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MONDAY, Aug. 27, 2018 (HealthDay News) — Care coordination strategies can be beneficial for older patients with multiple chronic diseases, according to a review published in the Aug. 27 issue of CMAJ<\/i>, the journal of the Canadian Medical Association.<\/p>\n
Monika Kastner, Ph.D., from North York General Hospital in Toronto, and colleagues conducted a systematic review of randomized controlled trials evaluating interventions for managing multiple chronic diseases. Data were included for 25 studies with 12,579 older adults (mean age, 67.3 years).<\/p>\n
The researchers found that care coordination strategies significantly improved depressive symptoms (standardized mean difference, \u22120.41; 95 percent confidence interval, \u22120.59 to \u22120.22) in patients with depression and chronic obstructive pulmonary disease (COPD) and in patients with cardiovascular disease (CVD) and diabetes mellitus (DM); in addition, the strategies decreased glycosylated hemoglobin levels (mean difference, \u22120.51; 95 percent confidence interval \u22120.9 to \u22120.11) but not mortality (relative risk, 0.79; 95 percent confidence interval, 0.53 to 1.17). In secondary outcomes, care coordination significantly reduced functional impairment in patients with arthritis and depression or DM and depression; improved cognitive functioning in patients with DM and depression or heart failure and COPD; and increased mental health service use in those with DM and either CVD or depression.<\/p>\n
“Care coordination interventions with one or a combination of case management, care pathways, self-management, and education appear to have the greatest potential for impact,” the authors write.<\/p>\n
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