Chronic Disease Management Program Research Articles

Who took care of patients with diabetes during the COVID-19-pandemic? A registry-based study

Abstract Background The rise of people with chronic diseases strains our healthcare system. Chronic disease management programs (CDMP) provide accessible care for patients with a chronic disease, aiming to prevent further development of the disease and avoid the need for (more costly and severe) hospital treatments. During the COVID-19 pandemic, CDMP provided at general practices (GP) for diabetic patients were downscaled. It remains unknown whether this downsizing led to increased care in other healthcare settings. We examined the changes in healthcare utilization by Dutch diabetic patients in 2020 and 2021 compared to 2019 regarding; 1) CDMP consultations, 2) hospital care for diabetes and 3) regular GP care. Methods In this retrospective observational study, data from electronic health records of GPs, participating in Nivel Primary Care Database, of 15,247 Dutch diabetic patients who were enrolled in CDMP, were linked to hospital claims data. Differences in healthcare utilization in 2020 and 2021 compared to 2019 were assessed quarterly using regression analyses. Results Results show that CDMP care was notably lower in 2020 and 2021, compared to 2019 (-35%). From Q1 2021 onwards, patients received more hospital care for diabetes (+13%) and regular GP care increased from Q3 2020 onwards (+14%). Compared to 2019, reduced CDMP contacts in 2020 were significantly associated (p = 0.001) with increased regular GP care in 2021. In the short-term, decreased CDMP in the first half of 2021 was significantly associated with increased regular GP care (p = 0.033) and hospital care (p = 0.037) in the second half of 2021. Conclusions Temporarily downscaling CDMP care during the COVID-19-pandemic was associated with increased hospital and regular GP care for diabetic patients. These findings contribute to making informed decisions regarding measures during future pandemics. Key messages • Chronic disease management programs at GPs appear to be effective in preventing disease exacerbations, and may help prevent (expensive) utilization of hospital care. • This research prompts further investigation into the desirability of CDMPs among patients, GPs, hospitals and policymakers, crucial for assessing undesirable healthcare shifts in diabetic patients.

Identification of Candida albicans in the Urine of Type 2 Diabetes Mellitus Patiens at Puskesmas Jaten 2, Karanganyar Regency

Background: Candida albicans is an opportunistic fungus that thrives in environments with high glucose concentrations, which makes patients with Diabetes Mellitus (DM) especially vulnerable to infection. Elevated blood glucose levels in DM can lead to glycosuria, providing a rich nutrient source for fungal growth. This research is critical because there is a lack of specific studies focusing on fungal infections in diabetic patients in Indonesia, despite the increasing prevalence of DM. This research provides a new perspective by highlighting a local diabetic population that has not been extensively studied before. Objective: The objective of this study is to identify the presence of Candida albicans in the urine of Type 2 Diabetes Mellitus patients at Puskesmas Jaten 2 in Karanganyar Regency. Materials and Methods: This descriptive study included 20 urine samples from Type 2 Diabetes Mellitus patients. The inclusion criteria were fasting blood glucose levels of 200 mg/dl or higher, and all patients were enrolled in the chronic disease management program (Prolanis) at Puskesmas Jaten 2. The samples were collected and examined macroscopically in February 2024 to detect the presence of Candida albicans. Results: The results showed that Candida albicans was found in 6 out of 20 urine samples (30%), while the fungus was not detected in 14 samples (70%). The majority of positive cases occurred in patients aged 50 and older, suggesting an age-related susceptibility to fungal infection in this population. Patients with higher glucose levels also showed a greater tendency for Candida growth. Conclusions: Based on the results of this study, it can be concluded that Candida albicans is present in the urine of Type 2 Diabetes Mellitus patients at Puskesmas Jaten 2, with a notable prevalence of 30%. This finding highlights an increased susceptibility to fungal infections in older patients and those with elevated glucose levels, suggesting the need for careful monitoring and potential intervention in this population. Further studies with larger sample sizes are suggested to confirm these results and explore additional preventive measures.

Relationship between Dietary Fat-Sodium and Hypertension in Prolanis at the Jarak Kulon Public Health Center

Hypertension is a disease that causes high pain. Consuming sodium and fatty acids every day can increase the risk of hypertension. The impact of high fatty acids affects the presence of cholesterol deposits in the blood, while the levels of fatty acids cause increased blood pressure. This study aimed to analyze the relationship between sodium fat and hypertension in the Chronic Disease Management Program (Prolanis) at the Jarak Kulon Public Health Center Jombang. The research design used was cross-sectional. The population of this study was all hypertensive patients who participated in Prolanis, as many as 50 people. The sampling technique used was total sampling. The independent variable is the fat-sodium diet, and the dependent variable is hypertension. The instrument for the fat-sodium diet uses a questionnaire, while the incident uses observation. Statistical tests use Spearman Ranks. Spearman ranked data analysis with a significance of 0.01 and obtained a value of 0.000. Because (<α) means there is a relationship between the fat-sodium diet and hypertension. The test results also show that the relationship level of 0.695 is included in the strong category. Based on the research results, it is hoped that food content that is low in fat and low in sodium levels will help blood pressure to reach near-normal levels to avoid more severe complications.

Effectiveness of Chronic Disease Management Program in Lowering Blood Pressure in Hypertensive Patients: Literature Review

Effectiveness of Chronic Disease Management Program in Lowering Blood Pressure in Hypertensive Patients: Literature Review

Nurses' Role in Obesity Management in Adults in Primary Healthcare Settings Worldwide: A Scoping Review.

Obesity is a chronic, prevalent, and complex health condition that adversely impairs physical and mental health. The World Health Organization calls for integrating obesity care into existing chronic disease management programs within primary healthcare services. This scoping review aimed to examine registered nurses' roles in the primary healthcare management of individuals with obesity. A scoping review was conducted using the Johanna Briggs Institute methodology framework. Thematic analysis was used to identify and categorize nurses' roles in primary healthcare obesity management of adults. Of 1142 documents included in this review, 15 papers met the inclusion criteria. Thematic analysis yielded the following six themes representing nurses' major roles: patient-centred care, patient assessments, therapeutic interventions, care management, patient education, and professional development. This review identified that the literature on nurses' roles primarily described their focus on lifestyle interventions (mainly nutrition and physical activity), anthropometric measurements, health planning, goal setting, supportive care, monitoring progress, and arranging follow-up. The Discussion highlights the importance of determining RN knowledge gaps and biases. More research is required to determine the need for additional RN pre-and or post-education related to obesity as a complex chronic disease.

STRATEGIES FOR THE PREVENTION AND CONTROL OF HYPERTENSION IN RURAL COMMUNITIES

Hypertension is a prevalent chronic condition that can lead to serious complications such as cardiovascular disease, stroke and kidney failure. The prevalence of hypertension is especially high in rural communities, where factors such as limited access to health care, lack of health information and socioeconomic conditions can contribute to a lack of control of the disease. Prevention and control strategies tailored to these communities are crucial to reducing the burden of hypertension and improving the overall health of the rural population. This brief explores effective strategies for the prevention and control of hypertension in rural communities, highlighting innovative approaches and associated challenges. The aim of this paper is to review and analyze strategies for the prevention and control of hypertension in rural communities. It aims to identify the main interventions that have proved effective, discuss approaches adapted to the needs and resources of rural communities, and address the challenges faced in implementing these strategies. This is a literature review, using qualitative and quantitative assumptions, using the PubMed, Scopus and Google Scholar databases. The health descriptors “Hypertension”, “Hypertension Management in Rural Areas”, “Telemedicine”, “Community Interventions” and “Rural Health Policies” were used to refine the research. The time frame covers the years 2018 to 2022. The focus is to promote a comprehensive understanding of best practices and areas that need more attention to improve the management of hypertension in rural contexts. Preventing and controlling hypertension in rural communities requires a multifaceted approach that takes into account the particularities of these areas, including barriers to accessing healthcare, resource limitations and specific cultural needs. Education is key to preventing hypertension. Awareness programs about risk factors, the importance of regular blood pressure monitoring and lifestyle changes can have a significant impact. Community initiatives such as workshops, lectures and local media campaigns can help raise awareness of hypertension and promote healthy habits. Improving access to healthcare is crucial for hypertension control in rural areas. This can include the implementation of mobile health units, telemedicine and partnerships with health organizations to provide regular medical services and blood pressure monitoring. Community screening programs and regular consultations can help identify and treat cases of hypertension early. Interventions that encourage a healthy diet, rich in fruit, vegetables and low in sodium, as well as regular physical activity, are essential for the prevention and control of hypertension. Nutritional education programs and the promotion of community physical activities, such as walking groups or sports, can be effective in promoting a healthy lifestyle. Thus, many people with hypertension also have other health conditions, such as diabetes or obesity. Integrated strategies that address hypertension alongside other health conditions can improve overall outcomes. This includes chronic disease management programs that provide support for managing multiple health conditions simultaneously. Involving the community in the planning and implementation of prevention and control strategies can increase the acceptance and effectiveness of interventions. Community groups, local leaders and non-governmental organizations can play an important role in promoting health programs and mobilizing resources. The effective implementation of hypertension control strategies in rural communities faces several challenges. Barriers can include a lack of adequate health infrastructure, a shortage of health professionals, limited access to medicines and treatments, and cultural factors that can affect the acceptance of interventions. In addition, logistical and financial difficulties can limit the ability to implement and maintain health programs in remote areas. Therefore, the approach to preventing and controlling hypertension in rural communities must be adapted to the specific needs and characteristics of these areas. Effective strategies include community education and awareness, improving access to health care, promoting a healthy lifestyle and integrated management of comorbidities. Involving the community and overcoming challenges related to infrastructure and resources are critical aspects for the success of these strategies. With a multifaceted and collaborative approach, it is possible to reduce the prevalence and impact of hypertension in rural communities, promoting better health and an improved quality of life for their inhabitants.

Proportion and factors influencing healthcare-seeking behavior among older people in Motta town, East Gojjam: a community-based cross-sectional study, Ethiopia, 2023

BackgroundIn resource-limited countries, older people who are at risk and face numerous health problems, often receive insufficient attention regarding their healthcare-seeking behavior. Assessing the proportion of healthcare-seeking behavior and associated factors among older people in Motta town, was the aim of the study.MethodA community-based cross-sectional study was carried out from April 22 to May 22, 2023. The study subjects were chosen using a systematic random sampling technique. To identify candidate variables for multivariable analysis, a bivariable logistic regression analysis was performed. Variables having a P-value of < 0.05 were considered statistically significant.ResultsFrom the total, 161 (39.3%) of respondents had good healthcare-seeking behavior with 95% CI [35%, 44%]. Secondary school [AOR = 2.69, 95% CI = 1.27, 5.68], Education college and above [AOR = 4.6, 95% CI = 2.27, 9.33], Family support during their illness [AOR = 1.39, 95% CI = 1.05, 3.09], Members of CBHI [AOR = 2.02, 95% CI = 1.21, 3.36], and presence of chronic illness [AOR = 2.55, 95%, CI = 1.64, 3.97] were significantly associated with good healthcare-seeking behavior.Conclusion and recommendationThis study found that good healthcare-seeking behavior among older people is significantly associated with higher education, strong family support, Community-Based Health Insurance (CBHI) membership, and chronic illnesses. Improving health literacy through education, strengthening family support systems, expanding CBHI participation for better healthcare access, and developing targeted chronic disease management programs to enhance this behavior is recommended. These strategies can collectively improve healthcare utilization and outcomes for older people.

Peningkatan Kualitas Hidup Pasien Hipertensi dan Diabetes Mellitus Melalui Promosi Kesehatan di UPT Puskesmas Alianyang Kota Pontianak

The number of people with chronic diseases in Indonesia, especially hypertension and diabetes mellitus, continues to increase, including in the Pontianak City area, West Kalimantan. Alianyang Community Health Center, Pontianak City, is one of the basic health facilities that implements the Chronic Disease Management Program. The problem experienced by patients with chronic diseases such as hypertension and diabetes mellitus is a decrease in quality of life due to the disease they suffer. One of the causes of a decrease in a person's quality of life is a lack of knowledge and motivation in implementing a healthy lifestyle. Health promotion in the form of education on healthy lifestyles needs to be provided directly to patients and to prolanist cadres of the Alianyang Health Center. The targets of this activity are patients and prolanist cadres of the Alianyang Health Center. The activity aims to provide information to patients and prolanist cadres regarding efforts to improve the quality of life of hypertension and diabetes mellitus patients. The method used is health promotion through educational videos and leaflets. The results showed that there were changes before and after the delivery of health promotion, namely that the average participant experienced an increase in knowledge between the pre-test and post-test, namely 63.33 and 79.17 respectively. Evaluation of activities through questionnaires showed that participants felt the material presented was very interesting and participants gained new knowledge through the educational media provided.

Factors Related to the Incidence of Diabetes Mellitus in the Kebon Baru Primary Health Center in South Jakarta in 2020

Introduction: Diabetes Mellitus is a health problem encountered in Indonesia as well as in the world, it can be seen from the number of sufferers that continues to increase every year. Data from the International Diabetes Federation (IDF) shows that the number of people with Diabetes Mellitus in 2015 has reached as many as 415 million people and increased in 2017 to 425 million people worldwide. The Basic Health Research (Riskesdas) showed an increase in the prevalence of Diabetes Mellitus in Indonesia from 6.9% in 2013 to 8.5% in 2018. At the Kebon Baru Health Center, Diabetes Mellitus was among the top 10 diseases in 2019 with 529 cases. Various counseling programs to prevent non-communicable diseases are carried out, the priority program is by organizing the Chronic Disease Management Program (Pronalis) and by counseling. Objective: The aim of this study is to determine the factors associated with the incidence of Diabetes Mellitus at the Kebon Baru Community Health Center, South Jakarta, in 2020. Method: This study used a quantitative approach with cross sectional design by analyzing the secondary data of the monthly report of Non-Communicable Diseases at Kebon Baru Primary Health Center in 2020. These data were collected in 2020 and analyzed in 2021. Result: The prevalence of Diabetes Mellitus at Kebon Baru Primary Health Care in 2020 was 16.5% with the average blood sugar level of 153 mg/dL. The variables that were proven to have a relationship with the incidence of Diabetes Mellitus were the variable age with a p value of 0.001 (OR 3.15; 95% CI 1.56-6.36) and the variable history Diabetes Mellitus with a p value of 0.00 (OR 5.3; 95% CI 2.74-10.37). Conclusion: Patients who go to Kebon Baru Primary Health Care at the age ranging from 45 years and over have a 3.15 times risk of suffering from Diabetes Mellitus than those in the age group under 45 years. In addition, patients who go to the Kebon Baru Primary Health Center and have family members suffering from Diabetes Mellitus have a risk of 5.33 times to suffer from DM than those who do not.

Gerontology in Public Health: A Scoping Review of Current Perspectives and Interventions.

The intersection of gerontology and public health is increasingly vital due to the global aging population and its implications for health systems. This scoping review aims to map existing literature on gerontology within public health, identify current perspectives, and evaluate interventions tailored to the needs of older adults. A systematic search was performed using predefined keywords across multiple databases, including PubMed, Google Scholar, Scopus, and Web of Science. The review included 42 studies that employed various designs, all focusing on public health interventions targeting the aging population. Key findings indicate a pressing need to integrate gerontological principles into public health practice, recognizing the heterogeneous nature of older adults and the significance of social determinants of health. Interventions ranged from preventive health measures and chronic disease management programs to health promotion activities and caregiver support, including the application of technology to improve health outcomes. However, there was a notable lack of research on diverse populations and mental health interventions. The review also uncovered critical gaps in the literature, such as economic barriers to care access and the necessity for comprehensive policies addressing the aging population's diverse needs. In conclusion, this review emphasizes the importance of a multidimensional approach to effectively addressing older adults' health needs. While several effective interventions exist, there is an urgent need to tackle identified gaps, particularly concerning diverse populations and mental health, to enhance overall health strategies for the aging demographic.

Korean National Burden of Disease: The Importance of Diabetes Management.

Diagnosing the current health status and disease burden in a population is crucial for public health interventions. The ability to compare the burden of different diseases through a single measure, such as disability-adjusted life years has become feasible and continues to be produced and updated through the Global Burden of Diseases (GBD) study. However, the disease burden values of the GBD study do not accurately reflect the unique situation in a specific country with various circumstances. In response, the Korean National Burden of Disease (KNBD) study was conducted to estimate the disease burden in Koreans by considering Korea's cultural context and utilizing the available data sources at the national level. Both studies identified non-communicable diseases, such as diabetes mellitus (DM), as the primary cause of disease burden among Koreans. However, the extent of public health interventions currently being conducted by the central and local governments does not align with the severity of the disease burden. This review suggests that despite the high burden of DM in South Korea, the current policies may not fully address its impact, underscoring the need for expanded chronic disease management programs and a shift towards prevention-focused healthcare paradigms.

ANALYSIS OF MEDICATION COMPLIANCE WITH TYPE 2 DIABETES MELLITUS PATIENTS OGAN ILIR DISTRICT 2024

Diabetes mellitus is a disease that can cause complications if proper treatment is not given. There are still high cases of diabetes mellitus, where there is an increase in diabetes mellitus cases from year to year. This study aims to determine factors related to medication adherence in diabetes mellitus patients at the Pegayut Community Health Center, Ogan Ilir Regency in 2024. The design of this research is quantitative with a cross-sectional approach.4 . The population in this study was 710 diabetes mellitus patients who visited the Community Health Center in 2023, with a total sample of 88 people in this study. The sampling method uses purposive sampling. This research was carried out on 10-29 February 2024. Data collection techniques are interviews using questionnaires. Bivariate data analysis used the Chi-Square test and multivariate logistic regression. The results of the research show that there is a relationship between motivation (p value 0.01) and the role of officers (p value 0.03) on compliance with taking medication for diabetes mellitus patients at the Pegayut Community Health Center, Ogan Ilir Regency in 2024. There is no relationship between age (p value 0.82 ), gender (p value 0.88), knowledge (p value 0.68) and family support (p value 0.15) on medication adherence for diabetes mellitus patients at the Pegayut Community Health Center, Ogan Ilir Regency in 2024. The most dominant factors with compliance with taking medication for diabetes mellitus patients at the Pegayut Community Health Center, Ogan Ilir Regency in 2024, namely motivation (p value 0.01) (odds ratio 3.07), meaning that if motivation is sufficient, they are 3.07 times less likely to comply with medication compared to those with good motivation. The conclusion is that there is a relationship between motivation and the role of officers. There is no relationship between age, type, knowledge and family support on compliance with taking medication for diabetes mellitus patients at the Pegayut Community Health Center, Ogan Ilir Regency in 2024. It is hoped that the Community Health Center will continue to provide motivation and support to diabetes mellitus sufferers to comply with taking diabetes mellitus medication and increase their participation. patients through a chronic disease management program (prolanis).

Is pay for performance promoting inverse inequality in Irish general practice?

In 2020, the Chronic Disease Management (CDM) programme was introduced in Ireland. This programme resources GPs to review public (GMS) patients, diagnosed with eight named chronic diseases, twice yearly according to a structured protocol. This pay for performance initiative has been widely adopted by GPs. However, it is hypothesised that private patients (PPs) receive a poorer standard of care, as they may be reluctant to attend due to the cost involved. To assess whether the management of eight chronic diseases named in the CDM programme is to the same standard among both PPs and GMS patients. A retrospective audit of GP practices in the Midwest of Ireland. Data relating to 25 GMS patients and 25 PPs, matched by age, gender, and clinical condition, is collected from each practice. Patients have at least 1 of the eight named chronic diseases. Parameters include vaccination status (influenza, pneumococcal, COVID); body mass index; blood pressure; smoking status; renal function; HbA1c; lipid profile; brain natriuretic peptide (BNP) in patients with heart failure; and lung function tests in patients with COPD or asthma. COVID vaccination status acts as a control because it is freely available for both PPs and GMS patients. Preliminary results from 2 GP practices show large consistent disparities in management between PPs and GMS patients in most parameters. Limiting Pay for Performance to the care of GMS patients only, based on age or income, promotes inverse inequality. We argue that CDM care should be offered to all patients.

Evaluating A Multicomponent Chronic Disease Management Pilot Intervention among Korean Patients with Hypertension and Diabetes.

A local clinic-based chronic disease management intervention including care planning, education about disease management, monitoring, and evaluation of the achievement of objects was introduced in Korea in 2019. We evaluated the effect of the intervention on medication adherence in patients with hypertension and diabetes. In 2019, a one-year retrospective case-control group study design was performed using data from the National Health Insurance Service in Korea. Propensity score matching was used to control for selection bias. Medication adherence, calculated by medication possession rate, was the dependent variable. We conducted multivariate logistic regression analyses to examine the association between participation in the intervention and medication adherence, adjusting for covariates. A control group was set as a reference for participation in the full/partial component intervention. The proportions of participants in the full component intervention in the experimental group were 43.2% and 42.6% for patients with hypertension or diabetes, respectively. Both these groups tended to be more medication adherent than their counterparts (hypertension OR: 1.23, 95% CI 1.03-1.45, diabetes OR: 1.64, 95% CI: 1.24-2.17). Institutionalizing a comprehensive chronic disease management program using multidisciplinary teams in the primary care context is crucial. Also, it is necessary to refine reimbursement payment systems.

Reframing Fall Prevention and Risk Management as a Chronic Condition Through the Lens of the Expanded Chronic Care Model: Will Integrating Clinical Care and Public Health Improve Outcomes?

Falls are a leading cause of morbidity and mortality among adults aged 65 years and older (older adults) and are increasingly recognized as a chronic condition. Yet, fall-related care is infrequently provided in a chronic care context despite fall-related death rates increasing by 41% between 2012 and 2021. One of the many challenges to addressing falls is the absence of fall-focused chronic disease management programs, which improve outcomes of other chronic conditions, like diabetes. Policies, information systems, and clinical-community connections help form the backbone of chronic disease management programs, yet these elements are often missing in fall prevention. Reframing fall prevention through the Expanded Chronic Care Model (ECCM) guided by implementation science to simultaneously support the uptake of evidence-based practices could help improve the care of older adults at risk for falling. The ECCM includes seven components: (1) self-management/develop personal skills, (2) decision support, (3) delivery system design/re-orient health services, (4) information systems, (5) build healthy public policy, (6) create supportive environments, and (7) strengthen community action. Applying the ECCM to falls-related care by integrating health care delivery system changes, community resources, and public policies to support patient-centered engagement for self-management offers the potential to prevent falls more effectively among older adults.

Client and clinician perspectives about a virtual education and exercise chronic disease management programme for people with hip and knee osteoarthritis.

Osteoarthritis (OA) is one of the most prevalent chronic conditions in Canada. Despite the established benefits of non-pharmacological management (education, exercise) for people with OA, many do not receive treatment, resulting in pain, decreased physical function, and poorer quality of life. Virtual programme options grew significantly during the recent pandemic and may provide longer-term opportunities for increased uptake by reaching individuals otherwise unable to participate. This study explored the experiences and perspectives of clients participating in and clinicians providing the Good Life with osteoArthritis: Denmark (GLA:DTM) Canada remote programme. This qualitative descriptive study recruited 10 clients with hip and/or knee OA and 11 clinicians across Canada using purposive sampling. An online pre-interview survey was completed, and individual interviews were conducted, audio-recorded, transcribed verbatim and analysed independently by two researchers using inductive thematic analysis. Coding and analyses were initially conducted separately by group and then compared and combined. Four overarching themes (and 11 subthemes) were identified: (1) Expected and unexpected benefits of virtual programs; (2) Drawbacks to virtual programs; (3) Programme delivery in a virtual world; (4) Shifting and non-shifting perspectives. Although initially sceptical, after completion of the programme, clients were in favour of virtual delivery with many benefits described. Clinicians' perspectives varied about feedback aimed to correct client movement patterns. Clients and clinicians identified important experiential and procedural elements for virtual chronic disease management programs that include education and exercise. Additional work is needed to understand if the GLA:DTM remote outcomes are equivalent to the in-person programme.

Patients Satisfaction with the Chronic Disease Management Program in Indonesia Using the Importance-Performance Matrix

Patients Satisfaction with the Chronic Disease Management Program in Indonesia Using the Importance-Performance Matrix

Employer Engagement Strategies to Promote and Add Evidence-Based Chronic Disease Prevention and Management Programs as a Covered Benefit

Employer Engagement Strategies to Promote and Add Evidence-Based Chronic Disease Prevention and Management Programs as a Covered Benefit

Education Influence Using Leaflet Media on the Level of Knowledge, Compliance, and Therapy Outcomes in Prolanis Hypertension Patients at X Clinic Surakarta

&#x0D; Hypertension prevalence in Indonesia reached 34.4%. Chronic Disease Management Program or Program Pengelolaan Penyakit Kronis (PROLANIS) was one of the preventive and promotive strategies from BPJS, carried out to reduce or prevent complications of chronic diseases, including hypertension. Aim of this study was to determine education influence using leaflet media on the level of knowledge, compliance and therapy outcomes in prolanis hypertension patients at X Clinic, Surakarta. Method of this study used a quasi-experimental with pre-test and post-test design with 40 patients in each control and treatment group. Knowledge level assessed using HK-LS questionnaire, compliance assessed using MARS questionnaire, and therapy outcomes collected from medical record. The results of this study showed that education using leaflet media influenced level of knowledge with a value of p = 0.014, level of taking medication adherence with a value of p = 0.015 and results of systolic blood pressure therapy with a value of p = 0.000. There were an influence of education using leaflet media on the level of knowledge, compliance and therapy coutcome for prolanis hypertension patients at X Clinic, Surakarta.&#x0D;

A rapid review to inform the policy and practice for the implementation of chronic disease prevention and management programs for Aboriginal and Torres Strait Islander people in primary care

BackgroundMore than 35% of Aboriginal and Torres Strait Islander adults live with cardiovascular disease, diabetes, or chronic kidney disease. There is a pressing need for chronic disease prevention and management among Aboriginal and Torres Strait Islander people in Australia. Therefore, this review aimed to synthesise a decade of contemporary evidence to understand the barriers and enablers of chronic disease prevention and management for Aboriginal and Torres Strait Islander People with a view to developing policy and practice recommendations.MethodsWe systematically searched for peer-reviewed published articles between January 2014 to March 2023 where the search was performed using subject headings and keywords related to “Aboriginal and Torres Strait Islander peoples,” “Chronic Disease,” and “Primary Health Care”. Quality assessment for all included studies was conducted using the Aboriginal and Torres Strait Islander Quality Appraisal Tool. The data were extracted and summarised using a conventional content analysis approach and applying strength-based approaches.ResultsDatabase searches identified 1653 articles where 26 met inclusion criteria. Studies varied in quality, primarily reporting on 14 criteria of the Aboriginal and Torres Strait Islander Quality Appraisal Tool. We identified six key domains of enablers and barriers of chronic disease prevention and management programs and implied a range of policy and practice options for improvement. These include culturally acceptable and safe services, patient-provider partnerships, chronic disease workforce, primary health care service attributes, clinical care pathways, and accessibility to primary health care services. This review also identified the need to address social and cultural determinants of health, develop the Aboriginal and Torres Strait Islander and non-Indigenous chronic disease workforce, support multidisciplinary teams through strengthening clinical care pathways, and engage Aboriginal and Torres Strait Islander communities in chronic disease prevention and management program design and delivery.ConclusionEnabling place-based partnerships to develop contextual evidence-guided strategies that align with community priorities and aspirations, with the provision of funding mechanisms and models of care through policy and practice reforms will strengthen the chronic disease prevention and management program for Aboriginal and Torres Strait Islander people.