Figure 1
PRIMSA Flowchart.
Table 1
General characteristics of the studies included in this scoping review.
| AUTHOR, YEAR | SETTING | STUDY DESIGN | METHODS | SAMPLE SIZE | SAMPLE CHARACTERISTICS | APPLICATION AREAS | OUTCOMES |
|---|---|---|---|---|---|---|---|
| Verdonck 2023 [9] | WHO Regions | Qualitative study | In-depth interviews | 35 | Patients with osteoporosis | Osteoporosis care | Patients’ perspectives of patient-centred integrated osteoporosis healthcare |
| Godinho 2020 [10] | Australia | Mixed methods case study | Documentary analysis and In-depth interviews | NA | Community health alliances | Primary Care | Context, mechanism, facilitators and barriers |
| Verdonck 2020 [11] | Belgium | Quantitative study | Study protocol | NA | General practitioners and their osteoporosis patients | Primary Care | Patient’s medication possession ratio |
| Witt 2020 [12] | Australia | Qualitative study | In-depth interviews | 26 | Community health care provider and health professionals from one tertiary hospital. | Cancer care | Health professionals’ perspectives on communication, continuity and between-service coordination for improving cancer care |
| Yin 2020 [13] | China | Qualitative study | In-depth interviews | 32 | Patients with STEMI, cardiologists and nurses from hospitals, emergency department doctors, primary healthcare providers, local health governors, and coordinators at the emergency medical system (EMS) | ST-elevated myocardial infarction | Recommendations for improvement in STEMI treatment |
| Sullivan-Taylor 2022 [14] | Canada | Qualitative study | In-depth interviews | 80 | Policy makers, health system decision-makers, Indigenous leaders, providers, patients, caregivers, and academics. (age 65 and over) and those with rare, low-prevalence, and complex diseases. | Theoretical study | Developing IPCHS standards for integrative care. The contents of IPCHS framework |
Table 2
Overview of studies that make reference to the sub-strategies.
| IPCHS STRATEGY | IPCHS SUB-STRATEGY | NUMBER OF STUDIES |
|---|---|---|
| 1. Engaging and empowering people and communities | 1.1 Empowering and engaging individuals and families. | 4 |
| 1.2 Empowering and engaging communities. | 5 | |
| 1.3 Empowering and engaging informal carers. | 0 | |
| 1.4 Reaching the underserved and marginalised. | 2 | |
| 2. Strengthening governance and accountability; | 2.1 Bolstering participatory governance. | 3 |
| 2.2 Enhancing mutual accountability. | 3 | |
| 3. Reorienting the model of care; | 3.1 Defining service priorities based on life course needs. | 3 |
| 3.2 Revaluing promotion, prevention and public health. | 2 | |
| 3.3 Building strong primary care-based systems. | 6 | |
| 3.4 Shifting towards more outpatient and ambulatory care. | 2 | |
| 3.5 Innovating and incorporating new technologies | 3 | |
| 4. Coordinating services within and across sectors; | 4.1 Coordinating care for individuals. | 6 |
| 4.2 Coordinating health programmes and providers. | 5 | |
| 4.3 Coordinating across sectors | 3 | |
| 5. Creating an enabling environment. | 5.1 Strengthening leadership and management for change. | 4 |
| 5.2 Strengthening information systems and knowledge management. | 4 | |
| 5.3 Striving for quality improvement and safety | 3 | |
| 5.4 Reorienting the health workforce | 3 | |
| 5.5 Aligning regulatory frameworks | 0 | |
| 5.6 Improving funding and reforming payment systems. | 2 |
Table 3
Identified facilitators and barriers for implementing the IPCHS strategies.
| STRATEGIES | FACILITATORS | BARRIERS |
|---|---|---|
| Engaging and empowering people and communities | Patient advocacy and involvement [9]; Continued relationships and trust with providers [912]; Value competencies of staff members [9]; | Lack of awareness [9]; Lack of knowledge [913]; Paternalistic approach and poor therapeutic alliances [9]; Patient concerns belittled [9]; Lack of shared decision making [9]; Lack of a holistic approach [9]; |
| Strengthening governance and accountability | Lack of policy support [13]; | |
| Reorienting the model of care | Technology, such as m-health, telemedicine [1112]; Integrated care models with multidisciplinary care [9]; More holistic approach [9]; | Lack of training for primary care providers [13]; Heavy workload of hospital staff [12]; Limited capacity of professionals in health system [13]; Inadequate staff knowledge [12]; Inequities in care [9]; Long waiting times for investigations [9]; Absence of primary care gatekeeping secondary care [9]; Limited awareness and prevention [9]; Late promotion of health [9]; |
| Coordinating services within and across sectors | Linking promotive and preventive healthcare to primary care [9]; Timely communication and information exchange [1213]; Specialised clinics [9]; Personalised care [9]; | Lack of coordination between hospitals at different levels [912]; Siloed care fragmentation [912]; Ineffective administration [12]; Delayed communication and information exchange on patients and condition [12]; Financial barriers to patient referrals in resource-constrained areas [12]; Lack of care pathways [9]; Lack of alternative treatments acknowledgement [9]; |
| Creating an enabling environment | Cultural appreciation [12]; Proactive approach to patient care [12]; | Lack of medical equipment in primary settings [13]; Lack of system processes and streamlined services [12]; Financial barriers to care [913]; |