Investigating the Sustainability of Outcomes in a Chronic Disease Treatment Programme

Bailie, Ross S., Robinson, Gary, Kondalsamy-Chennakesavan, Srinivas N., Halpin, Stephen and Wang, Zhiqiang (2006) Investigating the Sustainability of Outcomes in a Chronic Disease Treatment Programme. Social Science & Medicine, 63 6: 1661-1670. doi:10.1016/j.socscimed.2006.04.010

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Author Bailie, Ross S.
Robinson, Gary
Kondalsamy-Chennakesavan, Srinivas N.
Halpin, Stephen
Wang, Zhiqiang
Title Investigating the Sustainability of Outcomes in a Chronic Disease Treatment Programme
Journal name Social Science & Medicine   Check publisher's open access policy
ISSN 0277-9536
Publication date 2006-01-01
Year available 2006
Sub-type Article (original research)
DOI 10.1016/j.socscimed.2006.04.010
Open Access Status File (Author Post-print)
Volume 63
Issue 6
Start page 1661
End page 1670
Total pages 10
Editor Annandale, E.
Place of publication Oxford, United Kingdom
Publisher Pergamon
Language eng
Subject 321200 Public Health and Health Services
321214 Health and Community Services
321215 Health Care Administration
321207 Indigenous Health
321208 Primary Health Care
321202 Epidemiology
730200 Public Health
730206 Aboriginal and Torres Strait Islander health
Abstract This study examines trends in chronic disease outcomes from initiation of a specialised chronic disease treatment programme through to incorporation of programme activities into routine service delivery. We reviewed clinical records of 98 participants with confirmed renal disease or hypertension in a remote indigenous community health centre in Northern Australia. For each participant the review period spanned an initial three years while participating in a specialised cardiovascular and renal disease treatment programme and a subsequent three years following withdrawal of the treatment programme. Responsibility for care was incorporated into the comprehensive primary care service which had been recently redeveloped to implement best practice care plans. The time series analysis included at least six measures prior to handover of the specialised programme and six following handover. Main outcome measures were trends in blood pressure (BP) control, and systolic and diastolic BP. We found an improvement in BP control in the first 6-12 months of the programme, followed by a steady declining trend. There was no significant difference in this trend between the pre- compared to the post-programme withdrawal period. This finding was consistent for control at levels below 130/80 and 140/90, and for trends in mean systolic and diastolic BP. Investigation of the sustainability of programme outcomes presents major challenges for research design. Sustained success in the management of chronic disease through primary care services requires better understanding of the causal mechanisms related to clinical intervention, the basis upon which they can be 'institutionalised' in a given context, and the extent to which they require regular revitalisation to maintain their effect.
Keyword Australia
chronic disease
quality of care
Indigenous health
best practice
Australian Aboriginals
Q-Index Code C1
Institutional Status UQ
Additional Notes This is an author version of an article originally published as Ross S. Bailie, Gary Robinson, Srinivas N. Kondalsamy-Chennakesavan, Stephen Halpin and Zhiqiang Wang (2006) Investigating the sustainability of outcomes in a chronic disease treatment programme, Social Science & Medicine 63 (6) : 1661-1670. doi: 10.1016/j.socscimed.2006.04.010 Copyright 2006 Elsevier. All rights reserved. Single copies only may be downloaded and printed for a user's personal research and study.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 8 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 10 times in Scopus Article | Citations
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Created: Thu, 03 Aug 2006, 10:00:00 EST by Zhiqiang Wang on behalf of School of Medicine