski, Robyn Langham, Emmet O'Flaherty, David R Thompson, Susan L Rossell, Gaye Moore, Ya-Seng Arthur Hsueh, David J Castle
BACKGROUND: Chronic kidney disease (CKD) and end-stage kidney disease (ESKD) are serious and growing health problems with enormous impact on psychological and social functioning. Despite high rates of comorbid depression and anxiety in these patient populations, and the adverse impact these have upon treatment adherence, quality of life, social connectedness and healthcare costs there has been little attention focused on the prevention or management of these problems. Thus, our aim was to evaluate the Dialysis Optimal Health Program (DOHP) that adopts a person-centred approach and engages collaborative therapy to educate and support those diagnosed with ESKD who are commencing dialysis...
2016: Trials
https://www.readbyqxmd.com/read/27558630/cardiovascular-risk-outcome-and-program-evaluation-of-a-cluster-randomised-controlled-trial-of-a-community-based-lay-peer-led-program-for-people-with-diabetes
#2
M A Riddell, J A Dunbar, P Absetz, R Wolfe, H Li, M Brand, Z Aziz, B Oldenburg
BACKGROUND: The 2013 Global Burden of Disease Study demonstrated the increasing burden of diabetes and the challenge it poses to the health systems of all countries. The chronic and complex nature of diabetes requires active self-management by patients in addition to clinical management in order to achieve optimal glycaemic control and appropriate use of available clinical services. This study is an evaluation of a "real world" peer support program aimed at improving the control and management of type 2 diabetes (T2DM) in Australia...
2016: BMC Public Health
https://www.readbyqxmd.com/read/27549020/improving-access-to-medicines-for-non-communicable-diseases-in-rural-india-a-mixed-methods-study-protocol-using-quasi-experimental-design
#3
N S Prashanth, Maya Annie Elias, Manoj Kumar Pati, Praveenkumar Aivalli, C M Munegowda, Srinath Bhanuprakash, S M Sadhana, Bart Criel, Maryam Bigdeli, Narayanan Devadasan
BACKGROUND: India has the distinction of financing its healthcare mainly through out-of-pocket expenses by individual families contributing to catastrophic health expenditure and impoverishment. Nearly 70 % of the expenditure is on medicines purchased at private pharmacies. Patients with chronic ailments are especially affected, as they often need lifelong medicines. Over the past years in India, there have been several efforts to improve drug availability at government primary health centres...
2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27185295/the-effectiveness-of-self-management-mobile-phone-and-tablet-apps-in-long-term-condition-management-a-systematic-review
#4
Lisa Whitehead, Philippa Seaton
BACKGROUND: Long-term conditions and their concomitant management place considerable pressure on patients, communities, and health care systems worldwide. International clinical guidelines on the majority of long-term conditions recommend the inclusion of self-management programs in routine management. Self-management programs have been associated with improved health outcomes; however, the successful and sustainable transfer of research programs into clinical practice has been inconsistent...
2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27044360/a-protocol-for-a-pragmatic-randomized-controlled-trial-using-the-health-teams-advancing-patient-experience-strengthening-quality-health-tapestry-platform-approach-to-promote-person-focused-primary-healthcare-for-older-adults
#5
Lisa Dolovich, Doug Oliver, Larkin Lamarche, Gina Agarwal, Tracey Carr, David Chan, Laura Cleghorn, Lauren Griffith, Dena Javadi, Monika Kastner, Jennifer Longaphy, Dee Mangin, Alexandra Papaioannou, Jenny Ploeg, Parminder Raina, Julie Richardson, Cathy Risdon, P Lina Santaguida, Sharon Straus, Lehana Thabane, Ruta Valaitis, David Price
BACKGROUND: Healthcare systems are not well designed to help people maintain or improve their health. They are generally not person-focused or well-coordinated. The objective of this study is to evaluate the effectiveness of the Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) approach in older adults. The overarching hypothesis is that using the Health TAPESTRY approach to achieve better integration of the health and social care systems into a person's life that centers on meeting a person's health goals and needs will result in optimal aging...
2016: Implementation Science: IS
https://www.readbyqxmd.com/read/26995281/track-a-randomized-controlled-trial-of-a-digital-health-obesity-treatment-intervention-for-medically-vulnerable-primary-care-patients
#6
Perry Foley, Dori Steinberg, Erica Levine, Sandy Askew, Bryan C Batch, Elaine M Puleo, Laura P Svetkey, Hayden B Bosworth, Abigail DeVries, Heather Miranda, Gary G Bennett
INTRODUCTION: Obesity continues to disproportionately affect medically vulnerable populations. Digital health interventions may be effective for delivering obesity treatment in low-resource primary care settings. METHODS: Track is a 12-month randomized controlled trial of a digital health weight loss intervention in a community health center system. Participants are 351 obese men and women aged 21 to 65years with an obesity-related comorbidity. Track participants are randomized to usual primary care or to a 12-month intervention consisting of algorithm-generated tailored behavior change goals, self-monitoring via mobile technologies, daily self-weighing using a network-connected scale, skills training materials, 18 counseling phone calls with a Track coach, and primary care provider counseling...
May 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/26818484/improving-delivery-of-secondary-prophylaxis-for-rheumatic-heart-disease-in-remote-indigenous-communities-study-protocol-for-a-stepped-wedge-randomised-trial
#7
Anna P Ralph, Clancy Read, Vanessa Johnston, Jessica L de Dassel, Kerstin Bycroft, Alice Mitchell, Ross S Bailie, Graeme P Maguire, Keith Edwards, Bart J Currie, Adrienne Kirby, Jonathan R Carapetis
BACKGROUND: Rheumatic heart disease (RHD), caused by acute rheumatic fever (ARF), is a major health problem in Australian Aboriginal communities. Progress in controlling RHD requires improvements in the delivery of secondary prophylaxis, which comprises regular, long-term injections of penicillin for people with ARF/RHD. METHODS/DESIGN: This trial aims to improve uptake of secondary prophylaxis among Aboriginal people with ARF/RHD to reduce progression or worsening of RHD...
2016: Trials
https://www.readbyqxmd.com/read/26679768/informal-health-provider-and-practical-approach-to-lung-health-interventions-to-improve-the-detection-of-chronic-airways-disease-and-tuberculosis-at-primary-care-level-in-malawi-study-protocol-for-a-randomised-controlled-trial
#8
RANDOMIZED CONTROLLED TRIAL
Hastings T Banda, Kevin Mortimer, George A F Bello, Grace B Mbera, Ireen Namakhoma, Rachael Thomson, Moffat J Nyirenda, Brian Faragher, Jason Madan, Rasmus Malmborg, Berthe Stenberg, James Mpunga, Beatrice Mwagomba, Elvis Gama, Katherine Piddock, Stephen B Squire
BACKGROUND: In developing countries like Malawi, further investigation is rare after patients with chronic cough test negative for tuberculosis. Chronic airways disease has presentations that overlap with tuberculosis. However, chronic airways disease is often unrecognised due to a lack of diagnostic services. Within developing countries, referral systems at primary health care level are weak and patients turn to unskilled informal health providers to seek health care. Delayed diagnosis and treatment of these diseases facilitates increased severity and tuberculosis transmission...
2015: Trials
https://www.readbyqxmd.com/read/26559016/community-health-workers-as-chronic-care-coordinators-evaluation-of-an-australian-indigenous-primary-health-care-program
#9
Barbara Schmidt, Sandra Campbell, Robyn McDermott
OBJECTIVES: To explore how a client-centred Chronic Care model was implemented by Indigenous Health Workers (IHWs) at participating sites in a trial of IHW-led case management. To understand the experiences of engaging with the model from the perspective of the IHWs, health team members and clients. METHODS: The review was conducted within a cluster randomised trial of the model in six remote Indigenous communities in north Queensland over 18 months. Content analysis was undertaken on 377 project records of health worker activity...
April 2016: Australian and New Zealand Journal of Public Health
https://www.readbyqxmd.com/read/25971445/the-respiratory-health-of-urban-indigenous-children-aged-less-than-5-years-study-protocol-for-a-prospective-cohort-study
#10
Kerry K Hall, Anne B Chang, Theo P Sloots, Jennie Anderson, Anita Kemp, Jan Hammill, Michael Otim, Kerry-Ann F O'Grady
BACKGROUND: Despite the burden of acute respiratory illnesses (ARI) among Aboriginal and Torres Strait Islander children being a substantial cause of childhood morbidity and associated costs to families, communities and the health system, data on disease burden in urban children are lacking. Consequently evidence-based decision-making, data management guidelines, health resourcing for primary health care services and prevention strategies are lacking. This study aims to comprehensively describe the epidemiology, impact and outcomes of ARI in urban Aboriginal and Torres Strait Islander children (hereafter referred to as Indigenous) in the greater Brisbane area...
2015: BMC Pediatrics
https://www.readbyqxmd.com/read/25924825/engineering-a-mobile-health-tool-for-resource-poor-settings-to-assess-and-manage-cardiovascular-disease-risk-smarthealth-study
#11
Arvind Raghu, Devarsetty Praveen, David Peiris, Lionel Tarassenko, Gari Clifford
BACKGROUND: The incidence of chronic diseases in low- and middle-income countries is rapidly increasing both in urban and rural regions. A major challenge for health systems globally is to develop innovative solutions for the prevention and control of these diseases. This paper discusses the development and pilot testing of SMARTHealth, a mobile-based, point-of-care Clinical Decision Support (CDS) tool to assess and manage cardiovascular disease (CVD) risk in resource-constrained settings...
2015: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/25880660/using-an-electronic-medical-record-emr-to-conduct-clinical-trials-salford-lung-study-feasibility
#12
Hanaa F Elkhenini, Kourtney J Davis, Norman D Stein, John P New, Mark R Delderfield, Martin Gibson, Jorgen Vestbo, Ashley Woodcock, Nawar Diar Bakerly
BACKGROUND: Real-world data on the benefit/risk profile of medicines is needed, particularly in patients who are ineligible for randomised controlled trials conducted for registration purposes. This paper describes the methodology and source data verification which enables the conduct of pre-licensing clinical trials of COPD and asthma in the community using the electronic medical record (EMR), NorthWest EHealth linked database (NWEH-LDB) and alert systems. METHODS: Dual verification of extracts into NWEH-LDB was performed using two independent data sources (Salford Integrated Record [SIR] and Apollo database) from one primary care practice in Salford (N = 3504)...
2015: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/25685075/key-activities-used-by-community-based-primary-care-practices-to-improve-the-quality-of-diabetes-care-in-response-to-practice-facilitation
#13
RANDOMIZED CONTROLLED TRIAL
Polly Hitchcock Noël, Raquel Lozano Romero, Michaela Robertson, Michael L Parchman
BACKGROUND: A recent systematic review suggests that practice facilitation (PF) is a robust intervention for implementing evidence-based preventive care guidelines in primary care, but the ability of PF to improve chronic illness care remains unclear. AIMS: To examine the specific activities and Chronic Care model (CCM) components that primary care practices implemented and sustained in response to a 12-month PF intervention. METHODS: The ABC trial tested the effectiveness of PF to improve care for diabetes in 40 small community-based primary care practices that were randomized to "initial" or "delayed" intervention arms...
2014: Quality in Primary Care
https://www.readbyqxmd.com/read/25467772/expanding-paramedicine-in-the-community-epic-study-protocol-for-a-randomized-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
Ian R Drennan, Katie N Dainty, Paul Hoogeveen, Clare L Atzema, Norm Barrette, Gillian Hawker, Jeffrey S Hoch, Wanrudee Isaranuwatchai, Jane Philpott, Chris Spearen, Walter Tavares, Linda Turner, Melissa Farrell, Tom Filosa, Jennifer Kane, Alex Kiss, Laurie J Morrison
BACKGROUND: The incidence of chronic diseases, including diabetes mellitus (DM), heart failure (HF) and chronic obstructive pulmonary disease (COPD) is on the rise. The existing health care system must evolve to meet the growing needs of patients with these chronic diseases and reduce the strain on both acute care and hospital-based health care resources. Paramedics are an allied health care resource consisting of highly-trained practitioners who are comfortable working independently and in collaboration with other resources in the out-of-hospital setting...
2014: Trials
https://www.readbyqxmd.com/read/25293785/implementing-and-evaluating-a-program-to-facilitate-chronic-disease-prevention-and-screening-in-primary-care-a-mixed-methods-program-evaluation
#15
Donna Patricia Manca, Kris Aubrey-Bassler, Kami Kandola, Carolina Aguilar, Denise Campbell-Scherer, Nicolette Sopcak, Mary Ann O'Brien, Christopher Meaney, Vee Faria, Julia Baxter, Rahim Moineddin, Ginetta Salvalaggio, Lee Green, Andrew Cave, Eva Grunfeld
BACKGROUND: The objectives of this paper are to describe the planned implementation and evaluation of the Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care (BETTER 2) program which originated from the BETTER trial. The pragmatic trial, informed by the Chronic Care Model, demonstrated the effectiveness of an approach to Chronic Disease Prevention and Screening (CDPS) involving the use of a new role, the prevention practitioner. The desired goals of the program are improved clinical outcomes, reduction in the burden of chronic disease, and improved sustainability of the health-care system through improved CDPS in primary care...
2014: Implementation Science: IS
https://www.readbyqxmd.com/read/25218689/study-protocol-of-empower-participatory-action-research-empower-par-a-pragmatic-cluster-randomised-controlled-trial-of-multifaceted-chronic-disease-management-strategies-to-improve-diabetes-and-hypertension-outcomes-in-primary-care
#16
RANDOMIZED CONTROLLED TRIAL
Anis S Ramli, Sharmila Lakshmanan, Jamaiyah Haniff, Sharmini Selvarajah, Seng F Tong, Mohamad-Adam Bujang, Suraya Abdul-Razak, Asrul A Shafie, Verna K M Lee, Thuhairah H Abdul-Rahman, Maryam H Daud, Kien K Ng, Farnaza Ariffin, Hasidah Abdul-Hamid, Md-Yasin Mazapuspavina, Nafiza Mat-Nasir, Maizatullifah Miskan, Jaya P Stanley-Ponniah, Mastura Ismail, Chun W Chan, Yong R Abdul-Rahman, Boon-How Chew, Wilson H H Low
BACKGROUND: Chronic disease management presents enormous challenges to the primary care workforce because of the rising epidemic of cardiovascular risk factors. The chronic care model was proven effective in improving chronic disease outcomes in developed countries, but there is little evidence of its effectiveness in developing countries. The aim of this study was to evaluate the effectiveness of the EMPOWER-PAR intervention (multifaceted chronic disease management strategies based on the chronic care model) in improving outcomes for type 2 diabetes mellitus and hypertension using readily available resources in the Malaysian public primary care setting...
2014: BMC Family Practice
https://www.readbyqxmd.com/read/25121789/task-shifting-for-non-communicable-disease-management-in-low-and-middle-income-countries-a-systematic-review
#17
REVIEW
Rohina Joshi, Mohammed Alim, Andre Pascal Kengne, Stephen Jan, Pallab K Maulik, David Peiris, Anushka A Patel
BACKGROUND: One potential solution to limited healthcare access in low and middle income countries (LMIC) is task-shifting- the training of non-physician healthcare workers (NPHWs) to perform tasks traditionally undertaken by physicians. The aim of this paper is to conduct a systematic review of studies involving task-shifting for the management of non-communicable disease (NCD) in LMIC. METHODS: A search strategy with the following terms "task-shifting", "non-physician healthcare workers", "community healthcare worker", "hypertension", "diabetes", "cardiovascular disease", "mental health", "depression", "chronic obstructive pulmonary disease", "respiratory disease", "cancer" was conducted using Medline via Pubmed and the Cochrane library...
2014: PloS One
https://www.readbyqxmd.com/read/24886272/spironolactone-to-prevent-cardiovascular-events-in-early-stage-chronic-kidney-disease-stop-ckd-study-protocol-for-a-randomized-controlled-pilot-trial
#18
RANDOMIZED CONTROLLED TRIAL
Khai P Ng, Poorva Jain, Gurdip Heer, Val Redman, Odette L Chagoury, George Dowswell, Sheila Greenfield, Nick Freemantle, Jonathan N Townend, Paramjit S Gill, Richard J McManus, Charles J Ferro
BACKGROUND: Chronic kidney disease is associated with increased arterial stiffness even in the early stages and this is thought to be a key mediator in the pathophysiology of the increased cardiovascular risk associated with this condition. The use of low-dose spironolactone has previously been shown to improve arterial stiffness and reduce left ventricular mass safely in early-stage chronic kidney disease in the context of careful monitoring at a university hospital. However, the majority of patients with chronic kidney disease are managed by their general practitioners in the community...
May 6, 2014: Trials
https://www.readbyqxmd.com/read/24792948/chronic-disease-management-improving-care-for-people-with-osteoarthritis
#19
REVIEW
Caroline A Brand, Ilana N Ackerman, Joanne Tropea
Chronic disease management (CDM) service models are being developed for many conditions; however, there is limited evidence to support their effectiveness in osteoarthritis (OA). A systematic review was undertaken to examine effectiveness, cost effectiveness and barriers to the use of osteoarthritis-chronic disease management (OA-CDM) service models. Thirteen eligible studies (eight randomised controlled trial (RCTs)) were identified. The majority focussed on delivery system design (n = 9) and/or providing self-management support (SMS) (n = 8)...
February 2014: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/24678983/alignment-of-patient-and-primary-care-practice-member-perspectives-of-chronic-illness-care-a-cross-sectional-analysis
#20
RANDOMIZED CONTROLLED TRIAL
Polly H Noël, Michael L Parchman, Ray F Palmer, Raquel L Romero, Luci K Leykum, Holly J Lanham, John E Zeber, Krista W Bowers
BACKGROUND: Little is known as to whether primary care teams' perceptions of how well they have implemented the Chronic Care Model (CCM) corresponds with their patients' own experience of chronic illness care. We examined the extent to which practice members' perceptions of how well they organized to deliver care consistent with the CCM were associated with their patients' perceptions of the chronic illness care they have received. METHODS: Analysis of baseline measures from a cluster randomized controlled trial testing a practice facilitation intervention to implement the CCM in small, community-based primary care practices...
2014: BMC Family Practice
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