[Redefining primary care: CARABELA-PC recomendations for the management of prevalent chronic diseases]

The CARABELA-AP initiative aims to optimize the comprehensive management of prevalent chronic diseases (PCDs), such as asthma, diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, and heart failure, within the Primary Care (PC) setting in Spain.

The CARABELA methodology is structured into four phases: (1) characterization of the care process and development of quality indicators; (2) validation of results in pilot centers and identification of areas for improvement and potential solutions; (3) prioritization of improvement areas/solutions and consensus on indicators in a national meeting using the Delphi methodology; and (4) dissemination of results and implementation in other healthcare centers through the development of a guide to optimize and coordinate PCD management.

The analysis conducted in 104 pilot centers allowed for the characterization and standardization of the care process for the five PCDs, from diagnosis to follow-up. Additionally, 21 areas for improvement and 37 key solutions were identified and prioritized based on their impact and ease of implementation. Among the 35 quality indicators developed, 33 were validated.

CARABELA-AP proposes the groundwork for transforming the PC care model by strengthening multidisciplinary coordination and promoting a more efficient and sustainable management of PCDs. The structured implementation of key solutions and identified areas for improvement supports a comprehensive approach that ensures continuity of care and equitable access to treatment for these conditions. Additionally, the developed framework enables the adaptation of strategies to the local needs of the healthcare centers and facilitates ongoing monitoring of their impact through quality care indicators.