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Evaluating the integration of chronic disease prevention and management services into primary health care

Fortin Martin, Chouinard Maud-Christine, Bouhali Tarek, Dubois Marie-France, Gagnon Cynthia et Bélanger Martin. (2013). Evaluating the integration of chronic disease prevention and management services into primary health care. BMC Health Services Research, 13, (132), p. 1-13.

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URL officielle: http://www.biomedcentral.com/1472-6963/13/132

Résumé

Background

The increasing number of patients with chronic diseases represents a challenge for health care systems. The Chronic Care Model suggests a multi-component remodelling of chronic disease services to improve patient outcomes. To meet the complex and ongoing needs of patients, chronic disease prevention and management (CDPM) has been advocated as a key feature of primary care producing better outcomes, greater effectiveness and improved access to services compared to other sectors. The objective of this study is to evaluate the adaptation and implementation of an intervention involving the integration of chronic disease prevention and management (CDPM) services into primary health care.

Methods/Design

The implementation of the intervention will be evaluated using descriptive qualitative methods to collect data from various stakeholders (decision-makers, primary care professionals, CDPM professionals and patients) before, during and after the implementation. The evaluation of the effects will be based on a combination of experimental designs: a randomized trial using a delayed intervention arm (n = 326), a before-and-after design with repeated measures (n = 163), and a quasi-experimental design using a comparative cohort (n = 326). This evaluation will utilize self-report questionnaires measuring self-efficacy, empowerment, comorbidity, health behaviour, functional health status, quality of life, psychological well-being, patient characteristics and co-interventions. The study will take place in eight primary care practices of the Saguenay region of Quebec (Canada). To be included, patients will have to be referred by their primary care provider and present at least one of the following conditions (or their risk factors): diabetes, cardiovascular diseases, chronic obstructive pulmonary disease, asthma. Patients presenting serious cognitive problems will be excluded.

Discussion

In the short-term, improved patient self-efficacy and empowerment are expected. In the mid-term, we expect to observe an improvement in health behaviour, functional health status, quality of life and psychological well-being. At the organizational level, the project should lead to coordinated service delivery, improved patient follow-up mechanisms and enhanced interprofessional collaboration. Integration of CDPM services at the point of care in primary care practices is a promising innovation in care delivery that needs to be thoroughly evaluated.

Type de document:Article publié dans une revue avec comité d'évaluation
Volume:13
Numéro:132
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 et de la santé
Mots-clés:Maladie chronique, soins de santé primaire, chronic disease, primary health care
Déposé le:10 déc. 2015 00:42
Dernière modification:25 nov. 2016 18:36
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