Abstract
The co-occurrence of two or more chronic conditions within
one person is continuously growing. Currently, healthcare is
mostly characterized by fragmented interventions frequently
addressing single chronic diseases. Chronic Care Model
(CCM) is the forefather of disease management programs
(DMPs) developed to deliver to chronic patients coordinated
healthcare among several health services. A systematic review
was carried out in order to evaluate the impact of Chronic
Care Model determinants addressing patients with multiple
chronic conditions.
Methods
The search was conducted by querying electronic databases
and hand searching. Only studies concerning interventions
belonging to structured health plan and addressing adults
patients with long-term multiple chronic conditions were
selected. Studies were divided in two groups depending on the
inclusion of depression as comorbidity and in further
subgroups according to the CCM dimensions interested. To
describe the impact of CCM dimensions and to grade the
strength of recommendations, the outcomes of the studies
were grouped in macro-categories according to thematic
topics.
Results
12 studies (8 trials and 4 observational) out of 7807 were
included. The total sample regarded 57713 subjects. Years of
publication were comprised from 2002 to 2012. 8 studies were
set in USA and 4 in Germany, The Netherlands, Finland and
Canada. Interventions attributable to Delivery System Design
(DSD) and Self Management Support (SMS) as CCM
dimensions were represented in all the selected studies. A
positive impact on outcomes was observed in the subgroup
including DSD, SMS and Clinical Information System (CIS)
addressing depression and in the subgroup not addressing
depression but including all the six CCM dimensions.
Conclusions
Delivering coordinated interventions attributable to minimum
three CCM dimensions (DSD, SMS, CIS) seem to have a
positive impact on healthcare addressing multimorbid
patients.
Key messages
Our research contributes to the debate on which healthcare
interventions address multimorbid patients
Health plans addressing multi-chronic patients include
interventions attributable to Delivery System Design and
Self Management Support as Chronic Care Model (CCM)
dimensions
| Original language | English |
|---|---|
| Pages (from-to) | 174-174 |
| Number of pages | 1 |
| Journal | European Journal of Public Health |
| Volume | 25 (Suppl. 3) |
| Publication status | Published - 2015 |
| Event | 8th European Public Health Conference – “Health in Europe – from global to local policies, methods and practices” - Milano Duration: 14 Oct 2015 → 17 Oct 2015 |
Keywords
- chronic care model
- multimorbidity