Evidence map›Paper›PMID 25958128›Full record

SynthesisBMC health services research2015

Effectiveness of chronic care models: opportunities for improving healthcare practice and health outcomes: a systematic review.

Carol Davy, Jonathan Bleasel, Hueiming Liu, Maria Tchan, Sharon Ponniah, Alex Brown

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC health services research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 128 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
128citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

128 citing papers in PubMed, 10 syntheses or guidelines pooled it.

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68 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Carol DavySouth Australian Health & Medical Research Institute, Adelaide, South Australia, Australia. carol.davy@sahmri.com.
Jonathan BleaselThe George Institute for Global Health, Camperdown, New South Wales, Australia. jmbleasel@gmail.com.
Hueiming LiuThe George Institute for Global Health, Camperdown, New South Wales, Australia. hliu@georgeinstitute.org.au.
Maria TchanThe George Institute for Global Health, Camperdown, New South Wales, Australia. mtchan@georgeinstitute.org.au.
Sharon PonniahThe George Institute for Global Health, Camperdown, New South Wales, Australia. sponniah@georgeinstitute.org.au.
Alex BrownSouth Australian Health & Medical Research Institute, Adelaide, South Australia, Australia. alex.brown@sahmri.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe increasing prevalence of chronic disease and even multiple chronic diseases faced by both developed and developing countries is of considerable concern. Many of the interventions to address this within primary healthcare settings are based on a chronic care model first developed by MacColl Institute for Healthcare Innovation at Group Health Cooperative.

methodsThis systematic literature review aimed to identify and synthesise international evidence on the effectiveness of elements that have been included in a chronic care model for improving healthcare practices and health outcomes within primary healthcare settings. The review broadens the work of other similar reviews by focusing on effectiveness of healthcare practice as well as health outcomes associated with implementing a chronic care model. In addition, relevant case series and case studies were also included.

resultsOf the 77 papers which met the inclusion criteria, all but two reported improvements to healthcare practice or health outcomes for people living with chronic disease. While the most commonly used elements of a chronic care model were self-management support and delivery system design, there were considerable variations between studies regarding what combination of elements were included as well as the way in which chronic care model elements were implemented. This meant that it was impossible to clearly identify any optimal combination of chronic care model elements that led to the reported improvements.

conclusionsWhile the main argument for excluding papers reporting case studies and case series in systematic literature reviews is that they are not of sufficient quality or generalizability, we found that they provided a more detailed account of how various chronic care models were developed and implemented. In particular, these papers suggested that several factors including supporting reflective healthcare practice, sending clear messages about the importance of chronic disease care and ensuring that leaders support the implementation and sustainability of interventions may have been just as important as a chronic care model's elements in contributing to the improvements in healthcare practice or health outcomes for people living with chronic disease.

Indexed as

Models, OrganizationalQuality Assurance, Health CareQuality ImprovementTreatment OutcomeChronic DiseaseDelivery of Health CareDeveloping CountriesHumansLong-Term CarePrimary Health CareSelf Care

Identifiers

PMID25958128
PMCPMC4448852

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.