Benefits, implementation and sustainability of innovative paediatric models of care for children with type 1 diabetes: a systematic review.

Autor: Carrigan A; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, Sydney, Australia., Meulenbroeks I; Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia., Sarkies M; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, Sydney, Australia.; Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia., Dammery G; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, Sydney, Australia., Halim N; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, Sydney, Australia., Singh N; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, Sydney, Australia., Lake R; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, Sydney, Australia., Davis E; Telethon Kids Institute, Perth Children's Hospital, Western, Australia.; Perth Children's Hospital, Perth, Western, Australia., Jones TW; Telethon Kids Institute, Perth Children's Hospital, Western, Australia.; Perth Children's Hospital, Perth, Western, Australia., Braithwaite J; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, Sydney, Australia., Zurynski Y; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, Sydney, Australia. Yvonne.Zurynski@mq.edu.au.; Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia. Yvonne.Zurynski@mq.edu.au.
Jazyk: angličtina
Zdroj: BMC pediatrics [BMC Pediatr] 2024 Aug 05; Vol. 24 (1), pp. 502. Date of Electronic Publication: 2024 Aug 05.
DOI: 10.1186/s12887-024-04945-2
Abstrakt: Background and Aim: The evidence about the acceptability and effectiveness of innovative paediatric models of care for Type 1 diabetes is limited. To address this gap, we synthesised literature on implemented models of care, model components, outcomes, and determinants of implementation and sustainability.
Methods: A systematic review was conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Database searches of Medline, CINAHL, EMBASE and Scopus were conducted. Empirical studies focused on Type 1 diabetes paediatric models of care, published from 2010 to 2022 in English were included.
Results: Nineteen extant studies reported on models and their associations with health and psychosocial outcomes, patient engagement with healthcare, and healthcare costs. Thirteen studies described multidisciplinary teamwork, education and capacity building that supported self-care. Four studies involved shared decision making between providers and patients, and two discussed outreach support where technology was an enabler. Fourteen studies reported improvements in health outcomes (e.g. glycaemic control), mostly for models that included multidisciplinary teams, education, and capacity building (11 studies), outreach support or shared care (3 studies). Four studies reported improvements in quality of life, three reported increased satisfaction for patients and carers and, and one reported improved communication. Four of five studies describing shared care and decision-making reported improvements in quality of life, support and motivation. Outreach models reported no negative outcomes, however, accessing some models was limited by technological and cost barriers. Eight studies reported on model sustainability, but only half reported implementation determinants; none reported applying a theoretical framework to guide their research.
Conclusion: Some health and psychosocial benefits were associated with newer models. To address knowledge gaps about implementation determinants and model sustainability, longitudinal studies are needed to inform future adoption of innovative models of care for children with Type 1 diabetes.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: