The rising burden of diabetes and hypertension in southeast asian and african regions: need for effective strategies for prevention and control in primary health care settings.

Aim. To review the available literature on burden of diabetes mellitus (DM) and hypertension (HTN) and its coexistence in Southeast Asian (SEA) and the African (AFR) regions and to suggest strategies to improve DM and HTN prevention and control in primary health care (PHC) in the two regions. Methods. A systematic review of the papers published on DM, HTN, and prevention/control of chronic diseases in SEA and AFR regions between 1980 and December 2012 was included. Results. In the year 2011, SEA region had the second largest number of people with DM (71.4 million), while the AFR region had the smallest number (14.7 million). Screening studies identified high proportions (>50%) of individuals with previously undiagnosed HTN and DM in both of the SEA and AFR regions. Studies from both regions have shown that DM and HTN coexist in type 2 DM ranging from 20.6% in India ...

Improving the Delivery of Adult Diabetes Care Through Integration: Sharing Experience and Learning

In October 2014 the charity Diabetes UK published a report titled "Improving the Delivery of Adult Diabetes Care Through Integration: Sharing Experience and Learning".  The report identifies five key enablers for integrated care and outlines specific local initiatives in the UK which deliver integrated care for patients with diabetes. For example, the Royal Wolverhampton Hospitals NHS Trust (which delivers community and hospital services in Wolverhampton) along with the local Clinical Commissioning Group and various GP practices have been involved in an integrated and patient-centred model of diabetes care for many years. The model is characterised by partnerships between primary and specialist care that aim to increase the proportion of services delivered through primary care. All key enablers for integrated care that were identified by the report are present in Wolverhampton. Examples of these include:  1. Integrated IT. The CareCentric patient portal has allowed GP practices and the trust to integrate ...

Aspects of Multicomponent Integrated Care Promote Sustained Improvement in Surrogate Clinical Outcomes: A Systematic Review and Meta-analysis

The implementation of the Chronic Care Model (CCM) improves health care quality. This study examined the sustained effectiveness of multicomponent integrated care in type 2 diabetes. Despite the small effect size of multicomponent integrated care team-based care with better information flow may improve patient-provider communication and self-management in patients who are young, with suboptimal control, and in low-resource settings. 

Personalised care for long-term conditions

 Living with multiple conditions

Mary, aged 76, has diabetes, arthritis, and macular degeneration, and she’s feeling low. She recently lost her husband, Frank, who died after a long period of dementia. She cared for him devotedly for many years, but this occupied most of her time and energy and took a heavy toll on her health and wellbeing.

Mary’s GP reminds her to attend the local diabetes clinic. The specialist nurses are concerned about her test results and urge her to try to eat a healthier diet and take more exercise. Mary nods, but in her heart knows that this advice will be difficult to follow. Her knees are painful, her eyesight is deteriorating, the local shops don’t sell much in the way of healthy food, and she doesn’t feel confident to travel far on her own.

As populations age, increasing numbers of people live with ...

Challenges to Introducing Integrated Diabetes Care to an Inner-Regional Area in South Western Sydney, Australia

Diabetes care often requires collaboration between general practitioners, allied health professionals, nurses, and/or medical specialists. This study highlights the need to integrate new diabetes services with existing health activities in the community and the importance of allowing flexibility and regular contact with local healthcare professional and community to encourage their involvement.

A Validation Study of the Rainbow Model of Integrated Care- Measurement Tool for Patients in China

The original Rainbow Model of Integrated Care Measurement Tool (RMIC-MT) is based on the Rainbow Model of Integrated Care (RMIC), which provides a comprehensive theoretical framework for integrated care. The aim of this paper is to modify the original patient version of the RMIC-MT for the Chinese primary care context and validate its psychometric properties.

The conceptualisation of patient-centred care: A case study of diabetes management in public facilities in southern Malawi

Patient-centred care (PCC) is one of the pillars of Malawi’s quality of care policyinitiatives. The role of PCC in facilitating quality service delivery is well documented, and its importance may heighten in chronic disease management. Yet, PCC conceptualisation is known to be context specific. The prominent themes emerging from the participants’ conceptualisation of PCC included the following: meeting individual needs, goals and expectations, accessing medication, supporting relationship building, patient involvement, information sharing, holistic care, timeliness and being realistic.

Treatment outcomes among adults with HIV/non-communicable disease multimorbidity attending integrated care clubs in Cape Town, South Africa

The growing burden of the HIV and non-communicable disease (NCD) syndemic in Sub- Saharan Africa has necessitated introduction of integrated models of care in order to leverage existing HIV care infrastructure for NCDs.

Person centred care toolkit

The person-centred care toolkit aims to assist Credentialled Diabetes Educators and other health professionals to understand the benefits of and to adopt person-centred care practices.

Needs and resources of people with type 2 diabetes in peri-urban Cochabamba, Bolivia: a people-centred perspective

The rising prevalence of type 2 diabetes results in a worldwide public healthcare crisis, especially in low- and middle-income countries (LMICs) with unprepared and overburdened health systems mainly focused on infectious diseases and maternal and child health. This study identifies mostly contextual factors like low literacy levels, linguistic problems in care, the need to articulate people’s worldview including traditional use of natural remedies with the Bolivian health system and the lack of expertise on type 2 diabetes by primary health care providers. Understanding the needs and structuring them in different areas wherein action is required serves as a foundation for the planning and evaluation of an integrated people centred care program for people with type 2 diabetes. This participative method serves as a tool to implement the often theoretical concept of integrated people centred health care in health policy and program development.

An insight into patients' perspectives on barriers affecting participation in shared decision making among patients with diabetes mellitus in Malawi

Patient participation in decision making is a basic tenet for a patient centred care experience and, has potential to improve care experiences and responsiveness in chronic diseases such as Diabetes Mellitus (DM). However, documented experiences show that patient participation in decisions making is wanting. As Malawi strives to institutionalise patient centred care delivery, it is important to examine patients' experiences and perceptions to identify barriers affecting their participation in shared decision making because this may provide evidence supporting strategies in implementation of the institutionalisation.

The organisation of primary health care service delivery for non-communicable diseases in Nigeria: A case-study analysis

As chronic diseases, non-communicable diseases (NCDs) require sustained person-centred and community-based care. Given its direct link to communities and households, Primary Health Care (PHC) is well positioned to achieve such care. In Nigeria, the national government has prioritized PHC system strengthening as a means of achieving national NCD targets. However, strengthening PHC systems for NCDs require re-organization of PHC service delivery, based on contextual understanding of existing facilitators and barriers to PHC service delivery for NCDs.

Integrated person- and people-centred primary care for diabetes in low- and middle-income countries: The nurses' perspective on patient needs

The aim of this study was to identify what nurses working in primary care settings perceive as necessary to support the life needs of people with type 2 diabetes. Articulate these needs with the needs expressed by people with diabetes in a previous study. This study demonstrates nurses' important contribution to analysing and designing people-centred care in their community.