Original Research
The pros and cons of the implementation of a chronic care model in European rural primary care: the points of view of European rural general practitioners
AUTHORS
Donata Kurpas1 MD, PhD, Professor * 
Ferdinando Petrazzuoli2 MD, PhD, Physician
Katarzyna Szwamel3 MSc, PhD, Academic Teacher
Jane Randall-Smith4 Executive Secretary
Beata Blahova5 MD, General Practitioner
Gindrovel Dumitra6 MD, PhD, Lecturer
Kateřina Javorská7 MD, General Practitioner
András Mohos8 MD, General Practitioner
José Augusto Simões 9 MD, PhD, Professor
Victoria Tkachenko 10 MD, PhD, Professor
Jean-Baptiste Kern11 MD, General Practitioner, Internship Supervisor
Carol Holland12 PhD, Professor
Holly Gwyther13 MSc, PhD, Research Fellow
AFFILIATIONS
1 Department of Family Medicine, Wroclaw Medical University, Wroclaw, Poland; and European Rural and Isolated Practitioners Association (EURIPA)
2 Department of Clinical Sciences, Center for Primary Health Care Research, Lund University, Malmö, Sweden; and European Rural and Isolated Practitioners Association (EURIPA)
3 Institute of Health Sciences, University of Opole, Poland
4 European Rural and Isolated Practitioners Association (EURIPA)
5 Faculty of Public Health, Slovak Medical University, Bratislava, Slovakia; and European Rural and Isolated Practitioners Association (EURIPA)
6 Romanian National Society of Family Medicine, Bucharest, Romania; Department of Family Medicine, University of Medicine and Pharmacy, Craiova, Romania; and European Rural and Isolated Practitioners Association (EURIPA)
7 Medical Faculty of Hradec Králové, Charles University, Hradec Králové, Czech Republic; and European Rural and Isolated Practitioners Association (EURIPA)
8 Department of Family Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary; and European Rural and Isolated Practitioners Association (EURIPA)
9 Department of Medical Sciences, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; and European Rural and Isolated Practitioners Association (EURIPA)
10 Department of Family Medicine, Institute of Family Medicine at Shupyk National Healthcare University of Ukraine, Kiev, Ukraine; and European Rural and Isolated Practitioners Association (EURIPA)
11 General Practice Department, Faculty of Medicine, Université Grenoble Alpes, Grenoble, France; and European Rural and Isolated Practitioners Association (EURIPA)
12 Centre for Ageing Research, Lancaster University, Lancaster, UK
13 Centre for Ageing Research, Lancaster University, Lancaster, UK; and Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK
ACCEPTED: 24 June 2021
early abstract:
Objective: This paper describes the views of European Rural General Practitioners regarding the strengths, weaknesses, opportunities, and threats of the implementation of a Chronic Care Model (CCM) in European Rural Primary Care.
Design: A mixed-method, online survey. Data were collected between May and December 2017. Categorical data were analysed using descriptive methods while free text responses were analysed using qualitative methods.
Setting: Rural primary care in nine European countries (including Central and Eastern Europe).
Participants: 227 General Practitioners
Main outcomes measures: Respondents’ evaluations of a chronic care model in their rural healthcare settings in terms of Strengths, Weaknesses, Opportunities and Threats.
Results: The SWOT analysis revealed that the expertise of healthcare professionals and the strength of relationships and communications between professionals, caregivers and patients are positive components of the CCM system. However, ensuring adequate staffing levels and staff competency are issues that would need to be addressed. Opportunities included the need to enable patients to participate in decision making by ensuring adequate health literacy.
Conclusion: The chronic care model could certainly have benefits for healthcare in rural settings but staffing levels and staff competency would need to be addressed before implementation of CCM in such settings. Improving health literacy amongst patients and their carers will be essential to ensure their full participation in the implementation of a successful CCM.