IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0190852.html
   My bibliography  Save this article

Does the chronic care model meet the emerging needs of people living with multimorbidity? A systematic review and thematic synthesis

Author

Listed:
  • Kasey R Boehmer
  • Abd Moain Abu Dabrh
  • Michael R Gionfriddo
  • Patricia Erwin
  • Victor M Montori

Abstract

Background: The Chronic Care Model (CCM) emerged in the 1990s as an approach to re-organize primary care and implement critical elements that enable it to proactively attend to patients with chronic conditions. The chronic care landscape has evolved further, as most patients now present with multiple chronic conditions and increasing psychosocial complexity. These patients face accumulating and overwhelming complexity resulting from the sum of uncoordinated responses to each of their problems. Minimally Disruptive Medicine (MDM) was proposed to respond to this challenge, aiming at improving outcomes that matter to patients with the smallest burden of treatment. We sought to critically appraise the extent to which MDM constructs (e.g., reducing patient work, improving patients’ capacity) have been adopted within CCM implementations. Methods: We conducted a systematic review and qualitative thematic synthesis of reports of CCM implementations published from 2011–2016. Results: CCM implementations were mostly aligned with the healthcare system’s goals, condition-specific, and targeted disease-specific outcomes or healthcare utilization. No CCM implementation addressed patient work. Few reduced treatment workload without adding additional tasks. Implementations supported patient capacity by offering information, but rarely offered practical resources (e.g., financial assistance, transportation), helped patients reframe their biography with chronic illness, or assisted them in engaging with a supportive social network. Few implementations aimed at improving functional status or quality of life, and only one-third of studies were targeted for patients of low socioeconomic status. Conclusion: MDM provides a lens to operationalize how to care for patients with multiple chronic conditions, but its constructs remain mostly absent from how implementations of the CCM are currently reported. Improvements to the primary care of patients with multimorbidity may benefit from the application of MDM, and the current CCM implementations that do apply MDM constructs should be considered exemplars for future implementation work.

Suggested Citation

  • Kasey R Boehmer & Abd Moain Abu Dabrh & Michael R Gionfriddo & Patricia Erwin & Victor M Montori, 2018. "Does the chronic care model meet the emerging needs of people living with multimorbidity? A systematic review and thematic synthesis," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-17, February.
  • Handle: RePEc:plo:pone00:0190852
    DOI: 10.1371/journal.pone.0190852
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0190852
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0190852&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0190852?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Thompson-Lastad, Ariana & Rubin, Sara, 2020. "A crack in the wall: Chronic pain management in integrative group medical visits," Social Science & Medicine, Elsevier, vol. 258(C).
    2. Lena H. A. Raaijmakers & Tjard R. Schermer & Mandy Wijnen & Hester E. van Bommel & Leslie Michielsen & Floris Boone & Jan H. Vercoulen & Erik W. M. A. Bischoff, 2023. "Development of a Person-Centred Integrated Care Approach for Chronic Disease Management in Dutch Primary Care: A Mixed-Method Study," IJERPH, MDPI, vol. 20(5), pages 1-27, February.
    3. Amy-Louise Byrne & Clare Harvey & Diane Chamberlain & Adele Baldwin & Brody Heritage & Elspeth Wood, 2020. "Evaluation of a nursing and midwifery exchange between rural and metropolitan hospitals: A mixed methods study," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-22, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0190852. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.