The chronic care model and diabetes management in US primary care settings: a systematic review.
The chronic care model and diabetes management in US primary care settings: a systematic review.
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DOI：
10.5888/pcd10.120180
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发表时间：
2013
影响因子：
5.5
通讯作者：
Stopka C
中科院分区：
文献类型：
--
作者：
Stellefson M;Dipnarine K;Stopka C
慢性护理模式（CCM）采用系统方法重组医疗保健，在卫生系统和社区之间建立伙伴关系。本研究的目的是描述研究人员如何在美国初级保健机构中应用CCM为糖尿病患者提供护理，并描述CCM实施的结果。我们使用Cochrane系统综述数据库、CINAHL和Health数据库进行文献综述，来源：护理/学术版，搜索词：“慢性护理模式”（和）“糖尿病*”。我们纳入了1999年1月至2011年10月之间发表的文章。我们总结了16项研究CCM应用和健康结果的细节。这16项研究包括不同的研究设计，包括9个随机对照试验，和设置，包括学术附属的初级保健实践和私人实践。我们发现证据表明，CCM方法在美国初级保健机构管理糖尿病方面是有效的。卫生保健系统的组织领导发起了改善糖尿病护理协调的系统级重组。疾病登记和电子医疗记录用于建立以患者为中心的目标，监测患者的进展，并确定护理中的失误。培训初级保健医生（PCP）提供循证护理，以PCP为基础的糖尿病自我管理教育改善了患者的预后。只有7项研究描述了处理社区资源和政策的策略。CCM正在美国初级保健机构中用于糖尿病护理，并报道了积极的结果。未来关于将CCM整合到糖尿病管理的初级保健设置中的研究应测量糖尿病过程指标，如疾病管理和临床决策的自我效能。
The Chronic Care Model (CCM) uses a systematic approach to restructuring medical care to create partnerships between health systems and communities. The objective of this study was to describe how researchers have applied CCM in US primary care settings to provide care for people who have diabetes and to describe outcomes of CCM implementation. We conducted a literature review by using the Cochrane database of systematic reviews, CINAHL, and Health Source: Nursing/Academic Edition and the following search terms: “chronic care model” (and) “diabet*.” We included articles published between January 1999 and October 2011. We summarized details on CCM application and health outcomes for 16 studies. The 16 studies included various study designs, including 9 randomized controlled trials, and settings, including academic-affiliated primary care practices and private practices. We found evidence that CCM approaches have been effective in managing diabetes in US primary care settings. Organizational leaders in health care systems initiated system-level reorganizations that improved the coordination of diabetes care. Disease registries and electronic medical records were used to establish patient-centered goals, monitor patient progress, and identify lapses in care. Primary care physicians (PCPs) were trained to deliver evidence-based care, and PCP office–based diabetes self-management education improved patient outcomes. Only 7 studies described strategies for addressing community resources and policies. CCM is being used for diabetes care in US primary care settings, and positive outcomes have been reported. Future research on integration of CCM into primary care settings for diabetes management should measure diabetes process indicators, such as self-efficacy for disease management and clinical decision making.
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影响因子：
5.4
作者：
Lyles, Courtney Rees;Harris, Lynne T.;Ralston, James D.
通讯作者：
Ralston, James D.
影响因子：
16.2
作者：
通讯作者：
--
影响因子：
16.2
作者：
Piatt, GA;Orchard, TJ;Zgibor, JC
通讯作者：
Zgibor, JC
影响因子：
16.2
作者：
通讯作者：
--
影响因子：
3.9
作者：
Piatt, Gretchen A.;Anderson, Robert M.;Zgibor, Janice C.
通讯作者：
Zgibor, Janice C.