Effectiveness of care models for chronic disease management: A scoping review of systematic reviews

Abstract

ObjectiveTo conduct a scoping review of models of care for chronic disease management to identify potentially effective components for management of chronic traumatic brain injury (TBI).MethodsInformation sources: Systematic searches of three databases (Ovid MEDLINE, Embase, and Cochrane Database of Systematic Reviews) from January 2010 to May 2021. Eligibility criteria: Systematic reviews and meta‐analyses reporting on the effectiveness of the Chronic Care Model (CCM), collaborative/integrated care, and other chronic disease management models. Data: Target diseases, model components used (n = 11), and six outcomes (disease‐specific, generic health‐related quality of life and functioning, adherence, health knowledge, patient satisfaction, and cost/health care use). Synthesis: Narrative synthesis, including proportion of reviews documenting outcome benefits.ResultsMore than half (55%) of the 186 eligible reviews focused on collaborative/integrated care models, with 25% focusing on CCM and 20% focusing on other chronic disease management models. The most common health conditions were diabetes (n = 22), depression (n = 16), heart disease (n = 12), aging (n = 11), and kidney disease (n = 8). Other single medical conditions were the focus of 22 reviews, multiple medical conditions of 59 reviews, and other or mixed mental health/behavioral conditions of 20 reviews. Some type of quality rating for individual studies was conducted in 126 (68%) of the reviews. Of reviews that assessed particular outcomes, 80% reported disease‐specific benefits, and 57% to 72% reported benefits for the other five types of outcomes. Outcomes did not differ by the model category, number or type of components, or target disease.ConclusionsAlthough there is a paucity of evidence for TBI per se, care model components proven effective for other chronic diseases may be adaptable for chronic TBI care.

Cancer-related lymphedema

“…Cancer-related lymphedema is an incurable disease requiring sustained patient support and adherence to a chronic disease management model. 24 The criterion standard of lymphedema management is decongestive lymphatic therapy, [25][26][27] which aims to educate patients about the condition; decrease affected limb volume and fibrosis; optimize functional status; address body image concerns and improve quality of life; and promote patient engagement and self-management.…”

Le lymphœdème lié au cancer

“…Le lymphoedème lié au cancer est une maladie incurable qui exige un soutien continu envers le patient et l'adhésion à un modèle de gestion des maladies chroniques 24 . La règle d'or de la prise en charge du lymphoedème est une thérapie lymphatique décongestive [25][26][27] , qui vise à éduquer les patients à propos de cette condition; à réduire le volume et la fibrose du membre affecté; à optimiser l'état fonctionnel; à aborder les préoccupations entourant l'image corporelle et à améliorer la qualité de vie; de même qu'à favoriser l'engagement du patient et son autogestion.…”

Patient-centered care in diabetes care-concepts, relationships and practice

“…A recent report revealed that only three out of five examined PCC factors ( i.e. , communication, emotional support, and goal setting) were correlated with increased patient satisfaction among individuals with schizophrenia[ 26 ], but those PCC elements still constitute a paucity of evidence for traumatic brain injury[ 27 ]. Hence, discussing which PCC elements are critical for diabetes care is highly important.…”