The DOI matches its Crossref record; 63 of the 64 references it cites were found in a registry or an index.
Facilitators and barriers of implementing the chronic care model in primary care: a systematic review
Open accessAbstract
BACKGROUND: The Chronic Care Model (CCM) is a framework developed to redesign care delivery for individuals living with chronic diseases in primary care. The CCM and its various components have been widely adopted and evaluated, however, little is known about different primary care experiences with its implementation, and the factors that influence its successful uptake. The purpose of this review is to synthesize findings of studies that implemented the CCM in primary care, in order to identify facilitators and barriers encountered during implementation. METHODS: This study identified English-language, peer-reviewed research articles, describing the CCM in primary care settings. Searches were performed in three data bases: Web of Knowledge, Pubmed and Scopus. Article abstracts and titles were read based on whether they met the following inclusion criteria: 1) studies published after 2003 that described or evaluated the implementation of the CCM; 2) the care setting was primary care; 3) the target population of the study was adults over the age of 18 with chronic conditions. Studies were categorized by reference, study design and methods, participants and setting, study objective, CCM components used, and description of the intervention. The next stage of data abstraction involved qualitative analysis of cited barriers and facilitators using the Consolidating Framework for Research Implementation. RESULTS: This review identified barriers and facilitators of implementation across various primary care settings in 22 studies. The major emerging themes were those related to the inner setting of the organization, the process of implementation and characteristics of the individual healthcare providers. These included: organizational culture, its structural characteristics, networks and communication, implementation climate and readiness, presence of supportive leadership, and provider attitudes and beliefs. CONCLUSIONS: These findings highlight the importance of assessing organizational capacity and needs prior to and during the implementation of the CCM, as well as gaining a better understanding of health care providers' and organizational perspective.
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“Research papers more often tend to report clinical level variables (such as information given to patients to support self-management) than to assess organisational factors, such as professional culture, governance, financial management, communication patterns, implementation readiness, or presence of supportive leadership 35 .”
From Integrated care for people with long-term mental and physical health conditions in low-income and middle-income countries (2019) · cites this paper as [35]
In the citing paper
“In other similar studies, positive effects have been shown for people with depression 34 35 , chronic obstructive pulmonary disease 35 , asthma 35 36 , diabetes 35 36 and heart failure 36 .”
From Integrated care for people with long-term mental and physical health conditions in low-income and middle-income countries (2019) · cites this paper as [35]
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Barceló, A., Cafiero, E. T., de Boer, M., Mesa, A. E., Lopez, M. G., Jiménez, R. A., Esqueda, A. L., Martinez, J. A., Holguin, E., Meiners, M. M. M. D. A., et al. (2010) · Primary care diabetes · doi:10.1016/j.pcd.2010.04.005 · Cited by 96 · cited 4×
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Wolfson, D. B., Bernabeo, E. C., Leas, B. F., Sofaer, S., Pawlson, G., & Pillittere, D. M. (2009) · BMC Family Practice · doi:10.1186/1471-2296-10-14 · Cited by 70 · cited 2×
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“Some of the factors previously identified include: evidence fit and relevance to the organizational context, staff relationships and collaboration, availability of resources, strong and committed leadership, and a culture supportive of change [22-24].”
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Haggstrom, D. A., Taplin, S. H., Monahan, P. O., & Clauser, S. B. (2012) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.2012.0131 · Cited by 24 · cited 4×
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Reuben, D. B., Roth, C. P., KAMBERG, C. J., & Wenger, N. S. (2003) · Cited by 17
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Taylor, D. A., & Lahey, M. (2008) · Journal of Health Services Research & Policy · doi:10.1258/jhsrp.2007.007068 · Cited by 14 · cited 9×
“Willingness to advance and manage change was evident through incentivizing provider buy-in using financial reimbursement and work credit for project involvement [37,42,51].”
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The Chronic Care Model: Which Physician Practice Organizations Adapt Best?
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“The need for further research in this area is highlighted by both our finding and reviews by Kadu and Stolle [27] and Dauvrin et al. [28] who suggested that the scope of chronic care interventions should be expanded to transform health care organizations and systems.”
BackgroundResultInfluentialThe SELFIE framework for integrated care for multi-morbidity: Development and description
Leijten, F., Struckmann, V., van Ginneken, E., Czypionka, T., Kraus, M., Reiss, M., Tsiachristas, A., Boland, M. R. S., Bont, A. A. D., Bal, R. A., et al. (2017) · Health Policy · doi:10.1016/j.healthpol.2017.06.002 · Cited by 263
“Appropriate workforce planning at organisational level is necessary and includes attention for workload and sufficient team resources [71,104,111], professional education, and sustainability of staff and informal caregivers [111].”
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Struckmann, V., Leijten, F., van Ginneken, E., Kraus, M., Reiss, M., Spranger, A., Boland, M. R. S., Czypionka, T., Busse, R., & Mölken, M. R. (2017) · Health Policy · doi:10.1016/j.healthpol.2017.08.008 · Cited by 174
Metadata
- Authors
- Kadu, M. K., & Stolee, P.
- Affiliations
- University of Waterloo (CA)
- Corresponding author
- Stolee, Paul
- Venue
- BMC Family Practice
- Published
- 2015-02-06
- Volume
- 16
- Issue
- 1
- Pages
- 12-12
- ISSN
- 1471-2296 (ISSN-L)
- PMC
- PMC4340610
- OpenAlex
- W2006530818
- Cited by
- 204
- References
- 64
- Citations by year
- 2026: 7 · 2025: 15 · 2024: 11 · 2023: 16 · 2022: 12 · 2021: 38 · 2020: 40 · 2019: 23 · 2018: 11 · 2017: 15 · 2016: 11 · 2015: 5
- FWCI
- 2.53
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Family Practice (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- University of Waterloo
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- Chronic Care Model, implementation barriers, implementation facilitators, primary care, chronic care, organizational culture, implementation climate, leadership, provider attitudes, organizational capacity
- MeSH terms
- Chronic Disease, Humans, Organizational Innovation, Patient Care Management, Primary Health Care, Organizational Culture, Models, Organizational, Needs Assessment, Quality Improvement
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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