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      Offshore teaching in chronic disease management: The Monash-Shenzhen experience

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          Abstract

          The important role of GPs and the high prevalence and burden of chronic disease in China have been discussed in other articles in this series, so there is no need to reiterate this background here. This article deals with the pedagogy of chronic disease management as presented to cohorts of Chinese GPs from Shenzhen attending an offshore program at Monash University in Australia. The program, which commenced in 2010, was 7 weeks in duration and has now expanded to 13 weeks, enabling greater coverage of important topics, more site visits, and instruction in teaching and research methods, along with development of research proposals often based on management of a chronic disease.

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          Chronic disease management: what will it take to improve care for chronic illness?

          E. WAGNER, E.H WAGNER, EH Wagner … (1998)
          Article 0 comments Cited 81 times – based on 0 reviews     Review now
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            Management of type 2 diabetes in China: the Happy Life Club, a pragmatic cluster randomised controlled trial using health coaches

            Colette J Browning, Anna Chapman, Hui Yang … (2016)
            Objective To assess the effectiveness of a coach-led motivational interviewing (MI) intervention in improving glycaemic control, as well as clinical, psychosocial and self-care outcomes of individuals with type 2 diabetes mellitus (T2DM) compared with usual care. Design Pragmatic cluster randomised controlled trial (RCT). Setting Community Health Stations (CHSs) in Fengtai district, Beijing, China. Participants Of the 41 randomised CHSs (21 intervention and 20 control), 21 intervention CHSs (372 participants) and 18 control CHSs (296 participants) started participation. Intervention Intervention participants received telephone and face-to-face MI health coaching in addition to usual care from their CHS. Control participants received usual care only. Medical fees were waived for both groups. Outcome measures Outcomes were assessed at baseline, 6 and 12 months. Primary outcome measure was glycated haemoglobin (HbA1c). Secondary outcomes included a suite of anthropometric, blood pressure (BP), fasting blood, psychosocial and self-care measures. Results At 12 months, no differential treatment effect was found for HbA1c (adjusted difference 0.02, 95% CI −0.40 to 0.44, p=0.929), with both treatment and control groups showing significant improvements. However, two secondary outcomes: psychological distress (adjusted difference −2.38, 95% CI −4.64 to −0.12, p=0.039) and systolic BP (adjusted difference −3.57, 95% CI −6.08 to −1.05, p=0.005) were robust outcomes consistent with significant differential treatment effects, as supported in sensitivity analyses. Interestingly, in addition to HbA1c, both groups displayed significant improvements in triglycerides, LDL cholesterol and HDL cholesterol. Conclusions In line with the current Chinese primary healthcare reform, this study is the first large-scale cluster RCT to be implemented within real-world CHSs in China, specifically addressing T2DM. Although a differential treatment effect was not observed for HbA1c, numerous outcomes (including HbA1c) improved in both groups, supporting the establishment of regular, free clinical health checks for people with T2DM in China. Trial registration number ISRCTN01010526; Pre-results.
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              The CDM-Net Project: The Development, Implementation and Evaluation of a Broadband-Based Network for Managing Chronic Disease

              Kay Jones, Trisha Dunning, Beth Costa … (2012)
              Background. In Australia most chronic disease management is funded by Medicare Australia through General Practitioner Management Plans (GPMPs) and Team Care Arrangements (TCAs). Identified barriers may be reduced effectively using a broadband-based network known as the Chronic Disease Management Service (CDMS). Aims. To measure the uptake and adherence to CDMS, test CDMS, and assess the adherence of health providers and patients to GPMPs and TCAs generated through CDMS. Methods. A single cohort before and after study. Results. GPMPs and TCAs increased. There was no change to prescribed medicines or psychological quality of life. Attendance at allied health professionals increased, but decreased at pharmacies. Overall satisfaction with CDMS was high among GPs, allied health professionals, and patients. Conclusion. This study demonstrates proof of concept, but replication or continuation of the study is desirable to enable the impact of CDMS on diabetes outcomes to be determined.
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                Author and article information

                Journal
                Journal ID (publisher-id): FMCH
                Title: Family Medicine and Community Health
                Abbreviated Title: FMCH
                Publisher: Compuscript (Ireland )
                ISSN (Electronic): 2009-8774
                ISSN (Print): 2305-6983
                Publication date (Print): February 2018
                Publication date (Electronic): February 2018
                Volume: 6
                Issue: 1
                Pages: 10-13
                Affiliations
                [1] 1Department of General Practice, Monash University, Melbourne, Victoria, Australia
                [2] 2China GP Program, Monash Institute of Health and Clinical Education, Melbourne, Victoria, Australia
                [3] 3Shenzhen International Primary Health Care Research Institute, Shenzhen, Guangdong, China
                [4] 4Nossal Institute for Global Health and Melbourne Sustainable Society Institute, The University of Melbourne, Parkville, Victoria, Australia
                Author notes
                CORRESPONDING AUTHOR: Leon Piterman, Department of General Practice, Monash University, Bdg1, 270 Ferntree Gully Rd, Notting Hill, Melbourne, Victoria 3168, Australia, E-mail: Leon.piterman@ 123456monash.edu
                Article
                Publisher ID: FMCH.2018.0101
                DOI: 10.15212/FMCH.2018.0101
                SO-VID: 65732810-7563-4d01-af7f-a0f2a1442b19
                Copyright © Copyright © 2018 Family Medicine and Community Health
                License:

                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/.

                History
                Date received : 3 September 2017
                Date accepted : 21 November 2017
                Categories
                Subject: Original Research

                ScienceOpen disciplines: General medicine,Medicine,Geriatric medicine,Occupational & Environmental medicine,Internal medicine,Health & Social care
                Keywords: education and training,Chronic disease,general practice
                Data availability:
                ScienceOpen disciplines: General medicine, Medicine, Geriatric medicine, Occupational & Environmental medicine, Internal medicine, Health & Social care
                Keywords: education and training, Chronic disease, general practice

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