Integration of Chronic Disease Rehabilitation Services Into Primary Care

NCT01319656 | Completed

• 1 other identifier: FRSQ-24423
• Study Type: interventional
• Target: 326
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of PR1MaC is to establish a clinical intervention that will adapt and permanently integrate rehabilitation services into primary care settings, which would be the reference point in the health care system for people with Chronic diseases (CD). More specifically, the intervention will aim to: (1) clinically operationalize the mechanisms and tools necessary for delivery of integrated CD services, promoting continuity of care in response to the needs expressed by stakeholders; (2) implement and deploy rehabilitation services adapted to the realities of various clinical primary care settings and develop tools to ensure the sustainability of interventions beyond the rehabilitation period; and (3) support clinical primary care teams in the acquisition and maintenance of evidence-based practices for the targeted CDs.

Conditions

Cardiovascular Disease; Heart Failure; Chronic Obstructive Pulmonary Disease; Asthma; Diabetes

Keywords

Chronic diseases; Primary care; Rehabilitation; Chronic Care Model; Patient centered medical home

Outcome Measures

Primary Outcomes (1)

• Evaluation of effects

  Short term: * Self-Efficacy Managing Chronic Disease scale: SEMCD * Health Education Impact questionnaire: heiQ Medium term: * Risk factors * Functional health status/quality of life: SF12 * Psychological well being: K6 Other: * Socio-demographic: SD * comorbidity * co-intervention (CI) Visites: * 1:(week:- 2) : Group A and B: DBMA; SD; SF12; K6; SEMCD, heiQ * 2a:(week:0) : Group A, (week:12) for Group B: SEMCD, heiQ; CI * 2b, 2c: (weeks:4, 8) : Group A: CI * 3:(weeks:12) : Group A: SEMCD, heiQ; CI * 4:(weeks:52) : Group A: SF12, K6; SEMCD, heiQ; CI

  T1: Initial evaluation; T2: after three months; T3: one year after T1

Study Arms (3)

Group A

ACTIVE COMPARATOR

Intervention group(n = 163)

Behavioral: Support, management, educational, counselling, follow-up

Group B

ACTIVE COMPARATOR

Delayed intervention (n = 163)

Behavioral: Support, management, educational, counselling, follow-up

Group C

NO INTERVENTION

No intervention group (n = 163)

Interventions

Support, management, educational, counselling, follow-up BEHAVIORAL

The project offers a range of activities (educational, counselling, follow-up) by several professionals. The varied range of services is spread out over six months and may include individual or group meetings with professionals. Informational documents and follow-up tools are provided to patients based on their condition, to facilitate the acquisition and maintenance of knowledge, self-management, and changes in risk behaviour.

Also known as: dietetics, respiratory therapy, smoking cessation, physical activity, Stress management, Psychosocial support, Drug compliance

Group A; Group B

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• present at least one of the following conditions: type 2 diabetes, CVD, heart failure, risk factors (smoking, obesity, hyperlipidemia, glucose intolerance, and metabolic syndrome), COPD or asthma.
• have the potential for rehabilitation

You may not qualify if:

• serious cognitive problems

Sponsors & Collaborators

• Martin Fortin: lead
• Pfizer: collaborator
• Fonds de la Recherche en Santé du Québec: collaborator
• Ministere de la Sante et des Services Sociaux: collaborator
• Centre de santé et de services sociaux de Chicoutimi: collaborator
• Centre de santé et de services sociaux de Jonquière: collaborator

Study Sites (1)

CSSS de Chicoutimi, Unité de médecine de famille

Chicoutimi, Quebec, G7H 5H6, Canada

Location

Related Publications (20)

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  PMID: 18474705 BACKGROUND

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  PMID: 12535399 BACKGROUND

• Ellis SE, Speroff T, Dittus RS, Brown A, Pichert JW, Elasy TA. Diabetes patient education: a meta-analysis and meta-regression. Patient Educ Couns. 2004 Jan;52(1):97-105. doi: 10.1016/s0738-3991(03)00016-8.

  PMID: 14729296 BACKGROUND

• Gary TL, Genkinger JM, Guallar E, Peyrot M, Brancati FL. Meta-analysis of randomized educational and behavioral interventions in type 2 diabetes. Diabetes Educ. 2003 May-Jun;29(3):488-501. doi: 10.1177/014572170302900313.

  PMID: 12854339 BACKGROUND

• Smith SM, Allwright S, O'Dowd T. Effectiveness of shared care across the interface between primary and specialty care in chronic disease management. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD004910. doi: 10.1002/14651858.CD004910.pub2.

  PMID: 17636778 BACKGROUND

• Oelke ND, Cunning L, Andrews K, Martin D, MacKay A, Kuschminder K, Congdon V. Organizing care across the continuum: primary care, specialty services, acute and long-term care. Healthc Q. 2009;13 Spec No:75-9. doi: 10.12927/hcq.2009.21102.

  PMID: 20057254 BACKGROUND

• Delon S, Mackinnon B; Alberta Health CDM Advisory Committee. Alberta's systems approach to chronic disease management and prevention utilizing the expanded chronic care model. Healthc Q. 2009;13 Spec No:98-104. doi: 10.12927/hcq.2009.21106.

  PMID: 20057258 BACKGROUND

• Walsh K, Duke J, Foureur M, Macdonald L. Designing an effective evaluation plan: a tool for understanding and planning evaluations for complex nursing contexts. Contemp Nurse. 2007 May-Jun;25(1-2):136-45. doi: 10.5172/conu.2007.25.1-2.136.

  PMID: 17622997 BACKGROUND

• Nolte S, Elsworth GR, Sinclair AJ, Osborne RH. The extent and breadth of benefits from participating in chronic disease self-management courses: a national patient-reported outcomes survey. Patient Educ Couns. 2007 Mar;65(3):351-60. doi: 10.1016/j.pec.2006.08.016. Epub 2006 Oct 5.

  PMID: 17027221 BACKGROUND

• Contant E, Loignon C, Bouhali T, Almirall J, Fortin M. A multidisciplinary self-management intervention among patients with multimorbidity and the impact of socioeconomic factors on results. BMC Fam Pract. 2019 Apr 22;20(1):53. doi: 10.1186/s12875-019-0943-6.

  PMID: 31010425 DERIVED

• Fortin M, Chouinard MC, Diallo BB, Bouhali T. Integration of chronic disease prevention and management services into primary care (PR1MaC): findings from an embedded qualitative study. BMC Fam Pract. 2019 Jan 9;20(1):7. doi: 10.1186/s12875-018-0898-z.

  PMID: 30626313 DERIVED

• Fortin M, Chouinard MC, Dubois MF, Belanger M, Almirall J, Bouhali T, Sasseville M. Integration of chronic disease prevention and management services into primary care: a pragmatic randomized controlled trial (PR1MaC). CMAJ Open. 2016 Oct 12;4(4):E588-E598. doi: 10.9778/cmajo.20160031. eCollection 2016 Oct-Dec.

  PMID: 28018871 DERIVED

• Fortin M, Chouinard MC, Bouhali T, Dubois MF, Gagnon C, Belanger M. Evaluating the integration of chronic disease prevention and management services into primary health care. BMC Health Serv Res. 2013 Apr 8;13:132. doi: 10.1186/1472-6963-13-132.

  PMID: 23565674 DERIVED

Related Links

• CIHR Applied Research Chair - Health Services and Policy Research on Chronic Diseases in Primary Care
• Agence de la santé et des services sociaux du Saguenay-Lac-Saint-Jean
• Université de Sherbrooke
• Université du Québec à Chicoutimi

MeSH Terms

Conditions

Cardiovascular Diseases; Heart Failure; Pulmonary Disease, Chronic Obstructive; Asthma; Diabetes Mellitus; Chronic Disease

Interventions

Palliative Care; Therapeutics; Counseling; Respiratory Therapy; Exercise; Psychiatric Rehabilitation

Condition Hierarchy (Ancestors)

Heart Diseases; Lung Diseases, Obstructive; Lung Diseases; Respiratory Tract Diseases; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Bronchial Diseases; Respiratory Hypersensitivity; Hypersensitivity, Immediate; Hypersensitivity; Immune System Diseases; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases

Intervention Hierarchy (Ancestors)

Patient Care; Health Services; Health Care Facilities Workforce and Services; Mental Health Services; Behavioral Disciplines and Activities; Community Health Services; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Rehabilitation

Study Officials

• Martin Fortin, MD, M.Sc.

  Université de Sherbrooke

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Dr

Study Record Dates

• First Submitted: March 21, 2011
• First Posted: March 22, 2011
• Study Start: February 1, 2011
• Primary Completion: July 1, 2012
• Study Completion: November 1, 2013
• Last Updated: September 29, 2021

Record last verified: 2021-09

Locations

CA (1)