Impact of Practice Facilitation in Primary Care on Chronic Disease Care Processes and Outcomes

a Systematic Review

Andrew Wang*, Teresa Pollack, Lauren A. Kadziel, Samuel M. Ross, Megan Colleen McHugh, Neil Jordan, Abel N Kho

*Corresponding author for this work

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Background: More than 100 million individuals in the USA have been diagnosed with a chronic disease, yet chronic disease care has remained fragmented and of inconsistent quality. Improving chronic disease management has been challenging for primary care and internal medicine practitioners. Practice facilitation provides a comprehensive approach to chronic disease care. The objective is to evaluate the impact of practice facilitation on chronic disease outcomes in the primary care setting. Methods: This systematic review examined North American studies from PubMed, EMBASE, and Web of Science (database inception to August 2017). Investigators independently extracted and assessed the quality of the data on chronic disease process and clinical outcome measures. Studies implemented practice facilitation and reported quantifiable care processes and patient outcomes for chronic disease. Each study and their evidence were assessed for risk of bias and quality according to the Cochrane Collaboration and the Grade Collaboration tool. Results: This systematic review included 25 studies: 12 randomized control trials and 13 prospective cohort studies. Across all studies, practices and their clinicians were aware of the implementation of practice facilitation. Improvements were observed in most studies for chronic diseases including asthma, cancer (breast, cervical, and colorectal), cardiovascular disease (cerebrovascular disease, coronary artery disease, dyslipidemia, hypertension, myocardial infarction, and peripheral vascular disease), and type 2 diabetes. Mixed results were observed for chronic kidney disease and chronic illness care. Discussion: Overall, the results suggest that practice facilitation may improve chronic disease care measures. Across all studies, practices were aware of practice facilitation. These findings lend support for the potential expansion of practice facilitation in primary care. Future work will need to investigate potential opportunities for practice facilitation to improve chronic disease outcomes in other health care settings (e.g., specialty and multi-specialty practices) with standardized measures.

Original languageEnglish (US)
Pages (from-to)1968-1977
Number of pages10
JournalJournal of general internal medicine
Volume33
Issue number11
DOIs
StatePublished - Nov 1 2018

Fingerprint

Primary Health Care
Chronic Disease
Cerebrovascular Disorders
Peripheral Vascular Diseases
Internal Medicine
Disease Management
Dyslipidemias
Chronic Renal Insufficiency
PubMed
Type 2 Diabetes Mellitus
Coronary Artery Disease
Patient Care
Cohort Studies
Cardiovascular Diseases
Asthma
Myocardial Infarction
Research Personnel
Outcome Assessment (Health Care)
Databases
Prospective Studies

Keywords

  • chronic disease
  • practice facilitation
  • primary care
  • quality improvement
  • systematic review

ASJC Scopus subject areas

  • Internal Medicine

Cite this

@article{c642de6a24a34e638d4a62f1d15a6248,
title = "Impact of Practice Facilitation in Primary Care on Chronic Disease Care Processes and Outcomes: a Systematic Review",
abstract = "Background: More than 100 million individuals in the USA have been diagnosed with a chronic disease, yet chronic disease care has remained fragmented and of inconsistent quality. Improving chronic disease management has been challenging for primary care and internal medicine practitioners. Practice facilitation provides a comprehensive approach to chronic disease care. The objective is to evaluate the impact of practice facilitation on chronic disease outcomes in the primary care setting. Methods: This systematic review examined North American studies from PubMed, EMBASE, and Web of Science (database inception to August 2017). Investigators independently extracted and assessed the quality of the data on chronic disease process and clinical outcome measures. Studies implemented practice facilitation and reported quantifiable care processes and patient outcomes for chronic disease. Each study and their evidence were assessed for risk of bias and quality according to the Cochrane Collaboration and the Grade Collaboration tool. Results: This systematic review included 25 studies: 12 randomized control trials and 13 prospective cohort studies. Across all studies, practices and their clinicians were aware of the implementation of practice facilitation. Improvements were observed in most studies for chronic diseases including asthma, cancer (breast, cervical, and colorectal), cardiovascular disease (cerebrovascular disease, coronary artery disease, dyslipidemia, hypertension, myocardial infarction, and peripheral vascular disease), and type 2 diabetes. Mixed results were observed for chronic kidney disease and chronic illness care. Discussion: Overall, the results suggest that practice facilitation may improve chronic disease care measures. Across all studies, practices were aware of practice facilitation. These findings lend support for the potential expansion of practice facilitation in primary care. Future work will need to investigate potential opportunities for practice facilitation to improve chronic disease outcomes in other health care settings (e.g., specialty and multi-specialty practices) with standardized measures.",
keywords = "chronic disease, practice facilitation, primary care, quality improvement, systematic review",
author = "Andrew Wang and Teresa Pollack and Kadziel, {Lauren A.} and Ross, {Samuel M.} and McHugh, {Megan Colleen} and Neil Jordan and Kho, {Abel N}",
year = "2018",
month = "11",
day = "1",
doi = "10.1007/s11606-018-4581-9",
language = "English (US)",
volume = "33",
pages = "1968--1977",
journal = "Journal of General Internal Medicine",
issn = "0884-8734",
publisher = "Springer New York",
number = "11",

}

Impact of Practice Facilitation in Primary Care on Chronic Disease Care Processes and Outcomes : a Systematic Review. / Wang, Andrew; Pollack, Teresa; Kadziel, Lauren A.; Ross, Samuel M.; McHugh, Megan Colleen; Jordan, Neil; Kho, Abel N.

In: Journal of general internal medicine, Vol. 33, No. 11, 01.11.2018, p. 1968-1977.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Impact of Practice Facilitation in Primary Care on Chronic Disease Care Processes and Outcomes

T2 - a Systematic Review

AU - Wang, Andrew

AU - Pollack, Teresa

AU - Kadziel, Lauren A.

AU - Ross, Samuel M.

AU - McHugh, Megan Colleen

AU - Jordan, Neil

AU - Kho, Abel N

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: More than 100 million individuals in the USA have been diagnosed with a chronic disease, yet chronic disease care has remained fragmented and of inconsistent quality. Improving chronic disease management has been challenging for primary care and internal medicine practitioners. Practice facilitation provides a comprehensive approach to chronic disease care. The objective is to evaluate the impact of practice facilitation on chronic disease outcomes in the primary care setting. Methods: This systematic review examined North American studies from PubMed, EMBASE, and Web of Science (database inception to August 2017). Investigators independently extracted and assessed the quality of the data on chronic disease process and clinical outcome measures. Studies implemented practice facilitation and reported quantifiable care processes and patient outcomes for chronic disease. Each study and their evidence were assessed for risk of bias and quality according to the Cochrane Collaboration and the Grade Collaboration tool. Results: This systematic review included 25 studies: 12 randomized control trials and 13 prospective cohort studies. Across all studies, practices and their clinicians were aware of the implementation of practice facilitation. Improvements were observed in most studies for chronic diseases including asthma, cancer (breast, cervical, and colorectal), cardiovascular disease (cerebrovascular disease, coronary artery disease, dyslipidemia, hypertension, myocardial infarction, and peripheral vascular disease), and type 2 diabetes. Mixed results were observed for chronic kidney disease and chronic illness care. Discussion: Overall, the results suggest that practice facilitation may improve chronic disease care measures. Across all studies, practices were aware of practice facilitation. These findings lend support for the potential expansion of practice facilitation in primary care. Future work will need to investigate potential opportunities for practice facilitation to improve chronic disease outcomes in other health care settings (e.g., specialty and multi-specialty practices) with standardized measures.

AB - Background: More than 100 million individuals in the USA have been diagnosed with a chronic disease, yet chronic disease care has remained fragmented and of inconsistent quality. Improving chronic disease management has been challenging for primary care and internal medicine practitioners. Practice facilitation provides a comprehensive approach to chronic disease care. The objective is to evaluate the impact of practice facilitation on chronic disease outcomes in the primary care setting. Methods: This systematic review examined North American studies from PubMed, EMBASE, and Web of Science (database inception to August 2017). Investigators independently extracted and assessed the quality of the data on chronic disease process and clinical outcome measures. Studies implemented practice facilitation and reported quantifiable care processes and patient outcomes for chronic disease. Each study and their evidence were assessed for risk of bias and quality according to the Cochrane Collaboration and the Grade Collaboration tool. Results: This systematic review included 25 studies: 12 randomized control trials and 13 prospective cohort studies. Across all studies, practices and their clinicians were aware of the implementation of practice facilitation. Improvements were observed in most studies for chronic diseases including asthma, cancer (breast, cervical, and colorectal), cardiovascular disease (cerebrovascular disease, coronary artery disease, dyslipidemia, hypertension, myocardial infarction, and peripheral vascular disease), and type 2 diabetes. Mixed results were observed for chronic kidney disease and chronic illness care. Discussion: Overall, the results suggest that practice facilitation may improve chronic disease care measures. Across all studies, practices were aware of practice facilitation. These findings lend support for the potential expansion of practice facilitation in primary care. Future work will need to investigate potential opportunities for practice facilitation to improve chronic disease outcomes in other health care settings (e.g., specialty and multi-specialty practices) with standardized measures.

KW - chronic disease

KW - practice facilitation

KW - primary care

KW - quality improvement

KW - systematic review

UR - http://www.scopus.com/inward/record.url?scp=85052095467&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85052095467&partnerID=8YFLogxK

U2 - 10.1007/s11606-018-4581-9

DO - 10.1007/s11606-018-4581-9

M3 - Review article

VL - 33

SP - 1968

EP - 1977

JO - Journal of General Internal Medicine

JF - Journal of General Internal Medicine

SN - 0884-8734

IS - 11

ER -