LiveZilla Live Chat Software

Constellation, le dépôt institutionnel de l'Université du Québec à Chicoutimi

Case management and self-management support for frequent users with chronic disease in primary care : a pragmatic randomized controlled trial

Chouinard Maud-Christine, Hudon Catherine, Dudois Marie-France, Roberge Pascale, Loignon Christine, Tchouaket Éric, Fortin Martin, Couture Éva-Marjorie et Sasseville Maxime. (2013). Case management and self-management support for frequent users with chronic disease in primary care : a pragmatic randomized controlled trial. BMC Health Services Research, 13, (49), p. 1-13.

[img]
Prévisualisation
PDF - Version publiée
Disponible sous licence Creative Commons Attribution.

794kB

URL officielle: http://www.biomedcentral.com/1472-6963/13/49

Résumé

Background

Chronic diseases represent a major challenge for health care and social services. A number of people with chronic diseases require more services due to characteristics that increase their vulnerability. Given the burden of increasingly vulnerable patients on primary care, a pragmatic intervention in four Family Medicine Groups (primary care practices in Quebec, Canada) has been proposed for individuals with chronic diseases (diabetes, cardiovascular diseases, respiratory diseases, musculoskeletal diseases and/or chronic pain) who are frequent users of hospital services. The intervention combines case management by a nurse with group support meetings encouraging self-management based on the Stanford Chronic Disease Self-Management Program. The goals of this study are to: (1) analyze the implementation of the intervention in the participating practices in order to determine how the various contexts have influenced the implementation and the observed effects; (2) evaluate the proximal (self-efficacy, self-management, health habits, activation and psychological distress) and intermediate (empowerment, quality of life and health care use) effects of the intervention on patients; (3) conduct an economic analysis of the efficiency and cost-effectiveness of the intervention.

Methods/Design

The analysis of the implementation will be conducted using realistic evaluation and participatory approaches within four categories of stakeholders (Family Medicine Group and health centre management, Family Medicine Group practitioners, patients and their families, health centre or community partners). The data will be obtained through individual and group interviews, project documentation reviews and by documenting the intervention. Evaluation of the effects on patients will be based on a pragmatic randomized before-after experimental design with a delayed intervention control group (six months). Economic analysis will include cost-effectiveness and cost-benefit analysis.

Discussion

The integration of a case management intervention delivered by nurses and self-management group support into primary care practices has the potential to positively impact patient empowerment and quality of life and hopefully reduce the burden on health care. Decision-makers, managers and health care professionals will be aware of the factors to consider in promoting the implementation of this intervention into other primary care practices in the region and elsewhere.

Type de document:Article publié dans une revue avec comité d'évaluation
Volume:13
Numéro:49
Pages:p. 1-13
Version évaluée par les pairs:Oui
Date:2013
Sujets:Sciences de la santé
Sciences de la santé > Sciences infirmières
Sciences de la santé > Sciences médicales
Département, module, service et unité de recherche:Départements et modules > Département des sciences de la santé > Module des sciences infirmières
Mots-clés:Maladie chronique, soins primaires, groupe de médecine familiale, usagers fréquents, gestion de cas, autogestion, soins infirmiers primaires, chronic diseases, primary care, frequent users, case management, self-management, primary care nursing, services integration, Family Medicine Group
Déposé le:09 déc. 2015 23:50
Dernière modification:25 nov. 2016 18:21
Afficher les statistiques de telechargements

Éditer le document (administrateurs uniquement)

Creative Commons LicenseSauf indication contraire, les documents archivés dans Constellation sont rendus disponibles selon les termes de la licence Creative Commons "Paternité, pas d'utilisation commerciale, pas de modification" 2.5 Canada.

Bibliothèque Paul-Émile-Boulet, UQAC
555, boulevard de l'Université
Chicoutimi (Québec)  CANADA G7H 2B1
418 545-5011, poste 5630