A1† - Morsch P, Pelaez M, Veja E, Hommes C, Lorig K. (2021)1313. Morsch P, Pelaez M, Veja E, Hommes C, Lorig K. Evidence-based programs for older persons in the Americas. Rev Panam Salud Publica [Internet]. 2021 [cited 2022 Jul 04];45:e91. Available from: https://doi.org/10.26633/RPSP.2021.91
https://doi.org/10.26633/RPSP.2021.91...
|
United States of America |
Report |
Implementation perspective:
- Manager's commitment to the evidence-based self-management program;
- Leadership by someone with a chronic condition who found the program personally useful and committed to sharing it with others;
- Physicians and other qualified health professionals as trainers so that they can share the program with their professional colleagues;
- The self-management program as public health nurses' mission. Challenges:
- Difficulty among the health professional to understand the concept of “self-management”;
- Increased financial costs related to the program;
- Use of volunteer lay leaders to maintain a well-trained and motivated group of volunteers. |
IV‡
|
A2† - Pantoja T, Opiyo N, Lewin S, Paulsen E, Ciapponi A, Wiysonge CS, et al. (2017)1414. Pantoja T, Opiyo N, Lewin S, Paulsen E, Ciapponi A, Wiysonge CS, et al. Implementation strategies for health systems in low‐income countries: an overview of systematic reviews. Cochrane Database Syst Rev [Internet]. 2017 [cited 2022 Jul 02];12(9):CD011086. Available from: https://doi.org/10.1002/14651858.CD011086.pub2
https://doi.org/10.1002/14651858.CD01108...
|
Multicenter study |
Systematic review |
Implementation perspective:
- 39 reviews, which addressed strategies for implementing evidence-based interventions in health systems;
- Promotion of educational and training activities for health professionals;
- Interventions targeted at patient self-management;
- Use of theories and Evidence-Based Practice to implement improvements in health services;
- Continuous improvement in quality of the organizational processes, use of structured problem-solving processes;
- Participation of community leaders in the interventions developed by health professionals, in order to ease interaction with the patients. Challenges:
- Limited access to systematic reviews by public policy makers and their scientific grounds for improving health service policies;
- At the global level, health services are lack the practice of adhering to the best available evidence to inform decisions on implementing specific interventions, resulting in suboptimal results and inefficiencies;
- Complex changes in health services and in the health professionals' routine;
- Financial arrangements and management of health policies. |
I§
|
A3† - Lewinski AA, Vaughn J, Diane A, Barnes A, Matthew J, CrowLey MD, et al. (2021)1515. Lewinski AA, Vaughn J, Diane A, Barnes A, Matthew J, CrowLey MD, et al. Perceptions of using multiple mobile health devices to support self‐management among adults with type 2 diabetes: a qualitative descriptive study. J Nurs Scholarsh [Internet]. 2021 [cited 2022 Jul 03];53(5):643-52. Available from: https://doi.org/10.1111/jnu.12667
https://doi.org/10.1111/jnu.12667...
|
United States of America |
Qualitative and descriptive |
Implementation perspective:
- Use of various mobile technologies that supported self-management of chronic diseases;
- Agile learning to use the device, following the instructions given by the study coordinator, devices that are easy to use and did not encounter technical difficulties;
- Several participants found that using the devices together helped them develop a routine, such as adjusting eating behaviors, tracking blood glucose, tracking trends to share and discuss with their physician;
- Satisfaction of the participants with the fitness tracker and reminders and stage log to help them schedule and track exercise targets and sleep regimens;
- Provide positive messages and support self-management behaviors, such as medication use, physical exercise and sleep.
- It eased conversations with other people and physicians about the patients' health condition. Challenges:
- The participants reported difficulty with the glucometer, such as manually recording glucose readings, connecting to Bluetooth, updating the glucometer, or scanning glucose test strips. |
IV‡
|
A4† - Wit LM, Uden-Kraan CFV, Lissenberg-Witte BI, Melissant HC, Fleuren MAH, Cuijpers P, et al. (2019)1616. Wit LM, Uden-Kraan CFV, Lissenberg-Witte BI, Melissant HC, Fleuren MAH, Cuijpers P, et al. Adoption and implementation of a web-based self-management application “Oncokompas” in routine cancer care: a national pilot study. Support Care Cancer [Internet]. 2019 [cited 2022 Jul 04];27(8):2911-20. Available from: https://doi.org/10.1007/s00520-018-4591-5
https://doi.org/10.1007/s00520-018-4591-...
|
Netherlands |
Cross-sectional and multicenter pilot study |
Implementation perspective:
- Oncokompas is a self-help app that assesses a survivor's quality of life, based on a feasibility study among health professionals and patients who value independent use;
- The supported self-management approach (combined care) was explored, with the importance of empowering the users and respecting their privacy, which resulted in the implementation of Oncokompas as an autonomous self-management tool. Challenges:
- Lack of evidence regarding cost/effectiveness and uncertainty about long-term reimbursement by the health care provider;
- The professionals reported that aged individuals had difficulty with a given technology;
- Another barrier to adopting Oncokompas is related to the concept of self-management: some hospitals questioned whether access to an online self-management tool should be provided through a hospital or directly to the patients themselves. |
III||
|
A5† - Dongbo F, Hua F, McGoowan P, Yi-e S, Lizhen Z, Huiqin Y, et al. (2003)1717. Dongbo F, Hua F, McGoowan P, Yi-e S, Lizhen Z, Huiqin Y, et al. Implementation and quantitative evaluation of chronic disease self-management programme in Shanghai, China: randomized controlled trial. Bull World Health Organ [Internet]. 2003 [cited 2022 Jul 04];81(10):174-82. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2572423/pdf/12764513.pdf
https://www.ncbi.nlm.nih.gov/pmc/article...
|
China |
Randomized Clinical Trial |
Implementation perspective:
- Implementation and evaluation of a chronic disease self-management patient education program for Chinese people with one or more chronic diseases in Shanghai;
- The course content was repeatedly modified, pre-tested and piloted to ensure that the course was culturally acceptable;
- The course was offered to groups, mainly by lay leaders working in pairs. This new health education format was appreciated by most of the participants, which rendered implementation of The Chronic Disease Self-Management Program (CDSMP) very successful;
- The commonly participatory model, in which community government organizations, community health centers and researchers worked together for design purposes;
- Implementation and evaluation of the program through a community program advisory committee;
- Implementation of the program increased self-management behaviors and maintained and improved health status, reducing participation of health services. |
II¶
|
A6† - Harvey J, Dopson S, McManus RJ, Powell J (2015)1818. Harvey J, Dopson S, McManus RJ, Powell J. Factors influencing the adoption of self-management solutions: an interpretive synthesis of the literature on stakeholder experiences. Implement Sci [Internet]. 2015 [cited 2022 Jul 05];10(1):1-15. Available: Available: https://doi.org/10.1186/s13012-015-0350-x
https://doi.org/10.1186/s13012-015-0350-...
|
United Kingdom |
Narrative review |
Implementation perspective:
- Patients' knowledge of their condition, ability to understand and operate the solutions, their ability to incorporate or customize solutions into daily practices;
- Visible effect of the solution and its effectiveness in managing the condition, such as sending accurate readings, family and healthcare provider support, need for motivational factors, and their ability to independently make decisions about medication adjustment;
- Health professionals: supporting patients in managing their conditions, reassessing the patients' conditions and providing feedback on their progress, providing support in setting goals and advising on medication dosage adjustment;
- The factors that influenced adoption by health professionals included diverse evidence that integration of existing systems and practices, alignment of the solution with the work organization goals, adaptability to learn and incorporate changes, transfer of the decision-making power to patients and the effect of the physician-patient relationship, time and resource constraints, incentives and motivation, assessment of the patient's skill level, interest and adaptability of the solution to current roles and responsibilities.
- Managers: in charge of responsibly delivering the solution to the intended users, on time and within budget, and had tasks such as working with solution designers and developers, consulting with user groups, promoting the solution to users, and documenting effectiveness of the solutions. Challenges:
- Creation of effective policies for the implementation of actions that support self-management capable of providing the necessary benefits;
- Effectively engaging with sustainable business models, funding and resources;
- Making adoption mandatory for health professionals. |
IV‡
|
Thumbnail
Thumbnail
