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A programme to improve quality of care for patients with chronic diseases, Kazakhstan
OBJECTIVE: To evaluate the effect of a disease management programme in Kazakhstan on quality indicators for patients with hypertension, diabetes and chronic heart failure. METHODS: A supportive, interdisciplinary, quality improvement programme was implemented between November 2014 and November 2015...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
World Health Organization
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047019/ https://www.ncbi.nlm.nih.gov/pubmed/32132750 http://dx.doi.org/10.2471/BLT.18.227447 |
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author | Chan, Benjamin TB Rauscher, Chris Issina, Arman M Kozhageldiyeva, Laura H Kuzembaeva, Dametken D Davis, Connie L Kravchenko, Helena Hindmarsh, Michael McGowan, Jessie Kulkaeva, Gulnara |
author_facet | Chan, Benjamin TB Rauscher, Chris Issina, Arman M Kozhageldiyeva, Laura H Kuzembaeva, Dametken D Davis, Connie L Kravchenko, Helena Hindmarsh, Michael McGowan, Jessie Kulkaeva, Gulnara |
author_sort | Chan, Benjamin TB |
collection | PubMed |
description | OBJECTIVE: To evaluate the effect of a disease management programme in Kazakhstan on quality indicators for patients with hypertension, diabetes and chronic heart failure. METHODS: A supportive, interdisciplinary, quality improvement programme was implemented between November 2014 and November 2015 at seven polyclinics in Pavlodar and Petropavlovsk. Quality improvement teams were established at each clinic and quality improvement tools were introduced, including patient flowsheets, decision support tools, patient registries, a patient recall process, support for patient self-management and patient follow-up with intensity adjusted for level of disease control. Clinic teams met for four 3-day interactive learning sessions within 1 year, with additional coaching visits. Implementation was managed by five local coordinators and consultants trained by international consultants. National and regional steering committees monitored progress. FINDINGS: Between July and October 2015, the proportion of hypertensive patients with the recommended blood pressure increased from 24% (101/424) to 56% (228/409). Among patients with diabetes, the proportion who recently underwent eye examinations increased from 26% (101/391) to 71% (308/433); the proportion who had their low-density lipoprotein cholesterol measured increased from 57% (221/391) to 85% (369/433); and the proportion who had their albumin : creatinine ratio measured increased from 11% (44/391) to 49% (212/433). The proportion of chronic heart failure patients who underwent echocardiography rose from 91% (128/140) to 99% (157/158). All patients set themselves self-management goals. CONCLUSION: This intensive, supportive, multifaceted programme was associated with significant improvements in quality of care for patients with chronic disease. Further investment in coaching capacity is needed to extend the programme nationally. |
format | Online Article Text |
id | pubmed-7047019 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | World Health Organization |
record_format | MEDLINE/PubMed |
spelling | pubmed-70470192020-03-04 A programme to improve quality of care for patients with chronic diseases, Kazakhstan Chan, Benjamin TB Rauscher, Chris Issina, Arman M Kozhageldiyeva, Laura H Kuzembaeva, Dametken D Davis, Connie L Kravchenko, Helena Hindmarsh, Michael McGowan, Jessie Kulkaeva, Gulnara Bull World Health Organ Research OBJECTIVE: To evaluate the effect of a disease management programme in Kazakhstan on quality indicators for patients with hypertension, diabetes and chronic heart failure. METHODS: A supportive, interdisciplinary, quality improvement programme was implemented between November 2014 and November 2015 at seven polyclinics in Pavlodar and Petropavlovsk. Quality improvement teams were established at each clinic and quality improvement tools were introduced, including patient flowsheets, decision support tools, patient registries, a patient recall process, support for patient self-management and patient follow-up with intensity adjusted for level of disease control. Clinic teams met for four 3-day interactive learning sessions within 1 year, with additional coaching visits. Implementation was managed by five local coordinators and consultants trained by international consultants. National and regional steering committees monitored progress. FINDINGS: Between July and October 2015, the proportion of hypertensive patients with the recommended blood pressure increased from 24% (101/424) to 56% (228/409). Among patients with diabetes, the proportion who recently underwent eye examinations increased from 26% (101/391) to 71% (308/433); the proportion who had their low-density lipoprotein cholesterol measured increased from 57% (221/391) to 85% (369/433); and the proportion who had their albumin : creatinine ratio measured increased from 11% (44/391) to 49% (212/433). The proportion of chronic heart failure patients who underwent echocardiography rose from 91% (128/140) to 99% (157/158). All patients set themselves self-management goals. CONCLUSION: This intensive, supportive, multifaceted programme was associated with significant improvements in quality of care for patients with chronic disease. Further investment in coaching capacity is needed to extend the programme nationally. World Health Organization 2020-03-01 2019-01-27 /pmc/articles/PMC7047019/ /pubmed/32132750 http://dx.doi.org/10.2471/BLT.18.227447 Text en (c) 2020 The authors; licensee World Health Organization. This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (http://creativecommons.org/licenses/by/3.0/igo/legalcode), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL. |
spellingShingle | Research Chan, Benjamin TB Rauscher, Chris Issina, Arman M Kozhageldiyeva, Laura H Kuzembaeva, Dametken D Davis, Connie L Kravchenko, Helena Hindmarsh, Michael McGowan, Jessie Kulkaeva, Gulnara A programme to improve quality of care for patients with chronic diseases, Kazakhstan |
title | A programme to improve quality of care for patients with chronic diseases, Kazakhstan |
title_full | A programme to improve quality of care for patients with chronic diseases, Kazakhstan |
title_fullStr | A programme to improve quality of care for patients with chronic diseases, Kazakhstan |
title_full_unstemmed | A programme to improve quality of care for patients with chronic diseases, Kazakhstan |
title_short | A programme to improve quality of care for patients with chronic diseases, Kazakhstan |
title_sort | programme to improve quality of care for patients with chronic diseases, kazakhstan |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047019/ https://www.ncbi.nlm.nih.gov/pubmed/32132750 http://dx.doi.org/10.2471/BLT.18.227447 |
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