title: Chronic disease management: improving care for people with osteoarthritis.
abstract: Chronic disease management (CDM) service models are being developed for many conditions; however, there is limited evidence to support their effectiveness in osteoarthritis (OA). A systematic review was undertaken to examine effectiveness, cost effectiveness and barriers to the use of osteoarthritis-chronic disease management (OA-CDM) service models. Thirteen eligible studies (eight randomised controlled trial (RCTs)) were identified. The majority focussed on delivery system design (n = 9) and/or providing self-management support (SMS) (n = 8). Overall, reported model effectiveness varied, and where positive impacts on process or health outcomes were observed, they were of small to moderate effect. There was no information about cost effectiveness. There is some evidence to support the use of collaborative care/multidisciplinary case management models in primary and community care and evidence-based pathways/standardisation of care in hospital settings. Multiple barriers were identified. Future research should focus on identifying the effective components of multi-faceted interventions and evaluating cost-effectiveness to support clinical and policy decision-making.
authors.affiliation: Melbourne EpiCentre, The University of Melbourne and Melbourne Health, Parkville, Victoria 3050, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. Electronic address: Caroline.Brand@mh.org.au.
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Brand
authors.affiliation: Melbourne EpiCentre, The University of Melbourne and Melbourne Health, Parkville, Victoria 3050, Australia. Electronic address: i.ackerman@unimelb.edu.au.
authors.forename: Ilana N
authors.initials: IN
authors.lastname: Ackerman
authors.affiliation: Melbourne EpiCentre, The University of Melbourne and Melbourne Health, Parkville, Victoria 3050, Australia. Electronic address: Joanne.Tropea@mh.org.au.
authors.forename: Joanne
authors.initials: J
authors.lastname: Tropea
mesh_terms: D002908:Chronic Disease; D003695:Delivery of Health Care; D019468:Disease Management; D006297:Health Services Accessibility; D006801:Humans; D010003:Osteoarthritis / Q000628:therapy*; D011787:Quality of Health Care
keywords: Access; Chronic disease; Delivery of healthcare; Evaluation; Health-care quality; Osteoarthritis