Publications by authors named "Crt Zavrnik"

Article Synopsis
  • The SCUBY project analyzes the challenges and facilitators of scaling integrated care (IC) in Cambodia, Slovenia, and Belgium using a multi-case study approach with various data collection methods.
  • Key barriers identified across all three countries include issues with governance, workforce shortages, inadequate financing, and fragmented information systems.
  • The study suggests that responding to health workforce challenges through task shifting, along with a focus on the unique contexts of each country's health system, could enhance the scaling of integrated care.
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Aims: To determine the psychometric properties of the Slovenian versions of the Diabetes Empowerment Scale (DES), both the long form (S-DES-LF) and the short form (S-DES-SF).

Methods: Between April and September 2023, we recruited adults with type 2 diabetes (T2D) using convenient sampling in five primary health centres. We examined internal consistency, test-retest reliability, criterion validity, and discriminant validity.

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Objectives: To review the effect of telemedicine interventions on cardiovascular risk factors control in people with arterial hypertension (AH), type 2 diabetes (T2D), or both in primary care.

Methods: We conducted a systematic review in February 2024 using PubMed/MEDLINE, Cochrane Library, and EMBASE databases. We included randomised controlled trials from 2010 onwards, lasting ≥3 months, comparing telemedicine to standard care for managing cardiovascular risk factors in adults with AH, T2D, or both.

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Background: The training of peer supporters is critical because the success of the entire peer support intervention depends on the knowledge and experience that peer supporters can share with other patients. The objective of this study was to evaluate the pilot implementation of a specialist nurse-led self-management training programme for peer supporters with type 2 diabetes mellitus (T2DM) with or without comorbid hypertension (HTN) at the primary healthcare level in Slovenia, in terms of feasibility, acceptability, and effectiveness.

Methods: A prospective pre-post interventional pilot study was conducted in two Community Health Centres (CHC) in Slovenia from May 2021 to August 2022.

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Article Synopsis
  • Telemonitoring is highlighted as a beneficial tool for supporting integrated care in older patients with hypertension and type 2 diabetes, focusing on its acceptability and barriers to wider implementation.
  • The study involved a mixed-methods approach with interviews and surveys, revealing a high overall acceptability score of 4.4 out of 5, although rural participants found training to be more burdensome than urban ones.
  • To successfully scale up telemonitoring, there’s a need for eligibility screenings, device adaptations for elderly needs, health education integration, family involvement, and follow-up programmes.
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Patient empowerment is crucial for promoting and strengthening health. We aimed to assess patient empowerment and diabetes-specific health-related quality of life (HRQoL) in adults with type 2 diabetes (T2D). A multi-centre, cross-sectional survey was conducted among adults with T2D in urban and rural primary care settings in Slovenia between April and September 2023.

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Managing type 2 diabetes (T2D) effectively is a considerable challenge. The Appraisal of Diabetes Scale (ADS) has proven valuable in understanding how individuals perceive and cope with their condition. This study aimed to evaluate the psychometric properties of the Slovenian version of ADS (ADS-S).

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Introduction: Non-communicable diseases, such as arterial hypertension (HTN) and type-2 diabetes (T2D), pose a global public health problem. Integrated care with focus on person-centred principles aims to enhance healthcare quality and access. Previous qualitative research has identified facilitators and barriers for scaling-up integrated care, however the lack of standardized terms and measures hinder cross-country comparisons.

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Article Synopsis
  • The study aimed to assess health-related quality of life (HRQOL) among elderly individuals with type 2 diabetes (T2D) and identify factors linked to low HRQOL.
  • Researchers conducted a survey involving 358 elderly participants to evaluate HRQOL using the EQ-5D questionnaire and collected various demographic and health data.
  • Results showed that lower HRQOL was associated with older age, higher BMI, lower education levels, depressive symptoms, and poor diabetes appraisal, highlighting the need for integrated care that addresses mental health, obesity, and diabetes education.
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Introduction: Telemonitoring improves clinical outcomes in patients with arterial hypertension (AH) and type 2 diabetes (T2D), however, cost structure analyses are lacking. This study seeks to explore the cost structure of telemonitoring for the elderly with AH and T2D in primary care and identify factors influencing costs for potential future expansions.

Methods: Infrastructure, operational, patient participation, and out-of-pocket costs were determined using a bottom-up approach.

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Introduction: Arterial hypertension and type 2 diabetes are significant contributors to global non-communicable disease-related mortality. Integrated care, centred on person-centred principles, aims to enhance healthcare quality and access, especially for vulnerable populations. This study investigates integrated care for these diseases in Slovenia, providing a comprehensive analysis of facilitators and barriers influencing scalability.

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Introduction: Type 2 diabetes (T2D) and arterial hypertension (AH) are among the greatest challenges facing health systems worldwide and require comprehensive patient-centred care. The key to successful management in chronic patients is self-management support, which was found to be only weakly implemented in Slovenia. The aim of the study is to develop an evidence-based model of peer support for people with T2D and AH at the primary healthcare level in Slovenia, which could represent a potential solution for upgrading integrated care for these patients.

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Background: Integrated care involves good coordination, networking, and communication within health care services and externally between providers and patients or informal caregivers. It affects the quality of services, is more cost-effective, and contributes to greater satisfaction among individuals and providers of integrated care. In our study, we examined the implementation and understanding of integrated care from the perspective of providers - the health care team - and gained insights into the current situation.

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Introduction: Integrated care interventions for type 2 diabetes (T2D) and hypertension (HT) are effective, yet challenges exist with regard to their implementation and scale-up. The 'SCale-Up diaBetes and hYpertension care' (SCUBY) Project aims to facilitate the scale-up of integrated care for T2D and HT through the co-creation and implementation of contextualised scale-up roadmaps in Belgium, Cambodia and Slovenia. We hereby describe the plan for the process and scale-up evaluation of the SCUBY Project.

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Introduction: Arterial hypertension (AH) and type 2 diabetes (T2D) represent a significant burden for the public health system, with an exceptionally high prevalence in patients aged ≥65 years. This study aims to test the acceptability, clinical effectiveness, and cost-effectiveness of telemonitoring in elderly patients with AH and T2D at the primary care level.

Methods: A m ulti-centre, prospective, randomized, controlled t rial w ill be conducted.

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Introduction: Research on models of integrated health care for hypertension and diabetes is one of the priority issues in the world. There is a lack of knowledge about how integrated care is implemented in practice. Our study assessed its implementation in six areas: identification of patients, treatment, health education, self-management support, structured collaboration and organisation of care.

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Introduction: Although the concept of integrated care for non-communicable diseases was introduced at the primary level to move from disease-centered to patient-centered care, it has only been partially implemented in European countries. The aim of this study was to identify and compare identified facilitators and barriers to scale-up this concept between Slovenia and Belgium.

Methods: This was a qualitative study.

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Health systems worldwide struggle to manage the growing burden of type 2 diabetes and hypertension. Many patients receive suboptimal care, especially those most vulnerable. An evidence-based Integrated Care Package (ICP) with primary care-based diagnosis, treatment, education and self-management support and collaboration, leads to better health outcomes, but there is little knowledge of how to scale-up.

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