Introduction of the chronic care model into an academic rheumatology clinic
| Autor: | Maureen D. Francis, S Redding, S Ranatunga, Mark L. Francis, Steven L. Scaife, S Myers |
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| Rok vydání: | 2010 |
| Předmět: |
Self-efficacy
Chronic care medicine.medical_specialty WOMAC business.industry Visual analogue scale Health Policy Specialty Context (language use) Models Theoretical Ambulatory Care Facilities Severity of Illness Index Self Efficacy Rheumatology Surveys and Questionnaires Chronic Disease Organizational Case Studies Osteoarthritis Severity of illness Physical therapy Humans Medicine Ceiling effect Illinois business |
| Zdroj: | BMJ Quality & Safety. 19:e48-e48 |
| ISSN: | 2044-5423 2044-5415 |
| DOI: | 10.1136/qshc.2009.035030 |
| Popis: | Background While the chronic care model has been extensively used for the management of patients with diabetes in non-academic, primary care settings, it is not clear whether this model can be used effectively in academic, specialty clinics for other chronic disorders. Methods Through the Academic Chronic Care Collaborative, the chronic care model was introduced to help manage patients with osteoarthritis in an academic rheumatology service with seven prespecified goals. These goals included measurements of Western Ontario MacMaster (WOMAC) osteoarthritis scores, self-efficacy scores and exercise time. Results Five a priori goals were achieved in this study: average WOMAC scores less than 1000 mm as measured on a visual analogue scale, average self-efficacy score of less than 5 mm, average exercise time greater than 90 min, more than 40% of patients exercising at least 60 min per week and a 20% improvement in self-efficacy scores. However, a 20% improvement in WOMAC scores and a 60% completion of documented self-management goals in our patients were not achieved. Our inability to achieve our self-management goal underscores the fact that we have not yet fully implemented the chronic care model into our practice. The inability to detect a 20% improvement in WOMAC scores in the context of having reached our absolute WOMAC goal at baseline suggests a probable ceiling effect for this measure. Conclusions The chronic care model can be effectively introduced into an academic specialty service and can be used effectively in the management of patients with non-diabetic disorders, in this case osteoarthritis. |
| Databáze: | OpenAIRE |
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