WHO Montevideo Roadmap 2018-2030 on NCDs as a Sustainable Development Priority
United Nations high-level meeting on noncommunicable disease prevention
and control. NCD summit to shape the international agenda. 19-20
September 2011. New York, USA. download here
Journal articles of relevance
Hansen J, Groenewegen PP, Boerma WGW, Kringos DS. Living In A Country With A Strong Primary Care System Is Beneficial To People With Chronic Conditions. Health Affairs 34, No. 9 (2015): 1531–1537 doi:10.1377/hlthaff.2015.0582
Wallis KA, Andrews A, Henderson M. Swimming Against the Tide: Primary Care. Physicians' Views on Deprescribing in Everyday Practice. Ann Fam Med. 2017. Jul;15(4):341-346. doi: 10.1370/afm.2094. PubMed PMID: 28694270; PubMed Central. PMCID: PMC5505453. Full text:
Interventions to support safer prescribing in everyday practice should
consider the sociocultural, personal, relational, and organizational
constraints on deprescribing. Regulations and policies should be
designed to support physicians in practicing according to their
professional ethical values.
Demeyer H, Burtin C, Hornik M, Camillo CA, Van Remoortel H, Langer D, Janssens W, Troosters T. The Minimal Important Difference in Physical Activity in Patients with COPD. PLoS One. 2016 Apr 28;11(4):e0154587. doi:10.1371/journal.pone.0154587. eCollection 2016. PubMed PMID: 27124297; PubMed Central PMCID: PMC4849755. Full text:
The minimal important difference after pulmonary rehabilitation in
patients with COPD lies between 600 and 1100 steps.day-1. The clinical
importance of this change is supported by a reduced risk for hospital
admission in those patients with more than 600 steps improvement.
Leelakanok N, Holcombe AL, Lund BC, Gu X, Schweizer ML. Association between polypharmacy and death: A systematic review and meta-analysis. J Am Pharm Assoc (2003). 2017 Nov - Dec;57(6):729-738.e10. doi: 10.1016/j.japh.2017.06.002. Epub 2017 Aug 5. PubMed PMID: 28784299. Full text:
Pooled risk estimates from this meta-analysis reveal that
polypharmacy is associated with increased mortality risk. The causality
of this relationship remains unclear, but it emphasizes the need for
approaches to health care delivery that achieve an optimal balance of
risk and benefit in medication prescribing.
Barker I, Steventon A, Deeny SR. Association between continuity of care in general practice and hospital admissions for ambulatory care sensitive conditions: cross sectional study of routinely collected, person level data. BMJ. 2017 Feb 1;356:j84. doi: 10.1136/bmj.j84. PubMed PMID: 28148478. Full text:
Strategies that improve the continuity of care in general practice
may reduce secondary care costs, particularly for the heaviest users of
healthcare. Promoting continuity might also improve the experience of
patients and those working in general practice.
Smith SM, Cousins G, Clyne B, Allwright S, O'Dowd T.Shared care across the interface between primary and specialty care in management of long term conditions. Cochrane Database Syst Rev. 2017 Feb 23;2:CD004910. doi: 10.1002/14651858.CD004910.pub3. Accessed here
Shared care has been used in the management of many chronic
conditions with the assumption that it delivers better care than primary
or specialty care alone; however, little is known about the
effectiveness of shared care. This review suggests that shared care
improves depression outcomes and probably has mixed or limited effects
on other outcomes.
Schilling L, Chase A, Kehrli S, Liu AY, Stiefel M, Brentari R. Kaiser Permanente's performance improvement system, Part 1: From benchmarking to executing on strategic priorities. Jt Comm J Qual Patient Saf. 2010 Nov;36(11):484-98. PubMed PMID: 21090018.
Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness: the chronic care model, Part 2.
JAMA. 2002 Oct 16;288(15):1909-14. PubMed PMID: 12377092.