Integrated care programmes for adults with chronic conditions: a meta-review.
Integrated care programmes for adults with chronic conditions: a meta-review.
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DOI：
10.1093/intqhc/mzu071
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发表时间：
2014-10
期刊：
影响因子：
--
通讯作者：
Egger M
中科院分区：
文献类型：
--
作者：
Martínez-González NA;Berchtold P;Ullman K;Busato A;Egger M
回顾对慢性病患者综合护理方案的系统评价和荟萃分析，重点放在方法质量、评估的综合要素和报告的效果上。对Medline(1946-2012年3月)、Embase(1980-2012年3月)、CINHAL(1981-2012年3月)和Cochrane系统评价图书馆(2012年第1期)确定的系统评价和元分析进行元审查。方法质量由11项多系统评价评估(AMSTAR)检查表评估；整合要素使用已公布的10项整合关键原则清单进行评估；对以患者为中心的结果、过程质量、医疗保健使用和成本的影响。确定了27项系统性评价；疾病包括慢性心力衰竭(CHF；12项综述)、糖尿病(DM；7项综述)、慢性阻塞性肺疾病(COPD；7项综述)和哮喘(5项综述)。符合AMSTAR核对表项目的中位数为5项：很少有评价者搜索未发表的文献或详细描述主要研究和干预措施。大多数审查涵盖了跨护理连续体或通过跨专业团队实现护理标准化的全面服务，但很少对组织文化、治理结构或财务管理进行评估。大多数综述发现一体化的有益效果，包括减少入院和再入院(CHF和DM)，改善对治疗指南(DM、COPD和哮喘)或生活质量(DM)的遵守。很少有评论显示成本有所下降。对综合护理方案的系统审查质量参差不齐，只评估了综合护理的某些组成部分，并显示出对某些结果的一致益处，而对其他结果则没有。
To review systematic reviews and meta-analyses of integrated care programmes in chronically ill patients, with a focus on methodological quality, elements of integration assessed and effects reported. Meta-review of systematic reviews and meta-analyses identified in Medline (1946–March 2012), Embase (1980–March 2012), CINHAL (1981–March 2012) and the Cochrane Library of Systematic Reviews (issue 1, 2012). Methodological quality assessed by the 11-item Assessment of Multiple Systematic Reviews (AMSTAR) checklist; elements of integration assessed using a published list of 10 key principles of integration; effects on patient-centred outcomes, process quality, use of healthcare and costs. Twenty-seven systematic reviews were identified; conditions included chronic heart failure (CHF; 12 reviews), diabetes mellitus (DM; seven reviews), chronic obstructive pulmonary disease (COPD; seven reviews) and asthma (five reviews). The median number of AMSTAR checklist items met was five: few reviewers searched for unpublished literature or described the primary studies and interventions in detail. Most reviews covered comprehensive services across the care continuum or standardization of care through inter-professional teams, but organizational culture, governance structure or financial management were rarely assessed. A majority of reviews found beneficial effects of integration, including reduced hospital admissions and re-admissions (in CHF and DM), improved adherence to treatment guidelines (DM, COPD and asthma) or quality of life (DM). Few reviews showed reductions in costs. Systematic reviews of integrated care programmes were of mixed quality, assessed only some components of integration of care, and showed consistent benefits for some outcomes but not others.
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影响因子：
2.9
作者：
Mitchell, Geoffrey K.;Brown, Robyn M.;Tieman, Jennifer J.
通讯作者：
Tieman, Jennifer J.
DOI：
10.1186/1748-5908-6-130
发表时间：
2011-12-20
期刊：
Implementation science : IS
影响因子：
--
作者：
Brouwers MC;Garcia K;Makarski J;Daraz L;Evidence Expert Panel;KT for Cancer Control in Canada Project Research Team
通讯作者：
KT for Cancer Control in Canada Project Research Team
影响因子：
120.7
作者：
Jüni, P;Witschi, A;Egger, M
通讯作者：
Egger, M
影响因子：
4.7
作者：
Higginson, IJ;Finlay, I;Norman, CE
通讯作者：
Norman, CE
影响因子：
3.7
作者：
Hemming K;Pinkney T;Futaba K;Pennant M;Morton DG;Lilford RJ
通讯作者：
Lilford RJ