Effectiveness of Shared Care Across the Interface Between Primary and Specialty Care in Chronic Disease Management

A Cochrane review [Abstract] 1 included 20 studies of shared care interventions for chronic disease management, 19 of which were randomised controlled trials. The majority of studies examined complex multifaceted interventions and were of relatively short duration. The results were mixed. Overall there were no consistent improvements in physical or mental health outcomes, psychosocial outcomes, psychosocial measures including measures of disability and functioning, hospital admissions, default or participation rates, recording of risk factors and satisfaction with treatment. However, there were clear improvements in prescribing in the studies that considered this outcome. The methodological quality of studies varied considerably with only a minority of studies of high-quality design. Cost data were limited and difficult to interpret across studies.

Comment: The quality of evidence is downgraded by study quality (unclear blinding and allocation concealment).

References

• Smith SM, Allwright S, O'Dowd T. Effectiveness of shared care across the interface between primary and specialty care in chronic disease management. Cochrane Database Syst Rev 2007 Jul 18;(3):CD004910. [PubMed]