04829oam 2200769 450 991071607960332120220513104357.0(CKB)5470000002517306(OCoLC)814440675(OCoLC)1118520349(EXLCZ)99547000000251730620120913d2012 ua 0engurcn|||||||||txtrdacontentcrdamediacrrdacarrierShared medical appointments for chronic medical conditions a systematic review /David Edelman [and six others]Washington, DC :Department of Veterans Affairs, Veterans Health Administration, Quality Enhancement Research Initiative, Health Services Research & Development Service,2012.1 online resource (iii, 72 pages) illustrations"Evidence-based synthesis program.""July 2012."Includes bibliographical references.The most successful health care systems offer ready access to high-quality primary care--an approach that is embedded in the fundamental design of Veterans Affairs (VA) health care and which is consistent with the Institute of Medicine's definition of high-quality care. This definition emphasizes safe, effective, patient-centered, timely, efficient, and equitable health care. Group medical visits are a method to deliver health care that offers the promise of improving these aspects for patients with chronic conditions.^Group visits (or clinics) are a system redesign in which clinicians see multiple patients together in the same clinical setting.^Shared medical appointments (SMAs) are a subset of such clinics and are defined by groups of patients meeting over time for comprehensive care for a defining chronic condition or health care state.^SMAs usually involve both a person trained or skilled in delivering patient education or facilitating patient interaction and a practitioner with prescribing privileges. SMA sessions typically last 60 to 120 minutes, with time set aside for social integration, interactive education, and medication management, in an effort to achieve improved disease outcomes. SMAs have been scientifically tested in an array of primary care settings over the last 10 to 15 years.^However, there has been great variability among these studies in relation to setting; components included in the intervention; and measurement of clinical, cost, and utilization outcomes.^For example, the patient group may stay constant, in an attempt to provide group bonding, or the patients may be allowed to choose sessions from a schedule at their convenience to promote attendance. Like patients, provider teams can be constant or vary over time.^This uncertainty regarding the optimal design and impact of SMAs led the VA to commission this evidence synthesis report. Our objective was to summarize the effects of SMA on staff, patient, and economic outcomes and to evaluate whether the impact varied by clinical condition or specific intervention components.Shared medical appointments for chronic medical conditions Group medical appointmentsUnited StatesChronic diseasesTreatmentUnited StatesChronically illUnited StatesOutcome assessment (Medical care)United StatesMedical appointments and schedulesChronic diseasesTreatmentfastChronically illfastGroup medical appointmentsfastOutcome assessment (Medical care)fastUnited StatesfastTechnical reports.lcgftGroup medical appointmentsChronic diseasesTreatmentChronically illOutcome assessment (Medical care)Medical appointments and schedules.Chronic diseasesTreatment.Chronically ill.Group medical appointments.Outcome assessment (Medical care)Edelman David A.320843United States.Department of Veterans Affairs.Health Services Research and Development Service,Durham VA Medical Center.Evidence-based Synthesis Program Center.Evidence-based Synthesis Program (U.S.)NLMNLMOCLCQVT2NLMOCLCOOCLCAGPOOCLCOOCLCFOCLCQOCLCOCOMOCLCOGPOBOOK9910716079603321Shared medical appointments for chronic medical conditions3470597UNINA