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(698 results for Chronic Disease/Illness Management)

Chronic Disease/Illness Management

Chronic disease management (CDM) is a client-centered model of care involving the delivery of long-term services. The CDM modality encompasses integrated and coordinated primary medical and specialty care, client and clinician education, detailed evidence-based care plans and access to expert care. Incorporating mental health and specialty addiction services into one model has the potential for delivering improved care to people with substance dependence who often receive ineffective, fragmented care or none at all.

Treating Substance Abuse as a Chronic Disease

Substance dependence is a chronic disease for which many affected adults receive little to no intervention, detoxification or subsequent treatment. A wide array of medical and psychiatric comorbidities are common among those with substance addictions, making care delivery complex for both clinicians and clients. Relapse rates for people with addiction and other substance use disorders are similar to relapse rates for other well-understood chronic medical illnesses such as diabetes, hypertension and asthma, which also have physiological and behavioral components.

The CDM Model

Systems of care for substance dependence are rarely integrated with those for co-occurring medical and psychiatric disorders. Furthermore, treatment is too often episodic, poorly coordinated or difficult to access. In a CDM model, management is implemented by a multidisciplinary team consisting of a nurse care manager, social worker and clinicians with expertise in the primary disease and common comorbidities. Care can be delivered in a flexible manner with treatment intensity and modality customized to variations in disease severity and the specific needs of each client. The client is responsible for identifying problems, setting goals and changing behaviors based on internal motivation. Collectively, the team performs the following tasks:

– Coordination with primary care physicians (PCPs)
– Handling necessary releases of information
– Facilitating specialist referrals
– Providing access to community resources
– Implementing evidence-based protocols
– Encouraging self-management
– Being proactive about follow-up

The Efficacy of a CDM Approach

The CDM model is a relatively new approach to treatment. Limited research shows positive, although not necessarily statistically significant outcomes.

– A study analyzing primary care with elements of the CDM model customized for homeless people (70% with alcohol abuse), showed better medical outcomes (blood pressure, glycemic control and lipid levels) for the CDM group.
– Among clients in addiction treatment, researchers found continuing care, defined as receiving annual primary care and specialty addiction and psychiatric care when needed, was associated with abstinence over a 9-year follow-up period.
– People who received care from any healthcare source with core CDM features were more likely to abstain from heroin, cocaine and heavy drinking. Alcohol-dependent clients experienced lower alcohol addiction severity. Those who received higher quality care specifically from a CDM clinic were more likely to have lower drug addiction severity.

While the CDM model shows promise, additional evidence-based outcome studies are needed to help encourage widespread implementation.

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More on Chronic Disease/Illness Management

Chronic disease management (CDM) is a client-centered model of care involving the delivery of long-term services. The CDM modality encompasses integrated and coordinated primary medical and specialty care, client and clinician education, detailed evidence-based care plans and access to expert care. Incorporating mental health and specialty addiction services into one model has the potential for delivering improved care to people with substance dependence who often receive ineffective, fragmented care or none at all.

Treating Substance Abuse as a Chronic Disease

Substance dependence is a chronic disease for which many affected adults receive little to no intervention, detoxification or subsequent treatment. A wide array of medical and psychiatric comorbidities are common among those with substance addictions, making care delivery complex for both clinicians and clients. Relapse rates for people with addiction and other substance use disorders are similar to relapse rates for other well-understood chronic medical illnesses such as diabetes, hypertension and asthma, which also have physiological and behavioral components.

The CDM Model

Systems of care for substance dependence are rarely integrated with those for co-occurring medical and psychiatric disorders. Furthermore, treatment is too often episodic, poorly coordinated or difficult to access. In a CDM model, management is implemented by a multidisciplinary team consisting of a nurse care manager, social worker and clinicians with expertise in the primary disease and common comorbidities. Care can be delivered in a flexible manner with treatment intensity and modality customized to variations in disease severity and the specific needs of each client. The client is responsible for identifying problems, setting goals and changing behaviors based on internal motivation. Collectively, the team performs the following tasks:

– Coordination with primary care physicians (PCPs)
– Handling necessary releases of information
– Facilitating specialist referrals
– Providing access to community resources
– Implementing evidence-based protocols
– Encouraging self-management
– Being proactive about follow-up

The Efficacy of a CDM Approach

The CDM model is a relatively new approach to treatment. Limited research shows positive, although not necessarily statistically significant outcomes.

– A study analyzing primary care with elements of the CDM model customized for homeless people (70% with alcohol abuse), showed better medical outcomes (blood pressure, glycemic control and lipid levels) for the CDM group.
– Among clients in addiction treatment, researchers found continuing care, defined as receiving annual primary care and specialty addiction and psychiatric care when needed, was associated with abstinence over a 9-year follow-up period.
– People who received care from any healthcare source with core CDM features were more likely to abstain from heroin, cocaine and heavy drinking. Alcohol-dependent clients experienced lower alcohol addiction severity. Those who received higher quality care specifically from a CDM clinic were more likely to have lower drug addiction severity.

While the CDM model shows promise, additional evidence-based outcome studies are needed to help encourage widespread implementation.

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