FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2591073843> ?p ?o ?g. }

• W2591073843 abstract "Shared care has been used in the management of many chronic conditions with the assumption that it delivers better care than primary or specialty care alone; however, little is known about the effectiveness of shared care.To determine the effectiveness of shared care health service interventions designed to improve the management of chronic disease across the primary/specialty care interface. This is an update of a previously published review.Secondary questions include the following:1. Which shared care interventions or portions of shared care interventions are most effective?2. What do the most effective systems have in common?We searched MEDLINE, Embase and the Cochrane Library to 12 October 2015.One review author performed the initial abstract screen; then two review authors independently screened and selected studies for inclusion. We considered randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after studies (CBAs) and interrupted time series analyses (ITS) evaluating the effectiveness of shared care interventions for people with chronic conditions in primary care and community settings. The intervention was compared with usual care in that setting.Two review authors independently extracted data from the included studies, evaluated study quality and judged the certainty of the evidence using the GRADE approach. We conducted a meta-analysis of results when possible and carried out a narrative synthesis of the remainder of the results. We presented the results in a 'Summary of findings' table, using a tabular format to show effect sizes for all outcome types.We identified 42 studies of shared care interventions for chronic disease management (N = 18,859), 39 of which were RCTs, two CBAs and one an NRCT. Of these 42 studies, 41 examined complex multi-faceted interventions and lasted from six to 24 months. Overall, our confidence in results regarding the effectiveness of interventions ranged from moderate to high certainty. Results showed probably few or no differences in clinical outcomes overall with a tendency towards improved blood pressure management in the small number of studies on shared care for hypertension, chronic kidney disease and stroke (mean difference (MD) 3.47, 95% confidence interval (CI) 1.68 to 5.25)(based on moderate-certainty evidence). Mental health outcomes improved, particularly in response to depression treatment (risk ratio (RR) 1.40, 95% confidence interval (CI) 1.22 to 1.62; six studies, N = 1708) and recovery from depression (RR 2.59, 95% CI 1.57 to 4.26; 10 studies, N = 4482) in studies examining the 'stepped care' design of shared care interventions (based on high-certainty evidence). Investigators noted modest effects on mean depression scores (standardised mean difference (SMD) -0.29, 95% CI -0.37 to -0.20; six studies, N = 3250). Differences in patient-reported outcome measures (PROMs), processes of care and participation and default rates in shared care services were probably limited (based on moderate-certainty evidence). Studies probably showed little or no difference in hospital admissions, service utilisation and patient health behaviours (with evidence of moderate certainty).This review suggests that shared care improves depression outcomes and probably has mixed or limited effects on other outcomes. Methodological shortcomings, particularly inadequate length of follow-up, may account in part for these limited effects. Review findings support the growing evidence base for shared care in the management of depression, particularly stepped care models of shared care. Shared care interventions for other conditions should be developed within research settings, with account taken of the complexity of such interventions and awareness of the need to carry out longer studies to test effectiveness and sustainability over time." @default.
• W2591073843 created "2017-03-03" @default.
• W2591073843 creator A5002382571 @default.
• W2591073843 creator A5065855664 @default.
• W2591073843 creator A5083581618 @default.
• W2591073843 creator A5083999295 @default.
• W2591073843 creator A5089914898 @default.
• W2591073843 date "2017-02-23" @default.
• W2591073843 modified "2023-10-12" @default.
• W2591073843 title "Shared care across the interface between primary and specialty care in management of long term conditions" @default.
• W2591073843 cites W11664464 @default.
• W2591073843 cites W1580505443 @default.
• W2591073843 cites W1603154299 @default.
• W2591073843 cites W166996129 @default.
• W2591073843 cites W1787742557 @default.
• W2591073843 cites W1850166177 @default.
• W2591073843 cites W1870469727 @default.
• W2591073843 cites W1893961784 @default.
• W2591073843 cites W1910910337 @default.
• W2591073843 cites W1928028226 @default.
• W2591073843 cites W1964777084 @default.
• W2591073843 cites W1965349882 @default.
• W2591073843 cites W1966250423 @default.
• W2591073843 cites W1970941993 @default.
• W2591073843 cites W1971105675 @default.
• W2591073843 cites W1972737281 @default.
• W2591073843 cites W1979518810 @default.
• W2591073843 cites W1979598156 @default.
• W2591073843 cites W1980826503 @default.
• W2591073843 cites W1981692520 @default.
• W2591073843 cites W1981998450 @default.
• W2591073843 cites W1982423169 @default.
• W2591073843 cites W1984349834 @default.
• W2591073843 cites W1984355009 @default.
• W2591073843 cites W1985284293 @default.
• W2591073843 cites W1986577580 @default.
• W2591073843 cites W1987050086 @default.
• W2591073843 cites W1990086179 @default.
• W2591073843 cites W1992489069 @default.
• W2591073843 cites W1994336774 @default.
• W2591073843 cites W2002926979 @default.
• W2591073843 cites W2013519735 @default.
• W2591073843 cites W2018015766 @default.
• W2591073843 cites W2019337661 @default.
• W2591073843 cites W2020229129 @default.
• W2591073843 cites W2026003056 @default.
• W2591073843 cites W2028411997 @default.
• W2591073843 cites W2029421651 @default.
• W2591073843 cites W2038882540 @default.
• W2591073843 cites W2048616866 @default.
• W2591073843 cites W2054580430 @default.
• W2591073843 cites W2054949377 @default.
• W2591073843 cites W2057865243 @default.
• W2591073843 cites W2061282392 @default.
• W2591073843 cites W2061817629 @default.
• W2591073843 cites W2062991086 @default.
• W2591073843 cites W2064249357 @default.
• W2591073843 cites W2064326259 @default.
• W2591073843 cites W2064732203 @default.
• W2591073843 cites W2064798601 @default.
• W2591073843 cites W2068809503 @default.
• W2591073843 cites W2077141434 @default.
• W2591073843 cites W2080474738 @default.
• W2591073843 cites W2084832262 @default.
• W2591073843 cites W2085069191 @default.
• W2591073843 cites W2087035880 @default.
• W2591073843 cites W2088150920 @default.
• W2591073843 cites W2094019000 @default.
• W2591073843 cites W2095598339 @default.
• W2591073843 cites W2102054469 @default.
• W2591073843 cites W2104805752 @default.
• W2591073843 cites W2108123413 @default.
• W2591073843 cites W2109609702 @default.
• W2591073843 cites W2111142769 @default.
• W2591073843 cites W2113573516 @default.
• W2591073843 cites W2115172500 @default.
• W2591073843 cites W2116733373 @default.
• W2591073843 cites W2119095553 @default.
• W2591073843 cites W2121470298 @default.
• W2591073843 cites W2121763523 @default.
• W2591073843 cites W2122501553 @default.
• W2591073843 cites W2124553793 @default.
• W2591073843 cites W2125455707 @default.
• W2591073843 cites W2125875374 @default.
• W2591073843 cites W2127372938 @default.
• W2591073843 cites W2128092384 @default.
• W2591073843 cites W2130517010 @default.
• W2591073843 cites W2131241269 @default.
• W2591073843 cites W2131330383 @default.
• W2591073843 cites W2132447573 @default.
• W2591073843 cites W2134826790 @default.
• W2591073843 cites W2135060590 @default.
• W2591073843 cites W2136027328 @default.
• W2591073843 cites W2136943641 @default.
• W2591073843 cites W2137793136 @default.
• W2591073843 cites W2142174958 @default.
• W2591073843 cites W2143392102 @default.
• W2591073843 cites W2147285125 @default.
• W2591073843 cites W2147422639 @default.
• W2591073843 cites W2147735030 @default.

• next