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Key Publications in Chronic Illness Management

Study Examples | Key Publications | Intro

A few key publications follow:

In primary care and physical therapy settings, this study evaluated an intervention for chronic back pain patients that incorporated fear-reducing and activating techniques. This intervention, which integrated fear-reducing and activating interventions into care for chronic back pain patients, produced sustained reductions in patient fears, common activity limitations related to back pain, and days missed from usual activities due to back pain.

—Von Korff M, Balderson BHK, Saunders K, Miglioretti DL, Lin EHB, Berry S, Moore JE, Turner JA (2005). A trial of an activating intervention for chronic back pain in primary care and physical therapy settings. Pain, 113 (3): 323–330.

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Traditional approaches to change primary care practice have not led to full implementation of national asthma guidelines. This two-year randomized controlled clinical trial found that planned care (nurse-mediated organizational change plus peer leader education) is an effective model for improving asthma care. On its own, peer leader education may also serve as a useful model for improving asthma care, but it is less comprehensive and its effect on treatment less pronounced.

—Lozano P, Finkelstein JA, Carey VJ, Wagner EH, Inui TS, Fuhlbrigge AL, Soumerai SB, Sullivan SD, Weiss ST, Weiss KB (2004). A multisite randomized trial of the effects of physician education and organizational change in chronic-asthma care: health outcomes of the Pediatric Asthma Care Patient Outcomes Research Team II Study. Archives of Pediatrics & Adolescent Medicine, 158 (9): 875–883.

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This article reviews how the Chronic Care Model can affect the management and health care costs of chronic diseases. Of 39 medical studies, 32 found that model-based interventions improved at least one process or outcome measure for patients with diabetes. Of 27 cost studies, 18 associated model-based interventions with lower health care costs or less use of services for congestive heart failure, asthma, and/or diabetes.

—Bodenheimer T, Wagner EH, Grumbach K (2002). Improving primary care for patients with chronic illness: The chronic care model, Part 2. Journal of the American Medical Association, 288 (15): 1909–1914.

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These case studies describe how parts of the Chronic Care Model have been implemented in the primary-care practices of four health plans. The model predicts that improving its six interrelated parts—self-management support, clinical information systems, delivery system redesign, decision support, health care organization, and community resources—can reform systems.

—Bodenheimer T, Wagner EH, Grumbach K (2002). Improving primary care for patients with chronic illness. Journal of the American Medical Association, 288 (14): 1775–1779.

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Twenty-three health care organizations combined the collaborative approach—the Breakthrough Series (BTS)—with the Chronic Care Model for diabetes. Care processes and clinical outcomes apparently improved, based on changes that teams made in the collaborative. Many of the organizations showing the largest improvements were community health centers, with the scarcest resources and most challenged populations.

—Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A (2001). Improving chronic illness care: Translating evidence into action. Health Affairs, 20 (6): 64–78.

Study Examples | Key Publications | Intro

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