Chronic disease morbidity and income level in an employed population.

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Chronic disease morbidity and income level in an employed population.

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PMC
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  • Medicine
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Abstract

Does Adding Laypersons to Primary Care Teams Improve Care for Chronic Diseases? The full report is titled “Improving Chronic Disease Care by Adding Laypersons to the Primary Care Team. A Parallel Randomized Trial.” It is in the 6 August 2013 issue of Annals of Internal Medicine (volume 159, pages 176-184). The authors are R. Adair, D.R. Wholey, J. Christianson, K.M. White, H. Britt, and S. Lee. What is the problem and what is known about it so far? Chronic diseases, such as stroke, heart disease, cancer, arthritis, and diabetes, are the leading causes of death and disability in the United States today. They are expensive and sometimes complicated to treat, and patients who have them often do not receive recommended care. Improving care for patients with chronic disease is an important goal, but how to accomplish it efficiently is unclear. Evidence indicates that chronic disease care is best provided by a primary care–led team of physicians and caregivers, but how these teams should be structured is not yet clear. Why did the researchers do this particular study? The researchers wanted to test whether adult patients with chronic disease working with layperson “care guides” would receive better care than patients receiving usual care. The care guides received brief training about chronic diseases and strategies for behavior change. Who was studied? The study involved 2135 adults aged 18 to 79 years with hypertension, diabetes, or congestive heart failure. About half of the participants had more than 1 of these diseases. How was the study done? Investigators recruited patients with chronic diseases from 6 primary care clinics in Minnesota starting in July 2010. During an office visit, patients received information about standard care goals for their diseases. They were asked to work toward these goals for 1 year and were randomly assigned to work with or without the help of a care guide to achieve the goals. Researchers measured the percentage of the goals m

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