Effectiveness of a community care management program for multimorbid elderly patients with heart failure in the Veneto Region

Tiozzo, Silvia Netti; Basso, Cristina; Capodaglio, Giulia; Schievano, Elena; Dotto, M Del; Avossa, Francesco; Fedeli, Ugo; Corti, Maria Chiara

doi:10.1007/s40520-018-1102-y

Cited by 10 publications

(32 citation statements)

References 22 publications

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“…Across studies there was a total of n = 3803 participants, including patients, informal carers and family members. Studies were mostly conducted in the USA ( n = 13) [ 29 , 40 , 42 , 44 , 54 , 55 , 59 , 61 , 65 , 67 – 69 , 72 ], Australia ( n = 11) [ 26 – 28 , 30 , 34 , 36 , 41 , 52 , 57 , 63 , 66 ], UK ( n = 7) [ 31 , 39 , 46 – 48 , 53 , 60 ], Sweden ( n = 4) [ 38 , 49 – 51 ], Canada ( n = 3) [ 32 , 35 , 45 ] and The Netherlands ( n = 2) [ 9 , 64 ] with one study undertaken each in Belgium [ 62 ], Italy [ 71 ], France [ 33 ], New Zealand [ 43 ], Norway [ 58 ], Qatar [ 56 ] and, Spain [ 70 ], and one study conducted across multiple European countries [ 37 ]. Key characteristics of included studies are outlined in Additional file 3 .…”

Section: Resultsmentioning

confidence: 99%

“…Limitations for the single randomized-controlled trial was the low response rate of < 50% and that the randomization was inadequately described in the report [ 72 ]. Common limitations for quantitative non-randomized studies (one cross-sectional and one cohort study) were a lack of accountability of confounders [ 70 , 71 ]. Limitations for quantitative descriptive studies ( n = 3 surveys) included the sample not representing the target population [ 66 – 68 ], and that the risk of nonresponse bias was high [ 66 – 68 ].…”

Section: Resultsmentioning

confidence: 99%

“…A key limitation was the narrow inclusion criteria, which restricted studies to those that reported on patient views; however, those reporting only the views of family, friends and carers were omitted which could overlook vital viewpoints on IPCP. Another key limitation was the overall relative low quality of studies, and the inclusion of studies that did not have the patient experience as a primary aim but had apparently been included as an ‘afterthought’ [ 40 , 65 , 71 ]. Additionally, there is potential for positive publication bias of the included original research studies.…”

Section: Discussionmentioning

confidence: 99%

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What do patients experience? Interprofessional collaborative practice for chronic conditions in primary care: an integrative review

et al. 2022

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Background Improving the patient experience is one of the quadruple aims of healthcare. Therefore, understanding patient experiences and perceptions of healthcare interactions is paramount to quality improvement. This integrative review aimed to explore how patients with chronic conditions experience Interprofessional Collaborative Practice in primary care. Methods An integrative review was conducted to comprehensively synthesize primary studies that used qualitative, quantitative, and mixed methods. Databases searched were Medline, Embase, CINAHL and Web of Science on June 1st, 2021. Eligible studies were empirical full-text studies in primary care that reported experiences or perceptions of Interprofessional Collaborative Practice by adult patients with a chronic condition, in any language published in any year. Quality appraisal was conducted on included studies using the Mixed Method Appraisal Tool. Data on patients’ experiences and perceptions of Interprofessional Collaborative Practice in primary care were extracted, and findings were thematically analyzed through a meta-synthesis. Results Forty-eight (n = 48) studies met the inclusion criteria with a total of n = 3803 participants. Study quality of individual studies was limited by study design, incomplete reporting, and the potential for positive publication bias. Three themes and their sub-themes were developed inductively: (1) Interacting with Healthcare Teams, subthemes: widening the network, connecting with professionals, looking beyond the condition, and overcoming chronic condition collectively; (2) Valuing Convenient Healthcare, subthemes: sharing space and time, care planning creates structure, coordinating care, valuing the general practitioner role, and affording healthcare; (3) Engaging Self-care, subthemes: engaging passively is circumstantial, and, engaging actively and leading care. Conclusions Patients overwhelmingly had positive experiences of Interprofessional Collaborative Practice, signaling it is appropriate for chronic condition management in primary care. The patient role in managing their chronic condition was closely linked to their experience. Future studies should investigate how the patient role impacts the experience of patients, carers, and health professionals in this context. Systematic review registration PROSPERO: CRD42020156536.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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What do patients experience? Interprofessional collaborative practice for chronic conditions in primary care: an integrative review

et al. 2022

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“…The model, which has been validated in multiple European and non-European countries, is used to classify a regional population, providing several metrics that allow an accurate representation of the morbidity burden [17,18]. The ACG metrics and algorithms were used in this study to identify patients affected by specific pathologies [19][20][21]. The record-linkage was performed on previously anonymized records to protect the privacy of all individuals involved in the study.…”

Section: Study Design and Data Sourcementioning

confidence: 99%

Congestive heart failure and comorbidity as determinants of colorectal cancer perioperative outcomes

Basso¹,

Gennaro²,

Dotto³

et al. 2021

Updates Surg

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There has been an increase in surgical interventions in frailer elderly with concomitant chronic diseases. The purpose of this paper was to evaluate the impact of aging and comorbidities on outcomes in patients who underwent surgery for the treatment of colorectal cancer (CRC) in Veneto Region (Northeastern Italy). This is a retrospective cohort study in patients ≥ 40 years who underwent elective or urgent CRC surgical resection between January 2013 and December 2015. Independent variables included: age, sex, and comorbidities. We analyzed variables associated with the surgical procedure, such as stoma creation, hospitalization during the year before the index surgery, the surgical approach used, the American Society of Anesthesiologists (ASA) score, and the Charlson Comorbidity Index score. Eight thousand four hundred and forty-seven patients with CRC underwent surgical resection. Patient age affected both pre- and post-resection LOS as well as the overall survival (OS); however, it did not affect the 30-day readmission and reoperation rates. Multivariate analysis showed that age represented a risk factor for longer preoperative and postoperative LOS as well as for 30-day and 365-day mortality, but it was not associated with an increased risk of 30-day reoperation and 30-day readmission. Chronic Heart Failure increased the 30-day mortality risk by four times, the preoperative LOS by 51%, and the postoperative LOS by 33%. Chronic renal failure was associated with a 74% higher 30-day readmission rate. Advanced age and comorbidities require a careful preoperative evaluation and appropriate perioperative management to improve surgical outcomes in older patients undergoing elective or urgent CRC resection.

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“…Self-care is defined as individuals taking action by themselves to prevent disease, maintain and promote health and functioning, and manage chronic illnesses and disabilities [ 4 , 5 ]. Evidence suggests that people who adhere to self-care activities have a lower rate of health service utilization and lower health-care costs than those who cannot [ 6 , 7 ]. Self-care can also increase their life satisfaction [ 8 ], well-being [ 9 ], quality of life [ 10 ], and, most importantly, ability to age in place [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

A community-based health–social partnership program for community-dwelling older adults: a hybrid effectiveness–implementation pilot study

Wong

et al. 2022

BMC Geriatr

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Background A growing body of literature supports the efficacy of the health–social approach for the implementation of complex interventions to enhance self-care health management among community-dwelling older adults. However, there is little research on how interventions with this approach are implemented and disseminated in a real community setting. Methods This pilot study adopted an effectiveness–implementation hybrid design to 1) evaluate the effectiveness of a community-based Health–Social Partnership Program (HSPP) and 2) explore the reach, adoption, implementation, and maintenance of the HSPP in the community. Potential participants were recruited if they were aged 60 or above, owned a smartphone, and were cognitively competent. The participants received nurse-led case management with support from a social service team. Factors that hindered or facilitated the program delivery were examined to determine the implementation outcomes and sustained effects of the program. Data were collected at pre-intervention (T1), immediately post-intervention (T2), and 3 months post-intervention (T3). Results Ninety-two older adults joined and completed the program. The recruitment rate was 76.7%. A significant interaction effect was found for the mean self-efficacy scores from T1 to T2 (Wald χ2 = 12.28, p ≤ .001). Barriers to widespread program implementation included manpower shortage, lack of experienced staff, and unpredictable environment, whereas facilitators, as suggested by the older adults, providers, and community staff members, included regular communication between the research and service teams, recruitment of participants through community centers with the support of the research team, and seamless partnership among the health–social partnership team members. Strong implementation fidelity was achieved with zero attrition rate. Conclusion Most conventional randomized controlled trials investigating the effects of community-based programs have tended to control the contextual factors rather than incorporate the program in a real setting. This pilot study was the first to use a hybrid model to test the effectiveness and outcomes of HSPP implementation. The results imply that the program has a high potential sustainability in the real-life context. Trial registration This study was registered at clinicaltrials.gov (NCT04442867; date of first registration 23/06/2020).

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Effectiveness of a community care management program for multimorbid elderly patients with heart failure in the Veneto Region

Cited by 10 publications

References 22 publications

What do patients experience? Interprofessional collaborative practice for chronic conditions in primary care: an integrative review

What do patients experience? Interprofessional collaborative practice for chronic conditions in primary care: an integrative review

Congestive heart failure and comorbidity as determinants of colorectal cancer perioperative outcomes

A community-based health–social partnership program for community-dwelling older adults: a hybrid effectiveness–implementation pilot study

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