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.
INTRODUCTION
This article describes the views of European rural general practitioners regarding the strengths, weaknesses, opportunities and threats (SWOT) of the implementation of a chronic care model (CCM) in European rural primary care.


METHODS
This was a mixed-methods online survey. Data were collected from 227 general practitioners between May and December 2017. Categorical data were analysed using descriptive methods while free-text responses were analysed using qualitative methods. The setting was rural primary care in nine European countries (including Central and Eastern Europe). Main outcomes measures were respondents' evaluations of a chronic care model in their rural healthcare settings in terms of SWOT.


RESULTS
The SWOT analysis showed 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 CCM could certainly have benefits for health care in rural settings but staffing levels and staff competency would need to be addressed before implementation of CCM in such settings. Improving health literacy among patients and their carers will be essential to ensure their full participation in the implementation of a successful CCM.
['Kurpas|Donata|D|', 'Petrazzuoli|Ferdinando|F|', 'Szwamel|Katarzyna|K|', 'Randall-Smith|Jane|J|', 'Blahova|Beata|B|', 'Dumitra|Gindrovel|G|', 'Javorská|Kateřina|K|', 'Mohos|András|A|', 'Simões|José Augusto|JA|', 'Tkachenko|Victoria|V|', 'Kern|Jean-Baptiste|JB|', 'Holland|Carol|C|', 'Gwyther|Holly|H|']
D017028:Caregivers D003695:Delivery of Health Care D058005:General Practitioners D006801:Humans D011320:Primary Health Care D012424:Rural Population
Europe disease management health and wellbeing health services research primary health care survey research public policy issues rural health services chronic disease