Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montréal: does greater coordination of care with primary care physicians have an impact on health outcomes?
Introduction: Chronic disease management requires substantial services integration. A cardiometabolic risk management program inspired by the Chronic Care Model was implemented in Montréal for patients with diabetes or hypertension. One of this study's objectives was to assess the impact of car...
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| Format: | Article |
| Language: | English |
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Public Health Agency of Canada
2017-04-01
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| Series: | Health Promotion and Chronic Disease Prevention in Canada |
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| Online Access: | https://www.canada.ca/en/public-health/services/reports-publications/health-promotion-chronic-disease-prevention-canada-research-policy-practice/vol-37-no-4-2017/implementation-integrated-primary-care-cardiometabolic-risk-prevention-management-network-montreal.html |
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| author | Sylvie Provost Raynald Pineault Dominique Grimard José Pérez Michel Fournier Yves Lévesque Johanne Desforges Pierre Tousignant Roxane Borgès Da Silva |
| author_facet | Sylvie Provost Raynald Pineault Dominique Grimard José Pérez Michel Fournier Yves Lévesque Johanne Desforges Pierre Tousignant Roxane Borgès Da Silva |
| author_sort | Sylvie Provost |
| collection | DOAJ |
| description | Introduction: Chronic disease management requires substantial services integration. A cardiometabolic risk management program inspired by the Chronic Care Model was implemented in Montréal for patients with diabetes or hypertension. One of this study's objectives was to assess the impact of care coordination between the interdisciplinary teams and physicians on patient participation in the program, lifestyle improvements and disease control. Methods: We obtained data on health outcomes from a register of clinical data, questionnaires completed by patients upon entry into the program and at the 12-month mark, and we drew information on the program's characteristics from the implementation analysis. We conducted multiple regression analyses, controlling for patient sociodemographic and health characteristics to measure the association between interdisciplinary team coordination with primary care physicians and various health outcomes. Results: A total of 1689 patients took part in the study (60.1% participation rate). Approximately 40% of patients withdrew from the program during the first year. At the 12-month follow-up (n = 992), we observed a significant increase in the proportion of patients achieving the various clinical targets. The perception by the interdisciplinary team of greater care coordination with primary care physicians was associated with increased participation in the program and the achievement of better clinical results. Conclusion: Greater coordination of patient services between interdisciplinary teams and primary care physicians translates into benefits for patients. |
| first_indexed | 2024-12-23T14:32:33Z |
| format | Article |
| id | doaj.art-bb6610e068d14f4fbe48f5595bb5ea81 |
| institution | Directory Open Access Journal |
| issn | 2368-738X |
| language | English |
| last_indexed | 2024-12-23T14:32:33Z |
| publishDate | 2017-04-01 |
| publisher | Public Health Agency of Canada |
| record_format | Article |
| series | Health Promotion and Chronic Disease Prevention in Canada |
| spelling | doaj.art-bb6610e068d14f4fbe48f5595bb5ea812022-12-21T17:43:27ZengPublic Health Agency of CanadaHealth Promotion and Chronic Disease Prevention in Canada2368-738X2017-04-0137410511310.24095/hpcdp.37.4.01stringImplementation of an integrated primary care cardiometabolic risk prevention and management network in Montréal: does greater coordination of care with primary care physicians have an impact on health outcomes?Sylvie Provost0Raynald Pineault1Dominique Grimard2José Pérez3Michel Fournier4Yves Lévesque5Johanne Desforges6Pierre Tousignant7Roxane Borgès Da Silva8Direction de santé publique du Centre intégré universitaire de santé et services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Institut de recherche en santé publique de l'Université de Montréal, Montréal, Quebec, CanadaDirection de santé publique du Centre intégré universitaire de santé et services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Institut de recherche en santé publique de l'Université de Montréal, Montréal, Quebec, Canada; Institut national de santé publique du Québec, Montréal, Quebec, CanadaDirection de santé publique du Centre intégré universitaire de santé et services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, CanadaDirection de santé publique du Centre intégré universitaire de santé et services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Quebec, CanadaDirection de santé publique du Centre intégré universitaire de santé et services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, CanadaDirection de santé publique du Centre intégré universitaire de santé et services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, CanadaCIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada; Groupe de médecine de famille et Unité de médecine familiale de Verdun, Montréal, Quebec, CanadaDirection de santé publique du Centre intégré universitaire de santé et services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Institut de recherche en santé publique de l'Université de Montréal, Montréal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quebec, CanadaInstitut de recherche en santé publique de l'Université de Montréal, Montréal, Quebec, Canada; Faculté des sciences infirmières de l'Université de Montréal, Montréal, Quebec, CanadaIntroduction: Chronic disease management requires substantial services integration. A cardiometabolic risk management program inspired by the Chronic Care Model was implemented in Montréal for patients with diabetes or hypertension. One of this study's objectives was to assess the impact of care coordination between the interdisciplinary teams and physicians on patient participation in the program, lifestyle improvements and disease control. Methods: We obtained data on health outcomes from a register of clinical data, questionnaires completed by patients upon entry into the program and at the 12-month mark, and we drew information on the program's characteristics from the implementation analysis. We conducted multiple regression analyses, controlling for patient sociodemographic and health characteristics to measure the association between interdisciplinary team coordination with primary care physicians and various health outcomes. Results: A total of 1689 patients took part in the study (60.1% participation rate). Approximately 40% of patients withdrew from the program during the first year. At the 12-month follow-up (n = 992), we observed a significant increase in the proportion of patients achieving the various clinical targets. The perception by the interdisciplinary team of greater care coordination with primary care physicians was associated with increased participation in the program and the achievement of better clinical results. Conclusion: Greater coordination of patient services between interdisciplinary teams and primary care physicians translates into benefits for patients.https://www.canada.ca/en/public-health/services/reports-publications/health-promotion-chronic-disease-prevention-canada-research-policy-practice/vol-37-no-4-2017/implementation-integrated-primary-care-cardiometabolic-risk-prevention-management-network-montreal.htmlchronic diseases, Chronic Care Model, primary care services, medical practice, coordination of care |
| spellingShingle | Sylvie Provost Raynald Pineault Dominique Grimard José Pérez Michel Fournier Yves Lévesque Johanne Desforges Pierre Tousignant Roxane Borgès Da Silva Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montréal: does greater coordination of care with primary care physicians have an impact on health outcomes? Health Promotion and Chronic Disease Prevention in Canada chronic diseases, Chronic Care Model, primary care services, medical practice, coordination of care |
| title | Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montréal: does greater coordination of care with primary care physicians have an impact on health outcomes? |
| title_full | Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montréal: does greater coordination of care with primary care physicians have an impact on health outcomes? |
| title_fullStr | Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montréal: does greater coordination of care with primary care physicians have an impact on health outcomes? |
| title_full_unstemmed | Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montréal: does greater coordination of care with primary care physicians have an impact on health outcomes? |
| title_short | Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montréal: does greater coordination of care with primary care physicians have an impact on health outcomes? |
| title_sort | implementation of an integrated primary care cardiometabolic risk prevention and management network in montreal does greater coordination of care with primary care physicians have an impact on health outcomes |
| topic | chronic diseases, Chronic Care Model, primary care services, medical practice, coordination of care |
| url | https://www.canada.ca/en/public-health/services/reports-publications/health-promotion-chronic-disease-prevention-canada-research-policy-practice/vol-37-no-4-2017/implementation-integrated-primary-care-cardiometabolic-risk-prevention-management-network-montreal.html |
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