The prevention and management of chronic disease in primary care: Recommendations from a knowledge translation meeting Health Services Research

被引：12

作者：

Ahmed S. ^{[1
,2
,3
]}

Ware P. ^{[1
]}

Visca R. ^{[4
]}

Bareil C. ^{[5
]}

Chouinard M.-C. ^{[6
,7
]}

Desforges J. ^{[8
]}

Finlayson R. ^{[4
]}

Fortin M. ^{[7
,9
]}

Gauthier J. ^{[10
]}

Grimard D. ^{[11
]}

Guay M. ^{[12
,13
]}

Hudon C. ^{[9
]}

Lalonde L. ^{[14
,15
]}

Lévesque L. ^{[15
]}

Michaud C. ^{[16
]}

Provost S. ^{[11
]}

Sutton T. ^{[17
]}

Tousignant P. ^{[11
]}

Travers S. ^{[17
]}

Ware M. ^{[18
]}

Gogovor A. ^{[1
]}

机构：

[1] Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montreal, H3G 1Y5, QC

[2] Constance-Lethbridge Rehabilitation Center, Centre de Recherche Interdisciplinaire en Réadaptation (CRIR), 7005 Boulevard De Maisonneuve O, Montréal, H4B 1T3, QC

[3] Clinical Epidemiology, McGill University Health Center, 687 Pine Ave W, Montreal, H3A 1A1, QC

[4] Centre for Expertise in Chronic Pain of the Réseau, Universitaire Intégré de Santé McGill, 2155 Guy, Montreal, H3H 2R9, QC

[5] Department of Management, HEC Montreal, 3000, chemin de la Côte-Sainte-Catherine, Montreal, H3T 2A7, QC

[6] Département des Sciences de la Santé, Université du Québec À Chicoutimi, 555 boul. de l'Université, Chicoutimi, G7H 2B1, QC

[7] Centre de Santé et de Services Sociaux de Chicoutimi, 305 St-Vallier, Chicoutimi, G7H 5H6, QC

[8] Groupe de Médecine de Famille de Verdun, 4000, boulevard Lasalle, Verdun, H4G 2A3, QC

[9] Département de Médecine de Famille et Médecine d'Urgence, Faculte de Medecine et des Sciences de la Sante, Universite de Sherbrooke, 3001 12ème avenue Nord, Fleurimont, J1H 5N4, QC

[10] Institut National de Santé Publique du Quebec, Consortium InterEst Santé, Département des Sciences Infirmières, Université du Québec À Rimouski, 300 Allée des Ursulines, Bureau K-310, Rimouski, G5L 3A1, QC

[11] Direction de Sante Publique de l'Agence de la Sante et des Services Sociaux de Montreal, 1301 Sherbrooke Est, Montreal, H2L 1M3, QC

[12] Département des Sciences de la Santé Communautaire, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, J1H 5N4, QC

[13] Direction de Sante Publique de l'Agence de la Sante et des Services Sociaux de la Monteregie, 1255 Beauregard, Longueuil

[14] Faculté de Pharmacie, Université de Montréal, pavillion Jean-Coutu, Montreal, H3C 3J7, QC

[15] Centre de Santé et de Services Sociaux de Laval, 1755 boulevard René-Laennec, Laval, H7M 3L9, QC

[16] Faculté de Médecine et des Sciences de la Santé, École des Sciences Infirmières, Université de Sherbrooke, Campus de Longueil, 150, Place Charles LeMoyne, Bureau 200, Sherbrooke, J4K 0A8, QC

[17] Centre de Santé et de Services Sociaux du Roché-Percé, C.P. 3300,451, rue MGR-Ross Est, Chandler, G0C 1K0, QC

[18] Alan Edwards Pain Management Unit, McGill University Health Centre, 650 Cedar Avenue, Montreal, H3G 1A4, QC

来源：

BMC Research Notes | / 8卷 / 1期

关键词：

Chronic disease management; Evaluation; Implementation; Knowledge translation;

D O I：

10.1186/s13104-015-1514-0

中图分类号：

学科分类号：

摘要：

Background: Seven chronic disease prevention and management programs were implemented across Quebec with funding support from a provincial-private industry funding initiative. Given the complexity of implementing integrated primary care chronic disease management programs, a knowledge transfer meeting was held to share experiences across programs and synthesize common challenges and success factors for implementation. Methods: The knowledge translation meeting was held in February 2014 in Montreal, Canada. Seventy-five participants consisting of 15 clinicians, 14 researchers, 31 knowledge users, and 15 representatives from the funding agencies were broken up into groups of 10 or 11 and conducted a strengths, weaknesses, opportunities, and threats analysis on either the implementation or the evaluation of these chronic disease management programs. Results were reported back to the larger group during a plenary and recorded. Audiotapes were transcribed and summarized using pragmatic thematic analysis. Results and discussion: Strengths to leverage for the implementation of the seven programs include: (1) synergy between clinical and research teams; (2) stakeholders working together; (3) motivation of clinicians; and (4) the fact that the programs are evidence-based. Weaknesses to address include: (1) insufficient resources; (2) organizational change within the clinical sites; (3) lack of referrals from primary care physicians; and (4) lack of access to programs. Strengths to leverage for the evaluation of these programs include: (1) engagement of stakeholders and (2) sharing of knowledge between clinical sites. Weaknesses to address include: (1) lack of referrals; (2) difficulties with data collection; and (3) difficulties in identifying indicators and control groups. Opportunities for both themes include: (1) fostering new and existing partnerships and stakeholder relations; (2) seizing funding opportunities; (3) knowledge transfer; (4) supporting the transformation of professional roles; (5) expand the use of health information technology; and (6) conduct cost evaluations. Fifteen recommendations related to mobilisation of primary care physicians, support for the transformation of professional roles, and strategies aimed at facilitating the implementation and evaluation of chronic disease management programs were formulated based on the discussions at this knowledge translation event. Conclusion: The results from this knowledge translation day will help inform the sustainability of these seven chronic disease management programs in Quebec and the implementation and evaluation of similar programs elsewhere. © 2015 Ahmed et al.

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