Effectiveness, cost effectiveness, acceptability and implementation barriers/enablers of chronic kidney disease management programs for Indigenous people in Australia, New Zealand and Canada: a systematic review of mixed evidence
| Autor: | Rachel Reilly, Judith Streak Gomersall, Alan Cass, Rebekah O'Shea, Micah D J Peters, Alex Brown, Gillian Gorham, Katharine Evans, Steven Warren |
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| Přispěvatelé: | Reilly, Rachel, Evans, Katharine, Gomersall, Judith, Gorham, Gillian, Peters, Micah DJ, Warren, Steven, O'Shea, Rebekah, Cass, Alan, Brown, Alex |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Canada Health Knowledge Attitudes Practice Cost effectiveness Cost-Benefit Analysis 030232 urology & nephrology Health Promotion Health informatics Indigenous Health Services Accessibility Health administration 03 medical and health sciences 0302 clinical medicine Nursing Population Groups systematic review Renal Dialysis Chronic kidney disease chronic disease management Medicine Health Services Indigenous Humans 030212 general & internal medicine Disease management (health) Program Development Renal Insufficiency Chronic Qualitative Research Primary Health Care Indigenous health business.industry Health Policy Nursing research Public health Australia Disease Management Patient Acceptance of Health Care 3. Good health Health promotion Family medicine Chronic Disease Disease Progression Quality of Life business chronic kidney disease Research Article New Zealand |
| Zdroj: | BMC Health Services Research |
| Popis: | Background: Indigenous peoples in Australia, New Zealand and Canada carry a greater burden of chronic kidney disease (CKD) than the general populations in each country, and this burden is predicted to increase. Given the human and economic cost of dialysis, understanding how to better manage CKD at earlier stages of disease progression is an important priority for practitioners and policy-makers. A systematic review of mixed evidence was undertaken to examine the evidence relating to the effectivness, cost-effectiveness and acceptability of chronic kidney disease management programs designed for Indigenous people, as well as barriers and enablers of implementation of such programs. Methods: Published and unpublished studies reporting quantitative and qualitative data on health sector-led management programs and models of care explicitly designed to manage, slow progression or otherwise improve the lives of Indigenous people with CKD published between 2000 and 2014 were considered for inclusion. Data on clinical effectiveness, ability to self-manage, quality of life, acceptability, cost and cost-benefit, barriers and enablers of implementation were of interest. Quantitative data was summarized in narrative and tabular form and qualitative data was synthesized using the Joanna Briggs Institute meta-aggregation approach. Results: Ten studies were included. Six studies provided evidence of clinical effectiveness of CKD programs designed for Indigenous people, two provided evidence of cost and cost-effectiveness of a CKD program, and two provided qualitative evidence of barriers and enablers of implementation of effective and/or acceptable CKD management programs. Common features of effective and acceptable programs were integration within existing services, nurse-led care, intensive follow-up, provision of culturally-appropriate education, governance structures supporting community ownership, robust clinical systems supporting communication and a central role for Indigenous Health Workers. Conclusions: Given the human cost of dialysis and the growing population of people living with CKD, there is an urgent need to draw lessons from the available evidence from this and other sources, including studies in the broader population, to better serve this population with programs that address the barriers to receiving high-quality care and improve quality of life. Refereed/Peer-reviewed |
| Databáze: | OpenAIRE |
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