Implementing elements of a context-adapted chronic care model to improve first-line diabetes care: effects on assessment of chronic illness care and glycaemic control among people with diabetes enrolled to the First-Line Diabetes Care (FiLDCare) Project in the Northern Philippines

Aim The purpose of this study was to investigate the effects of implementing elements of a context-adapted chronic disease-care model (CACCM) in two local government primary healthcare units of a non-highly urbanized city and a rural municipality in the Philippines on Patients' Assessment of Ch...

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Bibliographic Details
Published in:Primary health care research & development 2015-09, Vol.16 (5), p.481-491
Main Authors: Ku, Grace M.V., Kegels, Guy
Format: Article
Language:English
Subjects:
Adaptation
Adult
Aged
Aged, 80 and over
Blood Glucose
Chronic Disease
Chronic illnesses
Diabetes
Diabetes Mellitus - blood
Diabetes Mellitus - therapy
Disease
Drug stores
Female
Health care policy
Humans
Laboratories
Local government
Long-Term Care
Male
Medical personnel
Middle Aged
Pharmacy
Philippines
Program Evaluation
Rural Population
Surveys and Questionnaires
Urban Population
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Summary:Aim The purpose of this study was to investigate the effects of implementing elements of a context-adapted chronic disease-care model (CACCM) in two local government primary healthcare units of a non-highly urbanized city and a rural municipality in the Philippines on Patients' Assessment of Chronic Illness Care (PACIC) and glycaemic control (HbA1c) of people with diabetes. Low-to-middle income countries like the Philippines are beset with rising prevalence of chronic conditions but their healthcare systems are still acute disease oriented. Attention towards improving care for chronic conditions particularly in primary healthcare is imperative and ways by which this can be done amidst resource constraints need to be explored. A chronic care model was adapted based on the context of the Philippines. Selected elements (community sensitization, decision support, minor re-organization of health services, health service delivery-system re-design, and self-management education and support) were implemented. PACIC and HbA1c were measured before and one year after the start of implementation. Findings The improvements in the PACIC (median, from 3.2 to 3.5) as well as in four of the five subsets of the PACIC were statistically significant (P-values: PACIC=0.009; 'patient activation'=0.026; 'goal setting'=0.017; 'problem solving'
ISSN:1463-4236
1477-1128
DOI:10.1017/S1463423614000553