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Interventions to improve chronic illness care: evaluating their effectiveness.

Abstract

Three overlapping initiatives can be found in the effort to improve the management of chronic illness: the report card initiative, the disease management industry, and "Improving Chronic Illness Care." The third of these initiatives proposes the Chronic Care Model to assist provider organizations in chronic care improvement. The Chronic Care Model is made up of six major elements: community resources, the health care system surrounding the provider organization, patient self-management, decision support, delivery system redesign, and clinical information systems. Within these elements are a number of components, for example, clinical practice guidelines, reminder prompts, disease registries, provider feedback systems, primary care teams, planned chronic care visits, and case management. A literature review is provided to summarize the effectiveness of these Chronic Care Model components.

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BibTeXRIS

Thomas Bodenheimer. 2003. Interventions to improve chronic illness care: evaluating their effectiveness.. https://doi.org/10.1089/109350703321908441

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The long-term effect of multidisciplinary back training: a systematic review.

STUDY DESIGN: Systematic review of randomized controlled trials. OBJECTIVES: To determine the long-term effect of multidisciplinary back training on the work participation of patients with nonspecific chronic low back pain. SUMMARY OF BACKGROUND DATA: Chronic low back pain is influenced by multiple factors. Multidisciplinary back training represents one of the options to take this multiplicity into account. So far, only evidence of the short-term effectiveness of this approach in terms of work participation is available. METHODS: Electronic databases were searched and the references of various articles were screened for relevant publications. Ten studies met the inclusion criteria. All included studies were evaluated for their methodologic quality. RESULTS: Five of the studies had a low methodologic quality. All high-quality studies found a positive effect on at least one of the 4 outcome measures used. Based on our criteria, effectiveness was found for the outcome measures of work participation and quality of life. No effectiveness was found for experienced pain and functional status. The intensity of the intervention seems to have no substantial influence on the effectiveness of the intervention. CONCLUSION: In the long-term, multidisciplinary back training has a positive effect on work participation in patients with nonspecific chronic low back pain.

Chronic Disease↗