Individualized Plans of Care to Improve Outcomes Among Children and Adults With Chronic Illness: A Systematic Review
Authors: Lion, K. Casey; Mangione-Smith, Rita; Britto, Maria T.
Source: Care Management Journals,
Volume 15, Number 1, 2014
, pp. 11-25(15)
Publisher: Springer Publishing Company
Abstract:
Background: Adults and children with chronic illness often require
services from multiple providers. Individualized plans of care (IPCs)
are sometimes developed to improve care coordination. However, their
association with improved outcomes is unknown.
Methods: We
searched literature
published between January 2001 and October 2011, using Medline, CINAHL,
EMBASE, PsychINFO, and bibliographic review. Eligible studies involved
an IPC with input from the patient and/or family of individuals with
chronic illness, evaluated outcomes, and were conducted in the United
States.
We assessed evidence quality using Oxford Centre for Evidence-Based
Medicine criteria.
Results: 15 studies met inclusion criteria.
Studies were heterogeneous regarding populations and outcomes examined
and were generally low quality. Most described IPC use within a
multifaceted care coordination
intervention. The strongest evidence links IPC use and symptom
improvement in depressed adults; the weakest evidence exists for
outcomes in children. Vague descriptions of the IPCs' limited analysis.
Conclusions: Current evidence supporting an association between IPC use
and improved outcomes,
particularly among children, is sparse. Well-designed evaluations of
clearly described IPCs are needed to examine who should be involved in
their development, what they should include, and how often they should
be updated to improve outcomes of care for this vulnerable population.
Background: Adults and children with chronic illness often require
services from multiple providers. Individualized plans of care (IPCs)
are sometimes developed to improve care coordination. However, their
association with improved outcomes is unknown.
Methods: We
searched literature
published between January 2001 and October 2011, using Medline, CINAHL,
EMBASE, PsychINFO, and bibliographic review. Eligible studies involved
an IPC with input from the patient and/or family of individuals with
chronic illness, evaluated outcomes, and were conducted in the United
States.
We assessed evidence quality using Oxford Centre for Evidence-Based
Medicine criteria.
Results: 15 studies met inclusion criteria.
Studies were heterogeneous regarding populations and outcomes examined
and were generally low quality. Most described IPC use within a
multifaceted care coordination
intervention. The strongest evidence links IPC use and symptom
improvement in depressed adults; the weakest evidence exists for
outcomes in children. Vague descriptions of the IPCs' limited analysis.
Conclusions: Current evidence supporting an association between IPC use
and improved outcomes,
particularly among children, is sparse. Well-designed evaluations of
clearly described IPCs are needed to examine who should be involved in
their development, what they should include, and how often they should
be updated to improve outcomes of care for this vulnerable population.
Keywords:
CASE MANAGEMENT;
DISEASE MANAGEMENT;
PATIENT CARE PLANNING;
PATIENT-CENTERED CARE
Document Type: Research Article
DOI: http://dx.doi.org/10.1891/1521-0987.15.1.11
Publication date: 1 de marzo de 2014
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