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- C. H. T. Yeung
- Department of Clinical Epidemiology and Biostatistics McMaster University Hamilton ON Canada
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- N. Santesso
- Department of Clinical Epidemiology and Biostatistics McMaster University Hamilton ON Canada
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- M. Pai
- Department of Medicine McMaster University Hamilton ON Canada
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- C. Kessler
- Georgetown University Washington DC USA
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- N. S. Key
- Department of Medicine University of North Carolina Chapel Hill NC USA
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- M. Makris
- Department of Infection Immunity and Cardiovascular Disease University of Sheffield Sheffield UK
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- T. Navarro‐Ruan
- Department of Clinical Epidemiology and Biostatistics McMaster University Hamilton ON Canada
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- J. M. Soucie
- Centers for Disease Control and Prevention Division of Blood Disorders National Center for Birth Defects and Developmental Disabilities Atlanta GA USA
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- H. J. Schünemann
- Department of Clinical Epidemiology and Biostatistics McMaster University Hamilton ON Canada
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- A. Iorio
- Department of Clinical Epidemiology and Biostatistics McMaster University Hamilton ON Canada
説明
<jats:sec><jats:title>Background</jats:title><jats:p>Haemophilia care is commonly provided via multidisciplinary specialized management. To date, there has been no systematic assessment of the impact of haemophilia care delivery models on patient‐important outcomes.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To conduct a systematic review of published studies assessing the effects of the integrated care model for persons with haemophilia (<jats:styled-content style="fixed-case">PWH</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Search methods</jats:title><jats:p>We searched<jats:styled-content style="fixed-case">MEDLINE</jats:styled-content>,<jats:styled-content style="fixed-case">EMBASE</jats:styled-content>and<jats:styled-content style="fixed-case">CINAHL</jats:styled-content>up to April 22, 2015, contacted experts in the field, and reviewed reference lists.</jats:p></jats:sec><jats:sec><jats:title>Selection criteria</jats:title><jats:p>Randomized and non‐randomized studies of<jats:styled-content style="fixed-case">PWH</jats:styled-content>or carriers, focusing mainly on the assessment of care models on delivery.</jats:p></jats:sec><jats:sec><jats:title>Data collection and analysis</jats:title><jats:p>Two investigators independently screened title, abstract, and full text of retrieved articles for inclusion. Risk of bias and overall quality of evidence was assessed using Cochrane's<jats:styled-content style="fixed-case">ACROBAT</jats:styled-content>‐<jats:styled-content style="fixed-case">NRSI</jats:styled-content>tool and<jats:styled-content style="fixed-case">GRADE</jats:styled-content>respectively. Relative risks, mean differences, proportions, and means and their variability were calculated as appropriate.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>27 non‐randomized studies were included: eight comparative and 19 non‐comparative studies. We found low‐ to very low‐quality evidence that in comparison to other models of care, integrated care may reduce mortality, hospitalizations and emergency room visits, may lead to fewer missed days of school and work, and may increase knowledge seeking.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Our comprehensive review found low‐ to very low‐quality evidence from a limited number of non‐randomized studies assessing the impact of haemophilia care models on some patient‐important outcomes. While the available evidence suggests that adoption of the integrated care model may provide benefit to<jats:styled-content style="fixed-case">PWH</jats:styled-content>, further high‐quality research in the field is needed.</jats:p></jats:sec>
収録刊行物
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- Haemophilia
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Haemophilia 22 (S3), 31-40, 2016-06-27
Wiley