Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montreal: does greater coordination of care with primary care physicians have an impact on health outcomes?

INTRODUCTION: Chronic disease management requires substantial services integration. A cardiometabolic risk management program inspired by the Chronic Care Model was implemented in Montreal for patients with diabetes or hypertension. One of this study's objectives was to assess the impact of care coordination between the interdisciplinary teams and physicians on patient participation in the program, lifestyle improvements and disease control. METHODS: We obtained data on health outcomes from a register of clinical data, questionnaires completed by patients upon entry into the program and at the
Authors (Zotero)
Provost, Sylvie; Pineault, Raynald; Grimard, Dominique; Perez, Jose; Fournier, Michel; Levesque, Yves; Desforges, Johanne; Tousignant, Pierre; Borges Da Silva, Roxane
Date (Zotero)
Abril, 2017