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Person-Centered Models for Cardiovascular Care: A Review of the Evidence: A Scientific Statement From the American
Insights
Person-centered care models for cardiovascular disease are emerging but require more evidence. Current models vary in approach, hindering optimal adoption and patient outcomes in complex chronic conditions.
Area of Science:
- Cardiology
- Health Services Research
- Patient-Centered Care
Background:
- Cardiovascular disease (CVD) is a leading cause of death globally, with increasing prevalence of multimorbidity.
- Existing clinical guidelines often fail to address complex health systems and diverse patient contexts.
- This leads to challenges in symptom management and health behavior support, impacting patient outcomes, especially in high-risk groups.
Purpose of the Study:
- To describe characteristics and outcomes of existing person-centered care delivery models for cardiovascular conditions.
- To evaluate the effectiveness of models incorporating patient perspectives and evidence-based guidelines.
- To identify gaps in current care delivery for chronic cardiovascular conditions.
Main Methods:
- A scoping review was conducted using multiple databases (Ovid MEDLINE, Embase, Web of Science, CINAHL, Cochrane) and ClinicalTrials.gov.
- Searched for studies published between 2010 and 2022 evaluating care delivery models for cardiovascular conditions.
- Included studies systematically evaluated models using evidence-based guidelines, decision support, and patient input.
Main Results:
- Significant variation exists in methodological approaches, outcome measures, and care processes across reviewed models.
- Models demonstrated differences in how they incorporated patient perspectives and evidence-based guidelines.
- No single optimal care delivery model emerged as universally superior.
Conclusions:
- Evidence supporting specific person-centered care delivery models for cardiovascular conditions remains limited.
- Inconsistencies in approaches, reimbursement variations, and health system limitations hinder effective implementation.
- Further research is needed to refine and validate models that address the complexities of chronic cardiovascular conditions and patient needs.
Abstract:
Cardiovascular disease remains the leading cause of death and disability in the United States and globally. Disease burden continues to escalate despite technological advances associated with improved life expectancy and quality of life. As a result, longer life is associated with multiple chronic cardiovascular conditions. Clinical guidelines provide recommendations without considering prevalent scenarios of multimorbidity and health system complexities that affect practical adoption. The diversity of personal preferences, cultures, and lifestyles that make up one's social and environmental context is often overlooked in ongoing care planning for symptom management and health behavior support, hindering adoption and compromising patient outcomes, particularly in groups at high risk. The purpose of this scientific statement was to describe the characteristics and reported outcomes in existing person-centered care delivery models for selected cardiovascular conditions. We conducted a scoping review using Ovid MEDLINE, Embase.com, Web of Science, CINAHL Complete, Cochrane Central Register of Controlled Trials through Ovid, and ClinicalTrials.gov from 2010 to 2022. A range of study designs with a defined aim to systematically evaluate care delivery models for selected cardiovascular conditions were included. Models were selected on the basis of their stated use of evidence-based guidelines, clinical decision support tools, systematic evaluation processes, and inclusion of the patient's perspective in defining the plan of care. Findings reflected variation in methodological approach, outcome measures, and care processes used across models. Evidence to support optimal care delivery models remains limited by inconsistencies in approach, variation in reimbursement, and inability of health systems to meet the needs of patients with chronic, complex cardiovascular conditions.
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