Disease Management for Nursing and Public Health Leaders

The Staggering Economic Costs of Chronic Conditions

Chronic conditions impact daily life and are associated with extraordinarily high costs for health care.

Diseases with Skyrocketing Financial Costs

Heart disease and stroke cost the health care system $199 billion per year and lead to $131 billion in lost productivity in the workplace. Estimated costs for diagnosed diabetes was $327 billion in 2017, while the estimated cost of cancer care was $150.8 billion in the U.S. Costs are projected to remain high in the future. The cost of all mental health problems to the global economy could reach $16 trillion by 2030, while the costs of treating Alzheimer’s disease are estimated at between $379 billion and $500 billion by 2040.

Risk Factors Leading to Chronic Conditions

One of the biggest influencers of chronic conditions is cigarette smoking, a habit of nearly 40 million Americans. Each year, 500,000 Americans die prematurely due to smoking or exposure to secondhand smoke. Another risk factor is a lack of physical activity. Among U.S. adults, 15% are physically inactive; this percentage doubles among Hispanics and non-Hispanic Blacks. Other risk factors include excessive alcohol use and poor nutrition.

The Components of a Disease Management Program

To be effective, a disease management program requires the coordination of health care practitioners across different specialties.

The Building Blocks of a Disease Management Program

Several foundational elements comprise an effective disease management program. One is the implementation of an effective tracking and monitoring system, which could integrate information technology and routine reporting and feedback loops involving patients and providers. Another component is using process and outcomes measurement and evaluation, which could involve tracking health care usage, expenditures, and patient satisfaction. Collaborative practice involvement including physicians, pharmacists, nurses, dietitians, and psychologists is a potential vital building block, as is  patient self-management education via behavior modification, support groups, and primary prevention. Other key building blocks can include population identification processes, risk identification and matching intervention to need, and evidence-based practice guidelines.

Primary benefits of disease management programs include improved financial cost containment without impacting care quality, improved patient self-management, enhanced efforts to provide population-based health improvement programs, improved safety and quality of care, and increased access to care.

Nurses Play a Key Role in Effective Disease Management

Nurses play a unique role in disease management because of their close connection to patients. On a daily basis, nurses have the opportunity to support and educate patients who are adjusting to life with a chronic condition.

Tips for Nurses Caring for Patients with Chronic Conditions

One of the ways that nurses can provide optimal care for patients with chronic conditions is tailoring recommendations and discussions to the individual patient. These activities can include setting realistic expectations for daily life with a serious chronic condition, collaborating with other health care professionals to create a personalized treatment plan, and creating an open accessible environment that makes patients and their families feel comfortable in asking questions.

Nurses also can take a holistic approach when caring for patients. They can involve helping patients obtain psychosocial support from psychologists, online or in-person support groups, and advocacy groups. They also can review a variety of options for treating and managing a patient’s condition.

Additionally, nurses can educate patients about health risks and recommended preventive steps. For example, they can provide personalized attention to individuals with compromised immune systems, as these patients have a greater risk of infection due to an infectious disease such as COVID-19. Nurses  also can collaborate with nonclinical professionals to create a plan that helps reduce a patient’s exposure to infectious diseases.

Role of Public Health Officials in Disease Prevention

The Association of State and Territorial Health Officials (ASTHO) “supports a variety of chronic disease prevention and health promotion policies and programs through a number of projects.”

One of the diseases the association helps prevent is breast cancer through more effective data resource mobilization. With a goal of preventing diabetes, the ASTHO looks to strengthen diabetes prevention and control efforts via leveraging a systems framework. They also work to prevent heart disease and stroke by identifying promising public health interventions for prevention and collaborating with clinical care professionals. The association also attempts to curtail obesity and promote wellness by supporting improvements to school health and worksite wellness efforts. Finally, ASTHO works to increase tobacco control efforts in state health agencies through the Tobacco Control Network.

Managing Today for a Better Tomorrow

By implementing and monitoring cross-disciplinary disease management programs, health care practitioners and public health officials can help reduce rates of chronic conditions, lessen their financial impact on national and global economies, and improve people’s quality of life.

Sources

Disease Management, Academy of Managed Care Pharmacy

Chronic Disease Prevention and Health Promotion, Association of State and Territorial Health Officials

Adult Physical Inactivity Prevalence Maps by Race/Ethnicity, Centers for Disease Control and Prevention

Health and Economic Costs of Chronic Diseases, Centers for Disease Control and Prevention

Poor Nutrition, Centers for Disease Control and Prevention

Smoking and Tobacco Use: Data and Statistics, Centers for Disease Control and Prevention

The Key Role Nurses Play in Patients' Journeys with Chronic Diseases, Daily Nurse

COVID-19: Vulnerability and the Power of Privilege in a Pandemic, Health Promotion Journal of Australia

This Is the World's Biggest Mental Health Problem - And You Might Not Have Heard of It, World Economic Forum