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Systematic Reviews
Published in: Systematic Reviews 1/2018

Open Access 01-12-2018 | Protocol

The effectiveness of patient-centred medical home model versus standard primary care in chronic disease management: protocol for a systematic review and meta-analysis of randomised and non-randomised controlled trials

Authors: James Rufus John, Shima Ghassempour, Federico Girosi, Evan Atlantis

Published in: Systematic Reviews | Issue 1/2018

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Abstract

Background

Studies suggest that the Patient-Centred Medical Home (PCMH) model of primary care is more effective than standard care for improving clinical outcomes in patients with chronic diseases (non-communicable diseases), but the strength of the evidence base is unclear. The aim of the proposed systematic review is to generate a current synthesis of relevant studies on the effectiveness of PCMH model of primary care versus standard care in chronic disease management.

Methods

Electronic databases such as MEDLINE, CINAHL, Embase, Cochrane Library, and Scopus will be searched using predefined search terms for PCMH, primary care, and chronic diseases for articles published up to November 2018. Reference lists of included articles and relevant reviews will also be hand searched. This review will consider eligible randomised controlled trials and controlled trials against predetermined criteria including two or more principles of PCMH model endorsed by Australian Medical Association. Data extraction will be performed independently by two reviewers, and retrieved papers will be assessed for quality using JBI Critical Appraisal Tools. Where possible, quantitative data will be pooled in statistical meta-analysis using the R packages ‘Meta’ and ‘metafor’. Effect sizes will be expressed as odds ratio (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals will be calculated for meta-analysis; robustness will be explored using sensitivity analysis. Heterogeneity will be assessed narratively and statistically using the Q statistics and visualised using Baujat plots including subgroup or sensitivity analyses techniques where possible. Where statistical pooling is not possible, the findings will be presented narratively.

Discussion

The findings of the proposed systematic review will provide the highest level of evidence to date on the effectiveness of the PCMH model versus standard primary care in chronic disease management. We believe that our findings will inform patients, primary care providers, and public health administrators and policy-makers on the benefits and risks of PCMH model of care.

Systematic review registration

PROSPERO CRD42018085378
Appendix
Available only for authorised users
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Metadata
Title
The effectiveness of patient-centred medical home model versus standard primary care in chronic disease management: protocol for a systematic review and meta-analysis of randomised and non-randomised controlled trials
Authors
James Rufus John
Shima Ghassempour
Federico Girosi
Evan Atlantis
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2018
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-018-0887-2

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