Evidence map›Paper›PMID 27006342›Full record

ReviewBMJ open2016

Potential workload in applying clinical practice guidelines for patients with chronic conditions and multimorbidity: a systematic analysis.

Céline Buffel du Vaure, Philippe Ravaud, Gabriel Baron, Caroline Barnes, Serge Gilberg, Isabelle Boutron

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 3 pooled it
–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

54 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. The experience of financial burden for people with multimorbidity: A systematic review of qualitative research.Health expectations : an international journal of public participation in health care and health policy · 2021
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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

6 authors.

Céline Buffel du VaureDépartement de Médecine Générale, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France METHODS Team, Epidemiology and Statistics Sorbonne Paris Cité, Research Center UMR 1153, INSERM, Paris, France.
Philippe RavaudFaculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France METHODS Team, Epidemiology and Statistics Sorbonne Paris Cité, Research Center UMR 1153, INSERM, Paris, France Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Epidémiologie Clinique, Paris, France Centre de Médecine Fondée sur les Preuves (EHESP, HAS, INSERM, AP-HP), Paris, France Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA.
Gabriel BaronFaculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France METHODS Team, Epidemiology and Statistics Sorbonne Paris Cité, Research Center UMR 1153, INSERM, Paris, France Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Epidémiologie Clinique, Paris, France Centre de Médecine Fondée sur les Preuves (EHESP, HAS, INSERM, AP-HP), Paris, France.
Caroline BarnesFaculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France METHODS Team, Epidemiology and Statistics Sorbonne Paris Cité, Research Center UMR 1153, INSERM, Paris, France.
Serge GilbergDépartement de Médecine Générale, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
Isabelle BoutronFaculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France METHODS Team, Epidemiology and Statistics Sorbonne Paris Cité, Research Center UMR 1153, INSERM, Paris, France Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Epidémiologie Clinique, Paris, France Centre de Médecine Fondée sur les Preuves (EHESP, HAS, INSERM, AP-HP), Paris, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo describe the potential workload for patients with multimorbidity when applying existing clinical practice guidelines.

designSystematic analysis of clinical practice guidelines for chronic conditions and simulation modelling approach. DATA SOURCES: National Guideline Clearinghouse index of US clinical practice guidelines. STUDY SELECTION: We identified the most recent guidelines for adults with 1 of 6 prevalent chronic conditions in primary care (ie hypertension, diabetes, coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD), osteoarthritis and depression). DATA EXTRACTION: From the guidelines, we extracted all recommended health-related activities (HRAs) such as drug management, self-monitoring, visits to the doctor, laboratory tests and changes of lifestyle for a patient aged 45-64 years with moderate severity of conditions. SIMULATION MODELLING APPROACH: For each HRA identified, we performed a literature review to determine the potential workload in terms of time spent on this HRA. Then, we used a simulation modelling approach to estimate the potential workload needed to comply with these recommended HRAs for patients with several of these chronic conditions.

resultsDepending on the concomitant chronic condition, patients with 3 chronic conditions complying with all the guidelines would have to take a minimum of 6 to a maximum of 13 medications per day, visit a health caregiver a minimum of 1.2 to a maximum of 5.9 times per month and spend a mean (SD) of 49.6 (27.3) to 71.0 (34.5) h/month in HRAs. The potential workload increased greatly with increasing number of concomitant conditions, rising to 18 medications per day, 6.6 visits per month and 80.7 (35.8) h/month in HRAs for patients with 6 chronic conditions.

Indexed as

Chronic DiseaseComorbidityWorkloadHumansPatient CompliancePolypharmacyPractice Guidelines as TopicPrimary Health CareSelf CareUnited StatesChronic diseaseMultimorbidityPractice guidelinesPRIMARY CARE

Identifiers

PMID27006342
PMCPMC4809109

What OpenQuestion holds

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Registered trials

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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.