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New models for chronic disease management in the United States and China

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Abstract

In the United States (US) the role of the general practitioner in primary care is changing rapidly as the team leader in the new “Patient-centered Medical Home” model of care that is designed to improve the management of chronic disease. The “Collaborative Care Model” is an integrated model of treating multiple medical and behavioral conditions. These new approaches include a nurse case manager who serves as the key point of contact to provide education, facilitate treatment adherence, and guide the patient to improvements in nutrition and physical activity that cause obesity and chronic disease. A gap analysis was conducted comparing the US and Chinese general practitioner models for providing care to patients with chronic diseases. The results of the analysis were used to make recommendations for adding components of these models that are feasible and effective for Chinese general practitioners in community health centers.

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Most cited references 26

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Prevalence, awareness, treatment, and control of hypertension in China: results from a national survey.

Hypertension is one of the major risk factor for cardiovascular disease worldwide. The objective of this study was to investigate the prevalence, awareness, treatment, and control of hypertension in China. A multistage, stratified sampling method was used to obtain a representative sample of persons aged 18 years or older in the general population of China. Blood pressure (BP) was measured by sphygmomanometer 3 times at 5-minute intervals. Hypertension was defined as a systolic BP ≥ 140mm Hg, or diastolic BP ≥ 90mm Hg, or self-reported use of antihypertensive medications in the last 2 weeks irrespective of the BP. Altogether 50,171 subjects finished the survey across the entire country. The adjusted prevalence of hypertension was 29.6% (95% confidence interval (CI) = 28.9%-30.4%) and was higher among men than among women (31.2%, 95% CI = 30.1%-32.4%; vs. 28.0%, 95% CI = 27.0%-29.0%). The awareness, treatment among all hypertensive participants, control among all hypertensive participants, and control among treated hypertensive participants were 42.6%, 34.1%, 9.3%, and 27.4%, respectively. Multiple lifestyle factors were independently associated with presence of hypertension, including physical inactivity, habitual drinking, chronic use of nonsteroidal anti-inflammatory drugs, high body mass index, and central obesity. Hypertension is an important public health burden in China, and control of hypertension is still suboptimal. Several modifiable lifestyle activities were associated with hypertension and thus should be considered potential targets for intervention, with special attention to socioeconomically disadvantaged subpopulations in China. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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Prevalence and natural course of late-life depression in China primary care: a population based study from an urban community

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Collaborative care for patients with depression and diabetes mellitus: a systematic review and meta-analysis

Author and article information

Affiliations
1Nicholas A. Cummings Doctor of Behavioral Health Program, College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
Author notes
CORRESPONDING AUTHOR: Ronald R. O’Donnell, Ph.D., Director, Nicholas A. Cummings Doctor of Behavioral Health Program, College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA, E-mail: ronald.odonnell@123456asu.edu
Journal
FMCH
Family Medicine and Community Health
FMCH
Family Medicine and Community Health & American Chinese Medical Education Association (USA)
xxx-xxx
2305-6983
December 2014
December 2014
: 2
: 4
: 13-19
Copyright © 2014 Family Medicine and Community Health

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

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Self URI (journal page): http://fmch-journal.org/
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