Making a jigsaw puzzle in 10 minutes: is case management feasible in general practice?

Steve Iliffe, Shelley Peacock, Anganie Seecharan, Ajit Shah, Prakash Chatlani, M C Patel, Karen Phekoo, Ricky Banarsee

Abstract read

In one paragraph

Article in London journal of primary care, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Steve IliffeProfessor of Primary Care for Older People, UCL and Member of Kilburn Practice-Based Commissioning Board, Brent PCT, Dept of Primary Care & Population Health, Royal Free Campus, Rowland Hill St, London, UK.

Shelley PeacockLecturer, Dept of Primary & Intermediate Care, Kings College London, London, UK.

Anganie SeecharanPractice Nurse & Member of Kilburn Practice-Based Commissioning Board, Brent PCT, London, UK.

Ajit ShahGeneral Practitioner & Member of Kingsbury Practice-Based Commissioning Board, Brent PCT, London, UK.

Prakash ChatlaniGeneral Practitioner & Member of Willesden Practice-Based Commissioning Board, Brent PCT, London, UK.

M C PatelGeneral Practitioner & Member of Wembley Practice-Based Commissioning Board, General Practitioner & Member of Wembley Practice-Based Commissioning Board, Brent PCT, London, UK.

Karen PhekooProgramme Lead, North West London CLAHRC, Chelsea & Westminster Hospital NHS Foundation Trust, London, UK.

Ricky BanarseeHead of Applied Research Unit, Brent PCT, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background Case management has been advocated as a method of optimising the care of patients with complex problems and reducing inappropriate use of hospital services, but its impact to date has been limited. It is not known whether case management earlier in the development of complex problems will be more effective. Aim To develop a case management protocol usable in general practice. Design Co-designed by practitioners using a technology development approach. Setting General practices and community nursing teams in one primary care trust (PCT). Method Nominal group techniques applied to six multidisciplinary workshops held over nine months, in order to design and refine a case management protocol. Then field testing of the protocol with selected patients in four practices. Results A modular case management protocol has been designed that can be used in routine practice and completed over successive consultations. The protocol asks the practitioner and patient about their different perspectives on need, and about mental health, social care needs, nutritional status, vision and hearing, bone fragility, pain, continence and where appropriate end-of-life plans. An electronic version can be partially populated automatically, from the existing medical record. Field testing suggests that a paper version can also be used as a patient-held record for other professionals to use. Conclusion This study has created a model of case management for general practice that appears to be useable in general practice. A wider feasibility study is now needed to test uptake of the protocol by practices.

Indexed as

case managementco-morbiditylong-term conditionsnurse practitionerspractice nurses

Identifiers

PMID25949649

PMCPMC3960674

What OpenQuestion holds

Textmetadata

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.