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An overview of chronic disease models: a systematic literature review
1. ashish.joshi@unmc.edu.
Insights
This study reviewed chronic disease models for managing diabetes, COPD, and CVD. The Chronic Care Model was most studied, but many elements require further research for broader application.
Area of Science:
- Public Health
- Health Services Research
- Chronic Disease Management
Background:
- Chronic diseases like diabetes, COPD, and CVD pose significant public health challenges.
- Effective management strategies and models are crucial for improving patient outcomes and reducing healthcare burdens.
Purpose of the Study:
- To systematically examine existing chronic disease models.
- To analyze the components and application of these models in managing diabetes, COPD, and cardiovascular diseases.
Main Methods:
- A comprehensive literature search was conducted using PubMed and CINAHAL databases.
- Keywords included "Chronic Disease Model" combined with "Diabetes Mellitus," "COPD," or "CVD."
- The search covered publications from January 2003 to March 2011.
Main Results:
- Twenty-three studies were included, primarily from the US.
- Five models were identified: Chronic Care Model (CCM), Improving Chronic Illness Care (ICIC), Innovative Care for Chronic Conditions (ICCC), Stanford Model (SM), and Community based Transition Model (CBTM).
- CCM was the most frequently studied model, with delivery system design and self-management support being the most examined elements.
Conclusions:
- Many elements of chronic disease models, such as patient-centered care and community policies, were understudied.
- The applicability of current models across diverse populations and geographical settings remains unclear.
- Future research should focus on testing models in diverse settings and addressing barriers like transportation and finances.
Aims:
The objective of our study was to examine various existing chronic disease models, their elements and their role in the management of Diabetes, Chronic Obstructive Pulmonary Disease (COPD), and Cardiovascular diseases (CVD).
Methods:
A literature search was performed using PubMed and CINHAL during a period of January 2003- March 2011. Following key terms were used either in single or in combination such as "Chronic Disease Model" AND "Diabetes Mellitus" OR "COPD" OR "CVD".
Results:
A total of 23 studies were included in the final analysis. Majority of the studies were US-based. Five chronic disease models included Chronic Care Model (CCM), Improving Chronic Illness Care (ICIC), and Innovative Care for Chronic Conditions (ICCC), Stanford Model (SM) and Community based Transition Model (CBTM). CCM was the most studied model. Elements studied included delivery system design and self-management support (87%), clinical information system and decision support (57%) and health system organization (52%). Elements including center care on the patient and family (13%), patient safety (4%), community policies (4%), built integrated health care (4%) and remote patient monitoring (4%) have not been well studied. Other elements including support paradigm shift, manage political environment, align sectoral policies for health, use healthcare personnel more effectively, support patients in their communities, emphasize prevention, identify patient specific concerns related to the transition process, and health literacy between visits and treatments have also not been well studied in the existing literature.
Conclusions:
It was unclear to what extent the results generated is applicable to different populations and locations and therefore is an area of future research. Future studies are also needed to test chronic disease models in settings where more racially and ethnically representative patients receive chronic care. Future program development should also include information on other barriers including transportation issues, finances and lack of services.
