A Systematic Review Of Interventions For The Management Of Chronic Diseases In Primary Care

Chronic diseases / non-communicable diseases are currently the leading cause of death in adults in almost all countries and the number is expected to increase by another 17% over the next 10 years. Six in ten adults in the United States have a chronic disease and four in ten adults have two or more. Of the 58 million deaths in 2005, approximately 35 million are estimated to result from chronic diseases.

When patient education, service and payment systems designs are aimed at developing the capacity of individuals and families to effectively fight the disease, improve disease control, reduce health care costs and improve family well-being. Health programs for rural communities that focus on nutrition, weight management, tobacco cessation, exercise and alcohol reduction can help prevent heart disease and prevent strokes. Implement strategies to attack high blood pressure and high cholesterol, with an emphasis on detection and intervention to help prevent or control heart disease. Community representatives are trained and community-based health professionals who provide health promotion and disease prevention services within their tribal communities. For more information on RCCs and how they can help tribal communities manage chronic diseases, see What a community representative is and how they can help provide medical care to AI / AN populations?? Primary and community care are key environments for effective long-term management of conditions.

See the RHIhub tobacco list for more project examples using national health models and innovations. Programs that provide specialists and sub-specialists to rural health facilities can help patients with chronic conditions get the care they need without leaving their community. Originally developed at Stanford University, the Self-Management Program for Chronic Diseases is a widely used evidence-based approach that can be used by patients in rural and urban areas.

It is an organizational approach to care for people with chronic diseases that mainly applies in primary care. The six elements of the CCM work within the context of the individual, the community, the supplier organization and the healthcare system, see Figure 1. The model can be used as a guide to improve the system to provide higher quality chronic disease management .

Adults with chronic diseases that limit their daily lives have more depression and a lower self-esteem than healthy adults and adults with chronic non-limiting diseases. The emotional influence of chronic diseases also has an effect on the intellectual and educational development of the individual. For example, people with type 1 diabetes suffer from monotonous and rigorous health care management for a lifetime, which generally includes daily blood glucose monitoring, insulin injections and constant self-care. This type of constant care that requires type 1 diabetes and other chronic diseases can cause psychological maladjustment. There have been several theories, called a theory of resilience to diabetes, that postulate that protection processes dampen the impact of risk factors on the development and functioning of the individual. Instead of sticking to a specific list of diseases and a specific period of time, we advocate a simpler approach.

Patients, physicians, health professionals and others interested in reducing public health and the economic burden of chronic diseases may benefit from HIV not being considered a single chronic disease, but as a precursor to other chronic diseases. As tobacco consumption is higher in rural areas and tobacco-related cancer is more common, tobacco stopping and prevention programs can also be an effective strategy chronic diseases to help reduce cancer in rural areas. For people at high risk of lung cancer due to a history of smoking, low dose computed tomography is the recommended screening approach. Rural programs that support access to healthy food and exercise opportunities assist in efforts to prevent diabetes. Programs that focus on weight management and healthy living can also reduce obesity, a risk factor for diabetes.