Chronic-Care-Management Programs for Multimorbid Patients with Diabetes in Europe: A Scoping Review with the Aim to Identify the Best Practice

Overview

Journal J Diabetes Res

Publisher Wiley

Specialty Endocrinology

Date 2021 Nov 19

PMID 34796236

Citations 1

Authors

Julia Heike Brettel

Ulf Manuwald

Henriette Hornstein

Joachim Kugler

Ulrike Rothe

Affiliations

Soon will be listed here.

Abstract

Aim: This scoping review is aimed at providing a current descriptive overview of care programs based on the chronic care model (CCM) according to E. H. Wagner. The evaluation is carried out within Europe and assesses the methodology and comparability of the studies.

Methods: A systematic search in the databases PubMed, Embase, and MEDLINE via OVID was conducted. In the beginning, 2309 articles were found and 48 full texts were examined, 19 of which were incorporated. Included were CCM-based programs from Belgium, Cyprus, Germany, Italy, Switzerland, and the Netherlands. All 19 articles were presented descriptively whereof 11 articles were finally evaluated in a checklist by Rothe et al. (2020). In this paper, the studies were tabulated and evaluated conforming to the same criteria.

Results: Due to the complexity of the CCM and the heterogeneity of the studies in terms of setting and implementation, a direct comparison proved difficult. Nevertheless, the review shows that CCM was successfully implemented in various care situations and also can be useful in single practices, which often dominate the primary care sector in many European health systems. The present review was able to provide a comprehensive overview of the current care situation of chronically ill patients with multimorbidities.

Conclusions: A unified nomenclature concerning the distinction between disease management programs and CCM-based programs should be aimed for. Similarly, homogeneous quality standards and a Europe-wide evaluation strategy would be necessary to identify best practice models and to provide better care for the steadily growing number of chronically multimorbid patients.

Citing Articles

Effects of a Digital Patient Empowerment and Communication Tool on Metabolic Control in People With Type 2 Diabetes: The DeMpower Multicenter Ambispective Study.

Orozco-Beltran D, Morales C, Artola-Menendez S, Brotons C, Carrascosa S, Gonzalez C JMIR Diabetes. 2022; 7(4):e40377.

PMID: 36190763 PMC: 9577714. DOI: 10.2196/40377.

References

Profili F, Bellini I, Zuppiroli A, Seghieri G, Barbone F, Francesconi P . Changes in diabetes care introduced by a Chronic Care Model-based programme in Tuscany: a 4-year cohort study. Eur J Public Health. 2017; 27(1):14-19. DOI: 10.1093/eurpub/ckw181. View

Frei A, Senn O, Huber F, Vecellio M, Steurer J, Woitzek K . Congruency of diabetes care with the Chronic Care Model in different Swiss health care organisations from the patients' perspective: a cross sectional study. Swiss Med Wkly. 2014; 144:w13992. DOI: 10.4414/smw.2014.13992. View

Frei A, Chmiel C, Schlapfer H, Birnbaum B, Held U, Steurer J . The Chronic CARe for diAbeTes study (CARAT): a cluster randomized controlled trial. Cardiovasc Diabetol. 2010; 9:23. PMC: 2902433. DOI: 10.1186/1475-2840-9-23. View

Cramm J, Nieboer A . Short and long term improvements in quality of chronic care delivery predict program sustainability. Soc Sci Med. 2014; 101:148-54. DOI: 10.1016/j.socscimed.2013.11.035. View

Petersen J, Paulitsch M, Mergenthal K, Gensichen J, Hansen H, Weyerer S . Implementation of chronic illness care in German primary care practices--how do multimorbid older patients view routine care? A cross-sectional study using multilevel hierarchical modeling. BMC Health Serv Res. 2014; 14:336. PMC: 4132196. DOI: 10.1186/1472-6963-14-336. View

Arambewela M, Somasundaram N, Jayasekara H, Kumbukage M, Jayasena P, Chandrasekara C . Prevalence of Chronic Complications, Their Risk Factors, and the Cardiovascular Risk Factors among Patients with Type 2 Diabetes Attending the Diabetic Clinic at a Tertiary Care Hospital in Sri Lanka. J Diabetes Res. 2018; 2018:4504287. PMC: 5989171. DOI: 10.1155/2018/4504287. View

Sunaert P, Bastiaens H, Feyen L, Snauwaert B, Nobels F, Wens J . Implementation of a program for type 2 diabetes based on the Chronic Care Model in a hospital-centered health care system: "the Belgian experience". BMC Health Serv Res. 2009; 9:152. PMC: 2757022. DOI: 10.1186/1472-6963-9-152. View

Kostial C, Manuwald U, Schulze J, Kugler J, Rothe U . Disease-Management-Programs in the Field of Diabetes Mellitus with Identification of the Best Practice in Europe: A Scoping Review. Horm Metab Res. 2020; 52(3):149-157. DOI: 10.1055/a-1111-8998. View

Bonomi A, Wagner E, Glasgow R, VonKorff M . Assessment of chronic illness care (ACIC): a practical tool to measure quality improvement. Health Serv Res. 2002; 37(3):791-820. PMC: 1434662. DOI: 10.1111/1475-6773.00049. View

10.

Samoutis G, Soteriades E, Stoffers H, Philalithis A, Delicha E, Lionis C . A pilot quality improvement intervention in patients with diabetes and hypertension in primary care settings of Cyprus. Fam Pract. 2010; 27(3):263-70. DOI: 10.1093/fampra/cmq009. View

11.

Sunaert P, Bastiaens H, Nobels F, Feyen L, Verbeke G, Vermeire E . Effectiveness of the introduction of a Chronic Care Model-based program for type 2 diabetes in Belgium. BMC Health Serv Res. 2010; 10:207. PMC: 2912901. DOI: 10.1186/1472-6963-10-207. View

12.

Bowen J, Provost L, Stevens D, Johnson J, Woods D, Sixta C . Assessing Chronic Illness Care Education (ACIC-E): a tool for tracking educational re-design for improving chronic care education. J Gen Intern Med. 2010; 25 Suppl 4:S593-609. PMC: 2940447. DOI: 10.1007/s11606-010-1385-y. View

13.

Frei A, Senn O, Chmiel C, Reissner J, Held U, Rosemann T . Implementation of the chronic care model in small medical practices improves cardiovascular risk but not glycemic control. Diabetes Care. 2014; 37(4):1039-47. DOI: 10.2337/dc13-1429. View

14.

Palmer K, Marengoni A, Forjaz M, Jureviciene E, Laatikainen T, Mammarella F . Multimorbidity care model: Recommendations from the consensus meeting of the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS). Health Policy. 2017; 122(1):4-11. DOI: 10.1016/j.healthpol.2017.09.006. View

15.

Gerlach F, Beyer M, Saal K, Peitz M, Gensichen J . [New perspectives in the primary care of the chronically ill--against the "tyranny of the urgent". Part 2: The chronic care model und case management as the basis of a forward-looking approach to primary care]. Z Arztl Fortbild Qualitatssich. 2006; 100(5):345-52. View

16.

Chmiel C, Giewer I, Frei A, Rosemann T . Four-year long-term follow-up of diabetes patients after implementation of the Chronic Care Model in primary care: a cross-sectional study. Swiss Med Wkly. 2017; 147:w14522. DOI: 10.4414/smw.2017.14522. View

17.

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. Open Med. 2011; 3(3):e123-30. PMC: 3090117. View

18.

Glasgow R, Wagner E, Schaefer J, Mahoney L, Reid R, Greene S . Development and validation of the Patient Assessment of Chronic Illness Care (PACIC). Med Care. 2005; 43(5):436-44. DOI: 10.1097/01.mlr.0000160375.47920.8c. View

19.

Bodenheimer T, Wagner E, Grumbach K . Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA. 2002; 288(15):1909-14. DOI: 10.1001/jama.288.15.1909. View

20.

Zuercher E, Casillas A, Hagon-Traub I, Bordet J, Burnand B, Peytremann-Bridevaux I . Baseline data of a population-based cohort of patients with diabetes in Switzerland (CoDiab-VD). Swiss Med Wkly. 2014; 144:w13951. DOI: 10.4414/smw.2014.13951. View