Chronic Disease Management

Chronic Care Management encompasses the oversight and education activities conducted by health care professionals to help patients with chronic diseases and health conditions such as diabeteshigh blood pressurelupusmultiple sclerosis and sleep apnea learn to understand their condition and live successfully with it. This term is equivalent to disease management (health) for chronic conditions. The work involves motivating patients to persist in necessary therapies and interventions and helping them to achieve an ongoing, reasonable quality of life.

Personal Chronic Care Management

Patients with chronic conditions have an important role in the management of their conditions, as they are often the ones administering the treatments in everyday life. They also play an important role in monitoring their health and changes in their health by means of Observations of Daily Living (ODLs).[1] Resulting information may inform both self care and clinical care.

Importance of Chronic Care Management

Certain problems related to chronic illness are not specifically medical, but involve patients’ interactions with families and workplaces. Interventions often require patients and families to make difficult lifestyle changes. Patients need to be educated on the benefits of treatment and the risks of not properly following their treatment regimen. They need to be motivated to comply because treatment usually produces an improved state, rather than the results that most patients desire—a cure. Chronic care management helps patients systematically monitor their progress and coordinate with experts to identify and solve any problems they encounter in their treatment.

It would appear from the above, that chronically ill persons are better cared for by primary care physicians. Considering the diverse nature of chronic health problems and the roles that psychosocial environments play in their course, a purely biological model of care is usually inadequate. The biopsychosocial model of care is the ideal alternative.