PMID- 32831086
OWN - NLM
STAT- MEDLINE
DCOM- 20201119
LR  - 20240329
IS  - 1477-7525 (Electronic)
IS  - 1477-7525 (Linking)
VI  - 18
IP  - 1
DP  - 2020 Aug 24
TI  - Changes in health-related quality of life before and after a 12-month enhanced 
      primary care model among chronically ill primary care patients in Australia.
PG  - 288
LID - 10.1186/s12955-020-01539-1 [doi]
LID - 288
AB  - PURPOSE: Evidence suggests that Patient-centred Medical Home (PCMH) model 
      facilitates person-centred care and improves health-related quality of life for 
      patients with chronic illness. This study aims to evaluate changes in 
      health-related quality of life (HRQoL), before and after enrolment into a 
      12-month integrated care program called 'WellNet'. METHODS: This study includes 
      616 eligible consented patients aged 40 years and above with one or more chronic 
      conditions from six general practices across Sydney, Australia. The WellNet 
      program included a team of general practitioners (GPs) and clinical coordinators 
      (CCs) providing patient-tailored care plans configured to individual risk and 
      complexity. HRQoL was recorded using the validated EuroQol five dimensions five 
      levels (EQ-5D-5L) instrument at baseline and 12 months. Additionally, patients 
      diagnosed with osteoarthritis also reported HRQoL using short versions of Knee 
      and/or Hip disability and osteoarthritis outcome scores (KOOSjr and HOOSjr). A 
      case-series study design with repeated measures analysis of covariance (ANCOVA) 
      was used to assess changes in mean differences of EQ-5D index scores after 
      controlling for baseline covariates. Additionally, backward stepwise 
      multivariable linear regression models were conducted to determine significant 
      predictors of EQ-5D index scores at follow-up. RESULTS: Out of 616 patients, 417 
      (68%) reported EQ-5D scores at follow-up. Almost half (48%) of the WellNet 
      patients reported improved EQ-5D index scores at follow-up. After controlling for 
      baseline covariates, the adjusted mean difference was statistically significant 
      whilst also meeting the bare minimal clinically important difference (MCID) with 
      a change of 0.03 (95% CI 0.01, 0.05). The multivariable regression models 
      determined that baseline EQ-5D scores and positive diagnosis of a respiratory 
      illness were significant predictors of HRQoL at follow-up. There were significant 
      improvements across both KOOS and HOOS assessments, specifically, the pain and 
      symptom scores in both scales met statistical significance in addition to meeting 
      the MCID. CONCLUSION: Patient-tailored chronic disease management (CDM) plans 
      designed by team of GPs and CDM clinical coordinators could lead to better HRQoL 
      among primary care patients.
FAU - John, James Rufus
AU  - John JR
AUID- ORCID: 0000-0002-8720-8300
AD  - Translational Health Research Institute, Western Sydney University, Campbelltown, 
      Sydney, NSW, 2560, Australia. 18314234@student.westernsydney.edu.au.
AD  - Rozetta Institute (formerly Capital Markets Cooperative Research Centre), The 
      Rocks, Sydney, NSW, 2000, Australia. 18314234@student.westernsydney.edu.au.
FAU - Tannous, W Kathy
AU  - Tannous WK
AD  - Translational Health Research Institute, Western Sydney University, Campbelltown, 
      Sydney, NSW, 2560, Australia.
AD  - School of Business, Western Sydney University, Parramatta, NSW, 2150, Australia.
FAU - Jones, Amanda
AU  - Jones A
AD  - Sonic Clinical Services, The Rocks, Sydney, NSW, 2000, Australia.
LA  - eng
GR  - NA/Rozetta Institute industry PhD scholarship/
PT  - Journal Article
PT  - Multicenter Study
DEP - 20200824
PL  - England
TA  - Health Qual Life Outcomes
JT  - Health and quality of life outcomes
JID - 101153626
SB  - IM
MH  - Aged
MH  - Australia
MH  - Chronic Disease/psychology/therapy
MH  - Controlled Before-After Studies
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Minimal Clinically Important Difference
MH  - Patient-Centered Care/*standards
MH  - *Quality of Life
MH  - Reproducibility of Results
MH  - Surveys and Questionnaires
PMC - PMC7445903
OTO - NOTNLM
OT  - Australia
OT  - Chronic care model
OT  - Chronic disease
OT  - Collaborative care
OT  - EuroQol (EQ-5D)
OT  - Integrated care
OT  - Multimorbidity
OT  - Quality of life
COIS- JRJ and KT have no competing interests. AJ is employed by SCS as the Operational 
      Manager Integrated Care and is responsible for the implementation of WellNet. 
      However, SCS and WellNet partners had no control or influence over the decision 
      to submit the final manuscript for publication.
EDAT- 2020/08/25 06:00
MHDA- 2020/11/20 06:00
PMCR- 2020/08/24
CRDT- 2020/08/25 06:00
PHST- 2020/05/08 00:00 [received]
PHST- 2020/08/17 00:00 [accepted]
PHST- 2020/08/25 06:00 [entrez]
PHST- 2020/08/25 06:00 [pubmed]
PHST- 2020/11/20 06:00 [medline]
PHST- 2020/08/24 00:00 [pmc-release]
AID - 10.1186/s12955-020-01539-1 [pii]
AID - 1539 [pii]
AID - 10.1186/s12955-020-01539-1 [doi]
PST - epublish
SO  - Health Qual Life Outcomes. 2020 Aug 24;18(1):288. doi: 
      10.1186/s12955-020-01539-1.