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Chronic Disease Management in the Primary Care

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A special issue of Journal of Personalized Medicine (ISSN 2075-4426).

Deadline for manuscript submissions: closed (15 May 2022) | Viewed by 37233

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Special Issue Editor

Prof. Gianfranco Damiani

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Guest Editor

Associated Professor, Department of sanità pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
Interests: primary care; health services research; public health

Special Issue Information

Dear Colleagues,

Chronic disease and its burden are threatening the sustainability of the healthcare system, so improving its management could be considered a strategic point.

Primary care provides the first contact, addressing a large majority of personal health care needs, often undifferentiated, and person-focused care over time, guaranteeing access and continuity of care for chronic conditions. It develops a partnership with patients, practices in the context of family and community, and can be considered a complex system of relationship between individuals, community, and a variety of health professionals and structures of care. Furthermore, as a consequence of the shift of many specialist outpatient and inpatient services to COVID care, the role of chronic care management in primary care has grown up.

In this perspective, the role of chronic disease management has to be interpreted on the basis of value-based healthcare issues, taking into account clinical outcomes along with safe and appropriate processes of care as well as patient experience and wellbeing of professionals in a context of predefined resources.

This Special Issue of the Journal of Personalized Medicine aims to highlight the current state of chronic disease management in primary care and showcase some of the latest findings in the field.

This issue will include studies that show evidence of chronic disease management in primary care having implications in policies or practices and reporting the use of innovative organizational models, technologies, performance measures (e.g., based on value) or patient/ community engagement.

Prof. Gianfranco Damiani
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Chronic diseases
Multimorbidity
Primary care
Value-based
Patient experiences
Community engagement
Health system and service model
Clinical trials
Disease management
Health care quality

Published Papers (12 papers)

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Research

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9 pages, 1048 KiB

Open AccessArticle

National Chronic Disease Management Programmes in Irish General Practice-Preparedness and Challenges

by Meera Tandan, Bebhinn Twomey, Liam Twomey, Mairead Egan and Gerard Bury

J. Pers. Med. 2022, 12(7), 1157; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12071157 - 17 Jul 2022

Cited by 1 | Viewed by 1528

Abstract

Information on the readiness of Irish general practice to participate in structured chronic disease management (CDM) care is limited. This study explores the logistic, staffing, and organizational preparedness of Irish general practice to do so, stratified by their size, location, and training status; implementation challenges were also explored. An anonymous, paper-based random survey was performed. A chi-square test was applied to compare practices by location (urban/rural), post-graduate training status (with/without), and numbers of GMS patient (≥1500/>1500 patients) and prevalence ratio and Poisson regression analysis to examine the relationship of staffing with key variables. Overall, 125/243 practices participated, 22% were rural, 56.6% were post-graduate training practices, and 53.9% had ≥1500 GMS patients. The rural, non-training practices and those with <1500 GMS patients had substantially lower staffing levels. The average number of GPs was significantly less in rural practices; however, the difference was insignificant for nurses. Salary costs for practice nurses in all practices and staff IT training and clinical equipment in smaller practices were important barriers. Most practices reported ‘inadequate’ waiting times for access to almost all referral and paramedical services. The study recommends addressing the staffing, funding, and training challenges within Irish general practice to effectively implement a structured CDM program. Full article

(This article belongs to the Special Issue Chronic Disease Management in the Primary Care)

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16 pages, 1581 KiB

Open AccessArticle

Stakeholder Perspectives on the Development and Implementation of a Polypharmacy Management Program in Germany: Results of a Qualitative Study

by Truc Sophia Dinh, Maria-Sophie Brueckle, Ana Isabel González-González, Julian Witte, Marjan van den Akker, Ferdinand M. Gerlach, Christiane Muth and on behalf of the EVITA Study Group

J. Pers. Med. 2022, 12(7), 1115; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12071115 - 07 Jul 2022

Cited by 1 | Viewed by 1463

Abstract

Structured management programs have been developed for single diseases but rarely for patients with multiple medications. We conducted a qualitative study to investigate the views of stakeholders on the development and implementation of a polypharmacy management program in Germany. Overall, we interviewed ten experts in the fields of health policy and clinical practice. Using content analysis, we identified inclusion criteria for the selection of suitable patients, the individual elements that should make up such a program, healthcare providers and stakeholders that should be involved, and factors that may support or hinder the program’s implementation. All stakeholders were well aware of polypharmacy-related risks and challenges, as well as the urgent need for change. Intervention strategies should address all levels of care and include all concerned patients, caregivers, healthcare providers and stakeholders, and involved parties should agree on a joint approach. Full article

(This article belongs to the Special Issue Chronic Disease Management in the Primary Care)

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9 pages, 526 KiB

Open AccessArticle

The Effect of Gout on Thyroid Cancer Incidence: A Nested Case-Control Study Using a National Health Screening Cohort

by So Young Kim, Dae Myoung Yoo, Mi Jung Kwon, Ji Hee Kim, Joo-Hee Kim, Woo Jin Bang, Sung Kyun Kim and Hyo Geun Choi

J. Pers. Med. 2022, 12(6), 887; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12060887 - 27 May 2022

Viewed by 1802

Abstract

In this study, we investigated the risk of thyroid cancer in patients with gout. Participants ≥40 years old in the Korean National Health Insurance Service–Health Screening Cohort were investigated. A total of 5844 patients with thyroid cancer were paired with 23,376 comparison participants (no history of thyroid cancer) to build the nested case–control study. A previous history of gout was collected from both the thyroid cancer and comparison participants. The relationship of thyroid cancer with a prior history of gout was analyzed using a conditional logistic regression model. The rate of gout was higher in the patients with thyroid cancer than in the comparison group. In the total study population, the relationship of thyroid cancer with a prior history of gout was not statistically evident. A previous history of gout was related to an increased risk of gout in the <60 years old, normal weight, abnormal blood pressure, and CCI score = 0 groups. The occurrence of thyroid cancer was not associated with a prior history of gout in the general adult population. However, a prior history of gout was related to an elevated risk of thyroid cancer in middle-aged and healthy populations without comorbidities. Full article

(This article belongs to the Special Issue Chronic Disease Management in the Primary Care)

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16 pages, 703 KiB

Open AccessArticle

How to Improve Healthcare for Patients with Multimorbidity and Polypharmacy in Primary Care: A Pragmatic Cluster-Randomized Clinical Trial of the MULTIPAP Intervention

by Isabel del Cura-González, Juan A. López-Rodríguez, Francisca Leiva-Fernández, Antonio Gimeno-Miguel, Beatriz Poblador-Plou, Fernando López-Verde, Cristina Lozano-Hernández, Victoria Pico-Soler, Mª Josefa Bujalance-Zafra, Luis A. Gimeno-Feliu, Mercedes Aza-Pascual-Salcedo, Marisa Rogero-Blanco, Francisca González-Rubio, Francisca García-de-Blas, Elena Polentinos-Castro, Teresa Sanz-Cuesta, Marcos Castillo-Jimena, Marcos Alonso-García, Amaia Calderón-Larrañaga, José M. Valderas, Alessandra Marengoni, Christiane Muth, Juan Daniel Prados-Torres, Alexandra Prados-Torres and Multi-PAP Group Show full author list Hide full author list

J. Pers. Med. 2022, 12(5), 752; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12050752 - 06 May 2022

Cited by 5 | Viewed by 3380

Abstract

(1) Purpose: To investigate a complex MULTIPAP intervention that implements the Ariadne principles in a primary care population of young-elderly patients with multimorbidity and polypharmacy and to evaluate its effectiveness for improving the appropriateness of prescriptions. (2) Methods: A pragmatic cluster-randomized clinical trial was conducted involving 38 family practices in Spain. Patients aged 65–74 years with multimorbidity and polypharmacy were recruited. Family physicians (FPs) were randomly allocated to continue usual care or to provide the MULTIPAP intervention based on the Ariadne principles with two components: FP training (eMULTIPAP) and FP patient interviews. The primary outcome was the appropriateness of prescribing, measured as the between-group difference in the mean Medication Appropriateness Index (MAI) score change from the baseline to the 6-month follow-up. The secondary outcomes were quality of life (EQ-5D-5 L), patient perceptions of shared decision making (collaboRATE), use of health services, treatment adherence, and incidence of drug adverse events (all at 1 year), using multi-level regression models, with FP as a random effect. (3) Results: We recruited 117 FPs and 593 of their patients. In the intention-to-treat analysis, the between-group difference for the mean MAI score change after a 6-month follow-up was −2.42 (95% CI from −4.27 to −0.59) and, between baseline and a 12-month follow-up was −3.40 (95% CI from −5.45 to −1.34). There were no significant differences in any other secondary outcomes. (4) Conclusions: The MULTIPAP intervention improved medication appropriateness sustainably over the follow-up time. The small magnitude of the effect, however, advises caution in the interpretation of the results given the paucity of evidence for the clinical benefit of the observed change in the MAI. Trial registration: Clinicaltrials.gov NCT02866799. Full article

(This article belongs to the Special Issue Chronic Disease Management in the Primary Care)

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14 pages, 516 KiB

Open AccessEditor’s ChoiceArticle

eHealth and mHealth in Chronic Diseases—Identification of Barriers, Existing Solutions, and Promoters Based on a Survey of EU Stakeholders Involved in Regions4PerMed (H2020)

by Dorota Stefanicka-Wojtas and Donata Kurpas

J. Pers. Med. 2022, 12(3), 467; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12030467 - 15 Mar 2022

Cited by 14 | Viewed by 3156

Abstract

Background: In recent years, rapid population ageing has become a worldwide phenomenon. Both electronic health services (eHealth) and mobile health services (mHealth) are becoming important components of healthcare delivery. The market for mHealth is growing extremely fast. However, despite the increasing investment and interest in eHealth, several challenges still need to be overcome to enable broader and more systematic implementation of ICT in healthcare. Methods: This study presents data from the survey “Barriers and facilitators of Personalised Medicine implementation- qualitative study under Regions4PerMed (H2020) project”. In addition, this paper discusses the results of the conference, Health Technology in Connected & Integrated Care, held under the Horizon 2020 project and interregional coordination for a fast and deep uptake of personalised health (Regions4Permed) (July 2020—online conference). The above sections were preceded by an analysis of existing articles. Results: The data obtained from the surveys show that the main barriers to the adoption of eHealth and mHealth are the lack of skills of seniors, but also the lack of user-friendly technology and a simple user interface. Access to individual data while ensuring its security and the lack of digitisation of medical data are also serious issues. In addition, medical digital solutions are overly fragmented due to national legislations that deviate from the General Data Protection Regulation. Conclusions: By using technological solutions, it is possible to improve diagnosis and treatment decisions, and better adapt treatment and reduce its duration and cost. However, there are still barriers to the development of eHealth. Clear recommendations for implementation are needed to enable further development of personalised eHealth and mHealth solutions Full article

(This article belongs to the Special Issue Chronic Disease Management in the Primary Care)

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12 pages, 673 KiB

Open AccessArticle

Evidence-Based Decision Support for a Structured Care Program on Polypharmacy in Multimorbidity: A Guideline Upgrade Based on a Realist Synthesis

by Truc Sophia Dinh, Maria-Sophie Brueckle, Ana Isabel González-González, Joachim Fessler, Ursula Marschall, Manfred Schubert-Zsilavesz, Ferdinand M. Gerlach, Sebastian Harder, Marjan van den Akker, Ingrid Schubert, Christiane Muth and the EVITA Study Group

J. Pers. Med. 2022, 12(1), 69; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12010069 - 07 Jan 2022

Cited by 5 | Viewed by 2262

Abstract

Evidence-based clinical guidelines generally consider single conditions, and rarely multimorbidity. We developed an evidence-based guideline for a structured care program to manage polypharmacy in multimorbidity by using a realist synthesis to update the German polypharmacy guideline including the following five methods: formal prioritization in focus groups; systematic guideline review of evidence-based multimorbidity/polypharmacy guidelines; evidence search/synthesis and recommendation development; multidisciplinary consent of recommendations; feasibility test of updated guideline. We identified the need for a better description of the target group, decision support, prioritization of medication, consideration of patient preferences and anticholinergic properties, and of healthcare interfaces. We conducted a systematic guideline review of eight guidelines and extracted and synthesized recommendations using the Ariadne principles. We also included 48 systematic reviews. We formulated and agreed upon 34 recommendations for the revised guideline. During the feasibility test, guideline use enabled 57% of GPs to identify problems, leading to medication changes in 49% and self-assessed improvement in 56% of patients. Although 58% of GPs felt that it was too long, 92% recommended it. Polypharmacy should be systematically reviewed at least annually. Patients, family members, and healthcare professionals should monitor and adjust it using prospective process validation, taking into account patient preferences and agreed treatment goals. Full article

(This article belongs to the Special Issue Chronic Disease Management in the Primary Care)

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15 pages, 675 KiB

Open AccessArticle

Uncertainty, Anxiety and Isolation: Experiencing the COVID-19 Pandemic and Lockdown as a Woman with Polycystic Ovary Syndrome (PCOS)

by Lou Atkinson, Chris Kite, Gordon McGregor, Tamsin James, Cain C. T. Clark, Harpal S. Randeva and Ioannis Kyrou

J. Pers. Med. 2021, 11(10), 952; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm11100952 - 25 Sep 2021

Cited by 10 | Viewed by 4474

Abstract

Background: The COVID-19 pandemic and the related lockdown measures presented a significant risk to physical and mental wellbeing in affected populations. Women with polycystic ovary syndrome (PCOS) are predisposed to several cardio-metabolic risk factors which increase the susceptibility to severe COVID-19 and also exhibit increased likelihood of impaired mental health wellbeing. Therefore, these women who usually receive care from multiple primary and specialist healthcare services may be disproportionately impacted by this pandemic and the related restrictions. This study aimed to explore the lived experience of the first UK national lockdown as a woman with PCOS. Methods: As part of a larger cross-sectional study, 12 women with PCOS living in the UK during the first national COVID-19 lockdown were recruited to a qualitative study. Telephone interviews were conducted in June/July of 2020, and data collected were subjected to thematic analysis. Results: Five themes were identified. “My PCOS Journey” describes participants’ experiences of diagnosis, treatment and ongoing management of their PCOS. “Living Through Lockdown” describes the overall experience and impact of the lockdown on all aspects of participants’ lives. “Self-care and Managing Symptoms” describe multiple challenges to living well with PCOS during the lockdown, including lack of access to supplies and services, and disruption to weight management. “Healthcare on Hold” describes the uncertainty and anxiety associated with delays in accessing specialised healthcare for a range of PCOS aspects, including fertility treatment. “Exacerbating Existing Issues” captures the worsening of pre-existing mental health issues, and an increase in health anxiety and feelings of isolation. Conclusion: For the women with PCOS in this study, the COVID-19 pandemic and the first national lockdown was mostly experienced as adding to the pre-existing challenges of living with their condition. The mental health impact experienced by the study participants was increased due to lack of access to their normal support strategies, limitations on healthcare services and uncertainty about their risk of COVID-19. Full article

(This article belongs to the Special Issue Chronic Disease Management in the Primary Care)

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11 pages, 903 KiB

Open AccessArticle

The Risk of Bladder Cancer in Type 2 Diabetes Mellitus with Combination Therapy of SGLT-2 Inhibitors and Pioglitazone

by Yan-Rong Li, Chi-Hung Liu, Wei-Chiao Sun, Pei-Yi Fan, Feng-Hsuan Liu, Tien-Hsing Chen, Victor Chien-Chia Wu, Chihung Lin and Ching-Chung Hsiao

J. Pers. Med. 2021, 11(9), 828; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm11090828 - 24 Aug 2021

Cited by 5 | Viewed by 2992

Abstract

Background: Either sodium-glucose cotransporter-2 (SGLT-2) inhibitors or pioglitazone (Pio) has doubtful issues of bladder cancer, especially for the combination therapy with these two drugs. Our study aimed to investigate the risk of bladder cancer under combination therapy of SGLT-2 inhibitors and Pio. Materials and Methods: We included 97,024 patients with type 2 diabetes mellitus (T2DM) in the Chang Gung Research Database in Taiwan from 1 January 2016 to 31 December 2019. The primary outcome was newly diagnosed bladder cancer after combination therapy with SGLT-2 inhibitors and Pio. Group 1 received both study drugs, group 2 received SGLT-2 inhibitors, group 3 received Pio, and group 4 received non-study drugs (the reference group). The secondary outcome in each group was all-cause mortality. Results: In group 1, no newly diagnosed bladder cancer was detected after a mean 2.8-year follow-up and all-cause mortality decreased significantly (adjusted hazard ratio (AHR), 0.70; 95% confidence interval (CI), 0.54–0.92) in comparison to the reference group (group 4). In group 2 and group 3, no trend of increased bladder cancer was observed (group 2: AHR 0.49, 95% CI 0.05–4.94; group 3: AHR 0.48, 95% CI 0.15–1.58) and it still reduced all-cause mortality (group 2: AHR 0.83, 95% CI 0.70–0.99; group 3: AHR 0.90, 95% CI 0.83–0.99). Conclusions: In T2DM patients without previous or active bladder cancer, the combination therapy of SGLT-2 inhibitors and Pio was not associated with newly diagnosed bladder cancer and had lower all-cause mortality. Full article

(This article belongs to the Special Issue Chronic Disease Management in the Primary Care)

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12 pages, 1350 KiB

Open AccessArticle

Adherence to Therapy, Physical and Mental Quality of Life in Patients with Multiple Sclerosis

by Alessandra Buja, Guendalina Graffigna, Simona F. Mafrici, Tatjana Baldovin, Carlo Pinato, Umberto Bolzonella, Serena Barello, Alessia Tognetto and Gianfranco Damiani

J. Pers. Med. 2021, 11(7), 672; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm11070672 - 16 Jul 2021

Cited by 6 | Viewed by 2327

Abstract

Ensuring multiple sclerosis (MS) patients’ adherence to therapy is often challenging, but it is crucial to their survival and health-related quality of life (HRQoL). The aim of the present study was to outline connections between adherence, physical and mental HRQoL, levels of psychological readiness to engage in a treatment, levels of social support, anthropometric, socio-demographic and clinical factors in patients suffering from MS. This cross-sectional study involved a sample of 237 Italian MS patients. A survey was conducted with a structured self-administered online questionnaire using validated measures of quality of life, adherence to therapy and anthropometric, socio-demographic, psychological and clinical variables. A path analysis was used to test the overall structure of the associations between the variables. The pathway indicates a positive association between mental health index and a stronger degree of engagement and being or having been in a long-term relationship. Physical health index was positively associated with age, having an occupation, and having a specific form of MS. Having had relapses in the previous year raised the odds of better adherence to therapy, while an increase in Body Mass Index (BMI) reduced them. Our findings could help in the management of MS patients, promoting behavioral interventions that take the psychological and socio-demographic peculiarities of each patient into account with a view to improving their adherence to therapy. Full article

(This article belongs to the Special Issue Chronic Disease Management in the Primary Care)

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13 pages, 2251 KiB

Open AccessArticle

Exercise Improves Cognitive Function—A Randomized Trial on the Effects of Physical Activity on Cognition in Type 2 Diabetes Patients

by Roman Leischik, Katharina Schwarz, Patrick Bank, Ania Brzek, Birgit Dworrak, Markus Strauss, Henning Litwitz and Christian Erik Gerlach

J. Pers. Med. 2021, 11(6), 530; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm11060530 - 09 Jun 2021

Cited by 10 | Viewed by 3499

Abstract

Background: Lifestyle habits strongly influence health. It is strongly believed that physical activity may improve cognitive function. We examined the association between two kinds of physical activity and cognitive function in patients with type 2 diabetes. Methods: Using a random allocation sequence, 49 patients with type 2 diabetes (metformin, insulin, and diet-controlled) were randomized to a 12-week intervention of either walking 40 min three times a week (n = 17), performing pedometer-controlled activity (E-health, goal 10,000 steps a day, n = 17), or receiving standard care (n = 16 controls). We prospectively examined cognitive function, metabolic parameters, height, and weight. The groups were compared using linear regression adjusted for age. Results: Compared with the control group (n = 16), nonverbal memory improved significantly after the intervention in the walking group (n = 16) (28.2 (+/−6.1) vs. 35.3 (+/−5.3) p < 0.001) and the E-health (pedometer) group ((n = 17) (29.7 (+/−3.9) vs. 35.6 (+/−3.8) p < 0.001). The verbal memory test showed improvement in the walking and E-health groups. Cognitive attention/performance measured by the FAIR-test was also significantly enhanced in the walking group (252.4/304.3 p < 0.001, 51.87 (CI 27.13–76.62)) and the E-health-group (85.65 (CI: 52.04–119.26, p < 0.001)). Abdominal circumference (−3 cm (CI: −9.69–3.31, p < 0.001)), heart rate (−6.50 (CI: −9.69, −3.31, p < 0.001)) and fat percentage (−2.74 (CI: −4.71, −0.76, p < 0.007)) changed significantly in only the walking group. Conclusions: This is the first intervention study in patients with type 2 diabetes that shows that pedometer-supported training significantly improves brain function. Walking additionally improves body composition and waist circumference. Physical activity is an inexpensive treatment with substantial preventative and restorative properties for cognitive and memory brain function in patients with type 2 diabetes. Full article

(This article belongs to the Special Issue Chronic Disease Management in the Primary Care)

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Review

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12 pages, 965 KiB

Open AccessReview

Interprofessional Collaboration and Diabetes Management in Primary Care: A Systematic Review and Meta-Analysis of Patient-Reported Outcomes

by Mario Cesare Nurchis, Giorgio Sessa, Domenico Pascucci, Michele Sassano, Linda Lombi and Gianfranco Damiani

J. Pers. Med. 2022, 12(4), 643; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12040643 - 15 Apr 2022

Cited by 3 | Viewed by 3673

Abstract

The global spread of diabetes poses serious threats to public health requiring a patient-centered approach based both on interprofessional collaboration (IPC) given by the cooperation of several different health professionals, and patients’ perspective through the assessment of Patient-Reported Outcomes (PROs). The aim of the present study is to evaluate the impact of interprofessional collaboration interventions, for the management of type 2 diabetes in primary care settings, through PROs. A systematic review and meta-analysis was conducted querying the PubMed, Scopus and Embase databases. Out of the 1961 papers initially retrieved, 19 met the inclusion criteria. Interprofessional collaboration is significantly associated with an increase in both patient’s satisfaction (SMD 0.32 95% CI 0.05–0.59) and in the mental well-being component of the HRQoL (SMD 0.18; 95% CI 0.06–0.30), and there was also promising evidence supporting the association between an interprofessional approach and an increase in self-care and in generic and specific quality-of-life. No statistical differences were found, supporting the positive impact on IPC interventions on the physical component of the HRQoL, depression, emotional distress, and self-efficacy. In conclusion, the effect of IPC impacts positively on the few areas assessed by PROMs. Policymakers should promote the widespread adoption of a collaborative approach as well as to endorse an active engagement of patients across the whole process of care. Full article

(This article belongs to the Special Issue Chronic Disease Management in the Primary Care)

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22 pages, 1022 KiB

Open AccessReview

Educational Interventions for Promoting Food Literacy and Patient Engagement in Preventing Complications of Type 2 Diabetes: A Systematic Review

by M. Savarese, M. Sapienza, G. M. Acquati, M. C. Nurchis, M. T. Riccardi, V. Mastrilli, R. D’Elia, E. A. Graps, G. Graffigna and G. Damiani

J. Pers. Med. 2021, 11(8), 795; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm11080795 - 14 Aug 2021

Cited by 7 | Viewed by 4326

Abstract

The present review aims to map the current literature on educational interventions to promote food literacy in type 2 diabetes, with a particular focus on the concept of patient engagement. The systematic review was implemented on five databases with no restrictions on the publication year. The studies selected for the review were focused on patients with type 2 diabetes, ranging from 2003 to 2021 and published in 13 countries (44% USA). Thirty-three articles were analyzed. Twenty-seven articles targeted singular patients; fifteen articles conceptualized patient engagement as self-management. In seven articles, the provider is a multidisciplinary team. Twenty articles did not report a theoretical framework in the intervention development, and eleven did not use an intervention material. Twenty-six articles did not use a technology proxy. Outcome categories were narratively mapped into four areas: clinical, psychological, behavioral, and literacy. To date, most of the interventions are heterogeneous in the adopted methodology, measures, and outcomes considered. More attention should be given to the psychosocial characterization of patient engagement as well as the technological support. High-quality, randomized controlled trials and longitudinal studies are lacking and need to be conducted to verify the efficacy of these insights. Full article

(This article belongs to the Special Issue Chronic Disease Management in the Primary Care)

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