Title |
Case management and self-management support for frequent users with chronic disease in primary care: a pragmatic randomized controlled trial
|
---|---|
Published in |
BMC Health Services Research, February 2013
|
DOI | 10.1186/1472-6963-13-49 |
Pubmed ID | |
Authors |
Maud-Christine Chouinard, Catherine Hudon, Marie-France Dubois, Pasquale Roberge, Christine Loignon, Éric Tchouaket, Martin Fortin, Éva-Marjorie Couture, Maxime Sasseville |
Abstract |
Chronic diseases represent a major challenge for health care and social services. A number of people with chronic diseases require more services due to characteristics that increase their vulnerability. Given the burden of increasingly vulnerable patients on primary care, a pragmatic intervention in four Family Medicine Groups (primary care practices in Quebec, Canada) has been proposed for individuals with chronic diseases (diabetes, cardiovascular diseases, respiratory diseases, musculoskeletal diseases and/or chronic pain) who are frequent users of hospital services. The intervention combines case management by a nurse with group support meetings encouraging self-management based on the Stanford Chronic Disease Self-Management Program. The goals of this study are to: (1) analyze the implementation of the intervention in the participating practices in order to determine how the various contexts have influenced the implementation and the observed effects; (2) evaluate the proximal (self-efficacy, self-management, health habits, activation and psychological distress) and intermediate (empowerment, quality of life and health care use) effects of the intervention on patients; (3) conduct an economic analysis of the efficiency and cost-effectiveness of the intervention. |
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