Dataset Information

Chronic Care Model Decision Support and Clinical Information Systems interventions for people living with HIV: a systematic review.

ABSTRACT:

Background

The Chronic Care Model is an effective framework for improving chronic disease management. There is scarce literature describing this model for people living with HIV. Decision Support (DS) and Clinical Information Systems (CIS) are two components of this model that aim to improve care by changing health care provider behavior.

Objective

Our aim was to assess the effectiveness of DS and CIS interventions for individuals with HIV, through a systematic literature review.

Design

We performed systematic electronic searches from 1996 to February 2011 of the medical (E.g. Medline, EMBASE, CINAHL) and grey literature. Effectiveness was measured by the frequency of statistically significant outcome improvement. Data and key equity indicator extraction and synthesis was completed.

Participants and interventions

We included comparative studies of people living with HIV that examined the impact of DS or CIS interventions on outcomes.

Main measures

The following measures were assessed: outcome (immunological/virological, medical, psychosocial, economic measures) and health care process/performance measures.

Key results

Records were screened for relevance (n?=?10,169), full-text copies of relevant studies were obtained (n?=?123), and 16 studies were included in the review. Overall, 5/9 (55.6%) and 17/41 (41.5%) process measures and 5/12 (41.7%) and 3/9 (33.3%) outcome measures for DS and CIS interventions, respectively, were statistically significantly improved. DS-explicit mention of implementation of guidelines and CIS-reminders showed the most frequent improvement in outcomes. DS-only interventions were more effective than CIS-only interventions in improving both process and outcome measures. Clinical, statistical and methodological heterogeneity among studies precluded meta-analysis. Primary studies were methodologically weak and often included multifaceted interventions that made assessment of effectiveness challenging.

Conclusions

Overall, DS and CIS interventions may modestly improve care for people living with HIV, having a greater impact on process measures compared to outcome measures. These interventions should be considered as part of strategies to improve HIV care through changing provider performance.

SUBMITTER: Pasricha A

PROVIDER: S-EPMC3539016 | biostudies-literature | 2013 Jan

REPOSITORIES: biostudies-literature

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Publications

Chronic Care Model Decision Support and Clinical Information Systems interventions for people living with HIV: a systematic review.

Pasricha Anjori A Deinstadt Roo T M RT Moher David D Killoran Amanda A Rourke Sean B SB Kendall Claire E CE

Journal of general internal medicine 20120713 1

<h4>Background</h4>The Chronic Care Model is an effective framework for improving chronic disease management. There is scarce literature describing this model for people living with HIV. Decision Support (DS) and Clinical Information Systems (CIS) are two components of this model that aim to improve care by changing health care provider behavior.<h4>Objective</h4>Our aim was to assess the effectiveness of DS and CIS interventions for individuals with HIV, through a systematic literature review.< ...[more]

PMID: 22790615

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Project description:BackgroundDementia is an important health and social care problem and is one of the main causes of disability in later life. The number of families affected by dementia will dramatically increase over the next five decades. Despite the implications for health and social care services in the future, the overwhelming majority of care for people with dementia takes place away from health care settings. Providing informal care for someone with dementia can be psychologically, physically and financially expensive and a range of health service interventions aimed at supporting and providing information to these carers has developed to help carers meet these demands. This review examines whether information and support interventions improve the quality of life of people caring for someone with dementia.MethodsA systematic review examining evidence from randomised controlled trials in which technology, individualised or group-based interventions built around the provision of support and/or information were evaluated.ResultsForty-four studies were included in the review. Controlling for the quality of the evidence, we found statistically significant evidence that group-based supportive interventions impact positively on psychological morbidity. However, whilst the improvement was unlikely to be due to chance, the clinical significance of this finding should be interpreted tentatively, due to the difficulties in interpreting the standardised mean difference as a measure of effect and the complex aetiology of depression. No evidence was found for the effectiveness of any other form of intervention on a range of physical and psychological health outcomes.ConclusionThere is little evidence that interventions aimed at supporting and/or providing information to carers of people with dementia are uniformly effective. There is a pressing need to ensure that supportive interventions at the development stage are accompanied by good quality randomised evaluations in which outcomes that are important to clinicians and carers are measured.

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Dataset Information

Chronic Care Model Decision Support and Clinical Information Systems interventions for people living with HIV: a systematic review.

Background

Objective

Design

Participants and interventions

Main measures

Key results

Conclusions

Publications

Chronic Care Model Decision Support and Clinical Information Systems interventions for people living with HIV: a systematic review.

Similar Datasets

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