Feasibility, acceptability and effectiveness of integrated care for COPD patients: a mixed methods evaluation of a pilot community-based programme

Abstract

The evaluation demonstrated the feasibility and acceptability of the programme and confirmed the relevance of mixed method process evaluation to adjust and improve programme implementation. The introduction of multidisciplinary teams in a context characterised by fragmentation of care was identified as the main challenge in the programme implementation and could not be achieved as expected. Despite this area for improvement, patients' feedback and early effectiveness results confirmed the benefits of COPD integrated care programmes emphasising self-management education.

Challenging collaboration of general practitioners and specialists for patients with complex chronic conditions: A scoping review to identify improvement strategies

“…Their level of involvement varied, but nurses engaged rather actively and performed patient assessments, developed and reviewed care plans, coached staff, took over patient education and shared responsibilities with GPs (19, 21, 22, 30-33, 35-39, 43, 44, 47, 49). Other HCPs with active roles included pharmacists, physiotherapists and community health workers who provided patient education on profession-speci c care (31)(32)(33)38). In a Canadian project, the research staff was engaged actively and performed pharmacological consultations and medication reviews (29).…”

“…Authors reported on the respective condition's burden on healthcare facilities or system resources such as high consultation rates (23,24,28) or costs (29)(30)(31)(32)(33)(34). Furthermore, projects presented that the health condition of interest is a leading cause of morbidity, hospitalizations and death (30)(31)(32)(33)(35)(36)(37)(38)(39)(40). The current organization of care and its coordination was often considered suboptimal or even outdated for the speci c health condition.…”

“…Of the 22 original projects, ve were located in the United States (19, 23, 24, 31-33, 35-37, 45, 46), four in Canada (21, 22, 29, 30, 42); two projects, respectively, were located in Australia (43, 44, 47), Brazil (41), Spain (28,48), Switzerland (26,27,38) and the Netherlands (20,49). One project was based in Germany (25), Italy (34) and New Zealand (39).…”

“…Eight projects applied a before-and-after design with outcome measurements pre and post intervention (19, 23, 24, 30-34, 41, 45), whereof three before-and-after designs further compared the intervention group to a control group (38,47,48). Additionally, three projects compared the intervention group to a control group, which was usual care (28,(42)(43)(44).…”

Integrating care between an NHS hospital, a community provider and the role of commissioning: the experience of developing an integrated respiratory service

“…Previous research in relation to integrated respiratory care has identified some promising results in terms of integration and admission avoidance [4][5][6] but in general the results have been mixed. [7][8][9] Despite the policy prioritisation associated with integrated care, research and evaluations have not produced clear evidence of effectiveness. 3 10-14 Studies have shown how tensions between the professional cultures of different organisations can impede integration.…”