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Organisational Intervention: Continuity of care


An intervention which includes one or many episodes of care for inpatients or outpatients. Continuity of care also includes arrangements for follow-up and case management, including co-ordination of assessment, treatment and arrangement for referrals.


Seven high quality reviews (Archer, Laliberte, Lemmens, Little, O'Brien, Patterson, Smith) were identified. Only the Archer review had sufficient evidence to draw any conclusions about the effectiveness of this intervention.

Summary of Overall Findings from Reviews

15 reviews evaluated the effectiveness of continuity of care were identified. Seven of these were assessed as being high quality.

Summary of Findings Related to Prescribing

1/1 high quality or key reviews with a sufficient number of studies to draw conclusions found this intervention to be generally effective for improving prescribing outcomes.

Reviews listed as "Summary Pending" will be analyzed, summarized and reported at a later date.

The findings will then be incorporated in the overall evidence summaries of the interventions they address.

Reviews Addressing This Intervention Quality Assessment Tool:
AMSTAR Score (of 11 points)
Archer J, Bower P, Gilbody S, Lovell K, Richards D, Gask L, Dickens C, Coventry P. Collaborative care for depression and anxiety problems. Cochrane Database of Systematic Reviews 2012 10:CD006525. 9 (High)
Laliberte MC, Perreault S, Jouini G, Shea BJ, Lalonde L. Effectiveness of interventions to improve the detection and treatment of osteoporosis in primary care settings: a systematic review and meta-analysis. Osteoporosis International 2011 22 (11):2743-68. 9 (High)
Little EA, Eccles MP. A systematic review of the effectiveness of interventions to improve post-fracture investigation and management of patients at risk of osteoporosis. Implementation Science 2010 5 (1):80-97. 9 (High)
Patterson SM, Hughes C, Kerse N, Cardwell CR, Bradley MC. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database of Systematic Reviews 2012 5:CD008165. 9 (High)
Lemmens KMM, Nieboer AP, Huijsman R. A systematic review of integrated use of disease-management interventions in asthma and COPD. Respiratory Medicine 2009 103 (5):670-91. 8 (High)
O'Brien MA, Rogers S, Jamtvedt G, Oxman AD, Odgaard-Jensen J, Kristoffersen DT, Forsetlund L, Bainbridge D, Freemantle N, Davis DA, Haynes RB, Harvey EL. Educational outreach visits: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2007 4:CD000409. 8 (High)
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 of Systematic Reviews 2007 3:CD004910. 8 (High)
Viswanathan M, Golin CE, Jones CD, Ashok M, Blalock SJ, Wines RC, Coker-Schwimmer EJ, Rosen DL, Sista P, Lohr KN. Interventions to improve adherence to self-administered medications for chronic diseases in the United States: a systematic review. Annals of Internal Medicine 2012 157 (11):785-795. 8
Summary Pending
Davies SL, Goodman C, Bunn F, Victor C, Dickinson A, Iliffe S, Gage H, Martin W, Froggatt K. A systematic review of integrated working between care homes and health care services. BMC Health Services Research 2011 11:320. 7 (Medium)
Glynn LG, Murphy AW, Smith SM, Schroeder K, Fahey T. Interventions used to improve control of blood pressure in patients with hypertension. Cochrane Database of Systematic Reviews 2010 3:CD005182. 7 (Medium)
Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L, Whitty P, Eccles MP, Matowe L, Shirran L, Wensing M, Dijkstra R, Donaldson C. Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technology Assessment 2004 8 (6):iii-iiv. 7 (Medium)
Hesselink G, Schoonhoven L, Barach P, Spijker A, Gademan P, Kalkman C, Liefers J, Vernooij-Dassen M, Wollersheim H. Improving patient handovers from hospital to primary care: a systematic review. Annals of Internal Medicine 2012 157 (6):417-428. 7
Summary Pending
Renders CM, Valk GD, Griffin S, Wagner EH, Eijk JT, Assendelft WJ. Interventions to improve the management of diabetes mellitus in primary care, outpatient and community settings. Cochrane Database of Systematic Reviews 2001 1:CD001481. 7 (Medium)
De Bruin SR, Versnel N, Lemmens LC, Molema CC, Schellevis FG, Nijpels G, Baan CA. Comprehensive care programs for patients with multiple chronic conditions: A systematic literature review. Health Policy 2012 107 (41700):108-145. 6
Summary Pending
Gilbody S, Whitty P, Grimshaw J, Thomas R. Educational and organizational interventions to improve the management of depression in primary care: a systematic review. JAMA 2003 289 (23):3145-51. 6 (Medium)
Cleveringa FG, Gorter KJ, van den Donk M, van GJ, Rutten GE. Computerized decision support systems in primary care for type 2 diabetes patients only improve patients' outcomes when combined with feedback on performance and case management: a systematic review. Diabetes Technology & Therapeutics 2013 15 (2):180-192. 5
Summary Pending
Gensichen J, Beyer M, Muth C, Gerlach F, Von Korff M, Ormel J. Case management to improve major depression in primary health care: a systematic review. Psychological Medicine 2006 36 (1):7-14. 5 (Medium)
Chan R, Webster J. End-of-life care pathways for improving outcomes in caring for the dying. Cochrane Database of Systematic Reviews 2009 4:CD008006. 4 (Medium)
Kwan JL, Lo L, Sampson M, Shojania KG. Medication reconciliation during transitions of care as a patient safety strategy: a systematic review. Annals of Internal Medicine 2013 158 (5 Pt 2):397-403. 4
Summary Pending
Kwint HF, Bermingham L, Faber A, Gussekloo J, Bouvy ML. The relationship between the extent of collaboration of general practitioners and pharmacists and the implementation of recommendations arising from medication review: a systematic review. Drugs & Aging 2013 30 (2):91-102. 4
Summary Pending
Smits FT, Wittkampf KA, Schene AH, Bindels PJE, Van Weert HCPM. Interventions on frequent attenders in primary care: A systematic literature review. Scandinavian Journal of Primary Health Care 2008 26 (2):111-6. 4 (Medium)
Huang Y, Wei X, Wu T, Chen R, Guo A. Collaborative care for patients with depression and diabetes mellitus: a systematic review and meta-analysis. BMC Psychiatry 2013 13 (260). Summary Pending