{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T18:23:36Z","timestamp":1776277416090,"version":"3.50.1"},"reference-count":28,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,4,12]]},"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to elucidate the top five key priorities and barriers to chronic care in the health system of Abu Dhabi, United Arab Emirates (UAE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A modified Delphi study was performed to reach consensus on priority areas and barriers to the development of the Chronic Care Model in the health system of Abu Dhabi. Individual wireless audience response devices (keypads) linked to a computer were used to reduce 28 priorities and 20 barriers to the top five during three iterative rounds over three consecutive days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Chronic care services for patients with diabetes, cardiovascular diseases and cancer, in both private and publicly funded healthcare services in the emirate of Abu Dhabi.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A purposive sample of 20 health systems\u2019 experts were recruited. They were front-line healthcare workers from the public and private sector working in the delivery of care for patients with diabetes, cardiovascular diseases and cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The \u2018overall organizational leadership in chronic illness care\u2019 was ranked as the most important priority to address (26.3%) and \u2018patient compliance\u2019 was ranked as the most important barrier (36.8%) to the development of the Chronic Care Model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study has identified the current priorities and barriers to improving chronic care within Abu Dhabi\u2019s healthcare system. Our paper addresses the UAE\u2019s 2021 Agenda of achieving a world-class healthcare system, and findings may help inform strategic changes required to achieve this mission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-020189","type":"journal-article","created":{"date-parts":[[2018,6,4]],"date-time":"2018-06-04T09:51:35Z","timestamp":1528105895000},"page":"e020189","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["A pushing chronic care forward in Abu Dhabi by identifying priorities and addressing barriers: a modified Delphi technique"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6982-8063","authenticated-orcid":false,"given":"Mar\u00edlia Silva","family":"Paulo","sequence":"first","affiliation":[{"name":"Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal"},{"name":"Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates"}]},{"given":"Tom","family":"Loney","sequence":"additional","affiliation":[{"name":"College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates"}]},{"given":"Luis V","family":"Lap\u00e3o","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2018,6,4]]},"reference":[{"key":"2025121403222264000_8.6.e020189.1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.28.1.75"},{"key":"2025121403222264000_8.6.e020189.2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.20.6.64"},{"key":"2025121403222264000_8.6.e020189.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0009.2007.00477.x"},{"key":"2025121403222264000_8.6.e020189.4","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000167182.72251.a1"},{"key":"2025121403222264000_8.6.e020189.5","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.10.1821"},{"key":"2025121403222264000_8.6.e020189.6","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1186\/s12913-017-2691-4","article-title":"The primary health care in the emirate of Abu Dhabi: are they aligned with the chronic care model elements?","volume":"17","author":"Paulo","year":"2017","journal-title":"BMC Health Serv Res"},{"key":"2025121403222264000_8.6.e020189.7","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1186\/s12913-017-2597-1","article-title":"Progress and outcomes of health systems reform in the United Arab Emirates: a systematic review","volume":"17","author":"Koornneef","year":"2017","journal-title":"BMC Health Serv Res"},{"key":"2025121403222264000_8.6.e020189.8","unstructured":"Health Authority Abu Dhabi. Health Statistics 2016: Abu Dhabi, 2017."},{"key":"2025121403222264000_8.6.e020189.9","unstructured":"Prime Minister\u2019s Office. World-Class Healthcare | UAE Vision 2021. 2016 https:\/\/www.vision2021.ae\/en\/national-priority-areas\/world-class-healthcare (accessed 8 Jan 2018)."},{"key":"2025121403222264000_8.6.e020189.10","doi-asserted-by":"publisher","DOI":"10.1007\/BF00993988"},{"key":"2025121403222264000_8.6.e020189.11","first-page":"273","article-title":"The Delphi technique","volume":"12","author":"Hsu","year":"2007","journal-title":"Prat Assess Res Eval"},{"key":"2025121403222264000_8.6.e020189.12","doi-asserted-by":"publisher","DOI":"10.1093\/occmed\/kqw089"},{"key":"2025121403222264000_8.6.e020189.13","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1177\/0269216317690685","article-title":"Guidance on Conducting and Reporting Delphi Studies (CREDES) in palliative care: Recommendations based on a methodological systematic review","volume":"31","author":"J\u00fcnger","year":"2017","journal-title":"Palliat Med"},{"key":"2025121403222264000_8.6.e020189.14","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1590\/1413-81232017223.33532016","article-title":"Aten\u00e7\u00e3o Prim\u00e1ria \u00e0 Sa\u00fade na coordena\u00e7\u00e3o das Redes de Aten\u00e7\u00e3o \u00e0 Sa\u00fade no Rio de Janeiro, Brasil, e na regi\u00e3o de Lisboa, Portugal","volume":"22","author":"Lap\u00e3o","year":"2017","journal-title":"Ci\u00eancia & Sa\u00fade Coletiva"},{"key":"2025121403222264000_8.6.e020189.15","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1108\/17511871111172349","article-title":"PACES: a national leadership program in support of primary-care reform in Portugal","volume":"21","author":"Lap\u00e3o","year":"2011","journal-title":"Leadersh Heal Serv"},{"key":"2025121403222264000_8.6.e020189.16","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.12.2.162"},{"key":"2025121403222264000_8.6.e020189.17","unstructured":"Santos I , De QI , De DI , et al . Indicadores de desempenho na consulta. Rev Port Med Geral e Fam 2009:227\u201335."},{"key":"2025121403222264000_8.6.e020189.18","unstructured":"Silva Miguel L , Brito de Sa A , em C . Cuidados de Sa\u00fade Prim\u00e1rios em 2011-2016: refor\u00e7ar, expandir Contribui\u00e7\u00e3o para o Plano Nacional de Sa\u00fade 2011-2016. Lisboa: Alto Comissariado do Ministerio da Saude, 2010. http:\/\/1nj5ms2lli5hdggbe3mm7ms5.wpengine.netdna-cdn.com\/files\/2010\/08\/CSP1.pdf."},{"key":"2025121403222264000_8.6.e020189.19","doi-asserted-by":"crossref","first-page":"17","DOI":"10.4103\/2230-8229.97841","article-title":"Evidence based medicine: an overview","volume":"10","author":"Al-Almaie","year":"2003","journal-title":"J Family Community Med"},{"key":"2025121403222264000_8.6.e020189.20","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s12875-014-0219-0","article-title":"Facilitators and barriers of implementing the chronic care model in primary care: a systematic review","volume":"16","author":"Kadu","year":"2015","journal-title":"BMC Fam Pract"},{"key":"2025121403222264000_8.6.e020189.21","first-page":"4","article-title":"Strategies to enhance patient adherence: making it simple","volume":"7","author":"Atreja","year":"2005","journal-title":"MedGenMed"},{"key":"2025121403222264000_8.6.e020189.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2005.12.021"},{"key":"2025121403222264000_8.6.e020189.23","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1353\/hpu.2012.0131","article-title":"Chronic Care Model implementation for cancer screening and follow-up in community health centers","volume":"23","author":"Haggstrom","year":"2012","journal-title":"J Health Care Poor Underserved"},{"key":"2025121403222264000_8.6.e020189.24","doi-asserted-by":"publisher","DOI":"10.1370\/afm.571"},{"key":"2025121403222264000_8.6.e020189.25","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2015-103285"},{"key":"2025121403222264000_8.6.e020189.26","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1111\/jep.12542","article-title":"A modified Delphi study of structures and processes related to medicines management for elderly hospitalised patients in the United Arab Emirates","volume":"22","author":"Al Shemeili","year":"2016","journal-title":"J Eval Clin Pract"},{"key":"2025121403222264000_8.6.e020189.27","doi-asserted-by":"crossref","first-page":"165","DOI":"10.4300\/JGME-D-15-00310.1","article-title":"Creating a Framework for Medical Professionalism: An Initial Consensus Statement From an Arab Nation","volume":"8","author":"Abdel-Razig","year":"2016","journal-title":"J Grad Med Educ"},{"key":"2025121403222264000_8.6.e020189.28","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s12995-016-0098-5","article-title":"Use of an audience response system to maximise response rates and expedite a modified Delphi process for consensus on occupational health","volume":"11","author":"Aw","year":"2016","journal-title":"J Occup Med Toxicol"}],"updated-by":[{"DOI":"10.1136\/bmjopen-2017-020189corr1","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2018,8,10]],"date-time":"2018-08-10T00:00:00Z","timestamp":1533859200000}}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-020189","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T11:22:28Z","timestamp":1765711348000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-020189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6]]},"references-count":28,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2018,6,4]]},"published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1136\/bmjopen-2017-020189"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-020189","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6]]}}}