Chronic-Care-Management Programs for Multimorbid Patients with Diabetes in Europe: A Scoping Review with the Aim to Identify the Best Practice.

Julia Heike Brettel,Ulrike Rothe,Ulf Manuwald,Joachim Kugler,Henriette Hornstein,Michelangela Barbieri

doi:10.1155/2021/6657718

Abstract

Aim This scoping review is aimed at providing a current descriptive overview of care programs based on the chronic care model (CCM) according to E. H. Wagner. The evaluation is carried out within Europe and assesses the methodology and comparability of the studies. Methods A systematic search in the databases PubMed, Embase, and MEDLINE via OVID was conducted. In the beginning, 2309 articles were found and 48 full texts were examined, 19 of which were incorporated. Included were CCM-based programs from Belgium, Cyprus, Germany, Italy, Switzerland, and the Netherlands. All 19 articles were presented descriptively whereof 11 articles were finally evaluated in a checklist by Rothe et al. (2020). In this paper, the studies were tabulated and evaluated conforming to the same criteria. Results Due to the complexity of the CCM and the heterogeneity of the studies in terms of setting and implementation, a direct comparison proved difficult. Nevertheless, the review shows that CCM was successfully implemented in various care situations and also can be useful in single practices, which often dominate the primary care sector in many European health systems. The present review was able to provide a comprehensive overview of the current care situation of chronically ill patients with multimorbidities. Conclusions A unified nomenclature concerning the distinction between disease management programs and CCM-based programs should be aimed for. Similarly, homogeneous quality standards and a Europe-wide evaluation strategy would be necessary to identify best practice models and to provide better care for the steadily growing number of chronically multimorbid patients.

Highlights

Demographic change and the increasing number of patients with multiple chronic conditions will face a major challenge for the current health care system in Germany shortly
A unified nomenclature concerning the distinction between disease management programs and chronic care model (CCM)-based programs should be aimed for
The current models, which mostly deal with individual diseases in particular, often use so-called disease management programs (DMPs)

Summary

Introduction

Demographic change and the increasing number of patients with multiple chronic conditions will face a major challenge for the current health care system in Germany shortly. One possible model for the managed care of multimorbid patients with several chronic diseases is the widely accepted chronic care model (CCM) by Wagner et al [1,2,3]. The CCM integrates 6 key elements that are designed to optimize the coordination of care and the treatment, information, and motivation of multimorbid patients. The objective of this scoping review was to provide an actual descriptive overview of published chronic care management program

Methods

Results

Discussion

Conclusion