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. 2018 Nov 20;7(11):451.
doi: 10.3390/jcm7110451.

Barriers and Facilitators in Implementing Non-Face-to-Face Chronic Care Management in an Elderly Population with Diabetes: A Qualitative Study of Physician and Health System Perspectives

Alessandra N Bazzano  1 , M Kristina Wharton  2 , Alisha Monnette  3 , Elizabeth Nauman  4 , Eboni Price-Haywood  5 , Cathy Glover  6 , Patricia Dominick  7 , Peggy Malone  8 , Gang Hu  9 , Lizheng Shi  10
Affiliations

Barriers and Facilitators in Implementing Non-Face-to-Face Chronic Care Management in an Elderly Population with Diabetes: A Qualitative Study of Physician and Health System Perspectives

Alessandra N Bazzano et al. J Clin Med. .

Abstract

The burden of illness related to diabetes and its complications is exceedingly high and growing globally. Systematic approaches to managing chronic care are needed to address the complex nature of the disease, taking into account health system structures. This study presents data collected from interviews with physicians, health system administrators, and other healthcare staff about chronic care management for elderly people with diabetes co-morbid with other chronic conditions in light of new programs intended to reduce barriers by incentivizing care encounters that take place through telephone and electronic communications (non-face-to-face care). Results indicate that health system personnel view non-face-to-face care as potentially providing value for patients and addressing systemic needs, yet challenging to implement in practice. Barriers and facilitators to this approach for managing diabetes and chronic care management for its complications are presented, with consideration to different types of health systems, and recommendations are provided for implementation.

Keywords: aged; diabetes complications; disease management; health care quality, access, and evaluation; health systems research.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

References

    1. Bullard K.M., Cowie C.C., Lessem S.E., Saydah S.H., Menke A., Geiss L.S., Orchard T.J., Rolka D.B., Imperatore G. Prevalence of Diagnosed Diabetes in Adults by Diabetes Type—United States, 2016. MMWR Morb. Mortal. Wkly. Rep. 2018;67:359–361. doi: 10.15585/mmwr.mm6712a2. - DOI - PMC - PubMed
    1. Buttorff C., Teague R., Bauman M. Multiple Chronic Conditions in the United States. [(accessed on 21 September 2018)]; Available online: https://www.rand.org/pubs/tools/TL221.html.
    1. Rubin R.R., Peyrot M. Quality of life and diabetes. Diabetes Metab. Res. Rev. 1999;15:205–218. doi: 10.1002/(SICI)1520-7560(199905/06)15:3<205::AID-DMRR29>3.0.CO;2-O. - DOI - PubMed
    1. Nathan D.M., Genuth S., Lachin J., Lachin J., Cleary P., Crofford O., Davis M., Rand L., Siebert C. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New Engl. J. Med. 1993;329:977–986. - PubMed
    1. Schulze M.B., Hu F.B. Primary prevention of diabetes: What can be done and how much can be prevented? Annu Rev Public Health. 2005;26:445–467. doi: 10.1146/annurev.publhealth.26.021304.144532. - DOI - PubMed

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