Articles: community-health-services.
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Health Technol Assess · Aug 2015
Randomized Controlled Trial Multicenter StudyIndividual cognitive stimulation therapy for dementia: a clinical effectiveness and cost-effectiveness pragmatic, multicentre, randomised controlled trial.
Group cognitive stimulation therapy programmes can benefit cognition and quality of life for people with dementia. Evidence for home-based, carer-led cognitive stimulation interventions is limited. ⋯ iCST did not improve cognition or quality of life for people with dementia, or carers' physical and mental health. Costs of the intervention were offset by some reductions in social care and other services. Although there was some evidence of improvement in terms of the caregiving relationship and carers' health-related quality of life, iCST does not appear to deliver clinical benefits for cognition and quality of life for people with dementia. Most people received fewer than the recommended number of iCST sessions. Further research is needed to ascertain the clinical effectiveness of carer-led cognitive stimulation interventions for people with dementia.
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Internal medicine journal · Aug 2015
Long-term effectiveness of a community-based model of care in Māori and Pacific patients with type 2 diabetes and chronic kidney disease: a 4-year follow up of the DElay Future End Stage Nephropathy due to Diabetes (DEFEND) study.
The Delay Future End Stage Nephropathy due to Diabetes study was a randomised controlled trial of Māori and Pacific patients with advanced diabetic nephropathy, comparing a community-based model of care with usual care. The intervention group achieved lower blood pressure (BP), proteinuria and less end-organ damage. After the intervention ended, all patients reverted to usual care, and were followed to review the sustainability of the intervention. ⋯ Short-term intensive BP control followed by usual care did not translate into reduction in long-term mortality or ESRD rates, but was associated with reduced hospitalisations.
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Trop. Med. Int. Health · Aug 2015
Screening of patients with diabetes mellitus for tuberculosis in community health settings in China.
To assess the feasibility and results of screening of patients with DM for TB in routine community health services in China. ⋯ This pilot project shows it is feasible to carry out TB screening among patients with DM in community settings, but further work is needed to better characterise patients with DM at higher risk of TB. This may require a more targeted approach focused on high-risk groups such as those with untreated DM or poorly controlled hyperglycaemia.
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Trop. Med. Int. Health · Aug 2015
ReviewEvidence on feasibility and effective use of mHealth strategies by frontline health workers in developing countries: systematic review.
Given the large-scale adoption and deployment of mobile phones by health services and frontline health workers (FHW), we aimed to review and synthesise the evidence on the feasibility and effectiveness of mobile-based services for healthcare delivery. ⋯ Use of mHealth strategies by FHWs might offer some promising approaches to improving healthcare delivery; however, the evidence on the effectiveness of such strategies on healthcare outcomes is insufficient.
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Randomized Controlled Trial
Community-based walking exercise for peripheral artery disease: An exploratory pilot study.
Supervised walking exercise is an effective treatment to improve walking ability of patients with peripheral artery disease (PAD), but few exercise programs in community settings have been effective. The aim of this study was to determine the efficacy of a community-based walking exercise program with training, monitoring and coaching (TMC) components to improve exercise performance and patient-reported outcomes in PAD patients. This was a randomized, controlled trial including PAD patients (n=25) who previously received peripheral endovascular therapy or presented with stable claudication. ⋯ This pilot using a walking program with TMC and an ITT analysis did not improve the primary outcome in PAD patients. Other walking performance and patient self-reported outcomes were improved following exercise in community settings. Further study is needed to determine whether this intervention improves outcomes in a trial employing a larger sample size.