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Case management in primary care among frequent users of healthcare services with chronic conditions : protocol of a realist synthesis

Hudon Catherine, Chouinard Maud-Christine, Aubrey-Bassier Kris, Muhajarine Nazeem, Burge Fred, Pluye Pierre, Bush Paula L., Ramsden Vivan R., Legare France, Guenette Line, Morin Paul, Lambert Mireille, Groulx Antoine, Couture Martine, Campbell Cameron, Baker Margaret, Edwards Lynn, Sabourin Véronique, Spence Claude, Gauthier Gilles, Warren Mike, Godbout Julie, Davis Breanna et Rabbitskin Norma. (2017). Case management in primary care among frequent users of healthcare services with chronic conditions : protocol of a realist synthesis. BMJ Open, 7, (9), e017701.

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URL officielle: http://dx.doi.org/10.1136/bmjopen-2017-017701

Résumé

Introduction : A common reason for frequent use of healthcare services is the complex healthcare needs of individuals suffering from multiple chronic conditions, especially in combination with mental health comorbidities and/or social vulnerability. Frequent users (FUs) of healthcare services are more at risk for disability, loss of quality of life and mortality. Case management (CM) is a promising intervention to improve care integration for FU and to reduce healthcare costs. This review aims to develop a middle-range theory explaining how CM in primary care improves outcomes among FU with chronic conditions, for what types of FU and in what circumstances.

Methods and analysis : A realist synthesis (RS) will be conducted between March 2017 and March 2018 to explore the causal mechanisms that underlie CM and how contextual factors influence the link between these causal mechanisms and outcomes. According to RS methodology, five steps will be followed: (1) focusing the scope of the RS; (2) searching for the evidence; (3) appraising the quality of evidence; (4) extracting the data; and (5) synthesising the evidence. Patterns in context–mechanism–outcomes (CMOs) configurations will be identified, within and across identified studies. Analysis of CMO configurations will help confirm, refute, modify or add to the components of our initial rough theory and ultimately produce a refined theory explaining how and why CM interventions in primary care works, in which contexts and for which FU with chronic conditions.

Ethics and dissemination : Research ethics is not required for this review, but publication guidelines on RS will be followed. Based on the review findings, we will develop and disseminate messages tailored to various relevant stakeholder groups. These messages will allow the development of material that provides guidance on the design and the implementation of CM in health organisations.

Type de document:Article publié dans une revue avec comité d'évaluation
Volume:7
Numéro:9
Pages:e017701
Version évaluée par les pairs:Oui
Date:2017
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:case management, chronic conditions, frequent users, interventions, gestion de cas, maladies chroniques, problèmes chroniques, usagers fréquents, grands utilisateurs
Déposé le:24 oct. 2017 00:37
Dernière modification:24 oct. 2017 00:37
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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.

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