It is a growing cause for concern that the number of patients suffering from chronic ailments is steadily rising, along with an increased prevalence of patients suffering from chronic conditions, and sometimes even multiple chronic diseases. This scenario is not limited to developing countries; in fact, developed countries are also facing this situation and are equally concerned about a plan of healthcare and management for those suffering from chronic conditions.
Need for a disease management program
From a worldwide as well as a country-specific perspective, physicians and specialists have seen the need to have a chronic care management program in place to provide proper and systemic treatment to chronic condition sufferers. In fact, disease management is termed as the “system of coordinated healthcare interventions and communication for conditions where the patient self-care efforts are an integral part of the treatment.”
A disease management program must have –
- A process to identify the population
- Practice guidelines that are based on evidence
- Practice models that are collaborative and include support service providers along with physicians
- Education for the patient about self-management
- A program process and outcome that can easily be measured, evaluated, and managed
- Presence of a feedback loop and routine reporting
These are the standards on the basis of which the chronic care management or CMS program was based.
There has also been a disease management program put in place, the validity of which has led to chronic care management, which has been conceived by taking into account clinical findings, peer reviews, and literature.
Pros and cons of chronic care management
Such a program, like most others, has its share of advantages and disadvantages.
The pros include –
- The program will be systematic and streamlined and will be the same for chronic condition sufferers, whether of one condition or more, in any location.
- The program has a proper division of labor in terms of responsibility, which includes a team rather than a one-on-one approach.
- The CMS is helpful for specialists too, as they can see a greater number of patients in an organized fashion and reach out to more patients overall.
- Caregivers and other staff also benefit, apart from the specialists, because this program is a collaborative one in which everyone, not just the specialist, has an inclusive role to play.
- Patients can also learn self-management, which is useful for them.
The cons of the chronic care management program from the doctors’ as well as patients’ perspective are as follows –
- The program and plan is for chronic conditions only and is a CCM plan and not a disease management (DM) program, which can be inclusive of other conditions.
- There is a lack of proper guidelines, and clear instructions have not yet been instituted.
- The consent form is a bone of contention, as without the proper rules and instructions in place, doctors (specialists and others) are hesitant to sign up for the management program.
- Patients are also not happy about paying a small contribution out of the total that goes towards the chronic care management fund for the treatment of each patient.
These are just the basic pros and cons of the CCM plan, which is still under consideration.
By: Dr. Alexander G. Salerno