Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: World Health Organization 2020
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
_version_ 1783502061743112192
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
work_keys_str_mv AT chanbenjamintb aprogrammetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT rauscherchris aprogrammetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT issinaarmanm aprogrammetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT kozhageldiyevalaurah aprogrammetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT kuzembaevadametkend aprogrammetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT davisconniel aprogrammetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT kravchenkohelena aprogrammetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT hindmarshmichael aprogrammetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT mcgowanjessie aprogrammetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT kulkaevagulnara aprogrammetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT chanbenjamintb programmetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT rauscherchris programmetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT issinaarmanm programmetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT kozhageldiyevalaurah programmetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT kuzembaevadametkend programmetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT davisconniel programmetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT kravchenkohelena programmetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT hindmarshmichael programmetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT mcgowanjessie programmetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan
AT kulkaevagulnara programmetoimprovequalityofcareforpatientswithchronicdiseaseskazakhstan