What Is Chronic Care Management?

Chronic care management is the ongoing management of long-term illnesses and diseases. It focuses on helping patients maintain the highest quality of life by treating the symptoms associated with the condition and using interventions designed to prevent the condition from becoming worse. In addition to medical interventions, quality chronic care management also includes education and ongoing patient support.

There are numerous chronic diseases, including diabetes, cancer, heart disease, and arthritis. Proper chronic care management for each specific disease is important because, when left unchecked, these diseases can lead to severe complications or premature death. Coming up with a management regimen typically involves input from patients, physicians, caretakers, and other support staff.

Alleviating symptoms of a disease is one of the most important aspects of chronic care management because it allows patients to lead a fuller, more active lifestyle, which in turn can increase longevity. Pain is usually the first symptom that the medical team focuses on because pain can significantly interfere with daily living activities. Once that symptom is being managed, the team can focus on other symptoms, such as fatigue and mobility limitations.

While medications are often required for certain conditions and symptoms, lifestyle changes can also be beneficial. For example, those with heart disease can help their condition by eating diets low in sodium and saturated fats. Educating the patients about the benefits of these lifestyle changes and ways to go about incorporating them is an important part of chronic care management. The role of educator often falls on the nurses involved in patient care.

Nurses and other medical staff also spend time with patients’ caregivers and provide valuable education for them as part of overall chronic care management. Patients with chronic diseases typically fare better when they have a strong and knowledgeable support system. Caregivers and family members should be instructed on what to do in the event of an emergency as well as how to handle day-to-day issues associated with the chronic illness. In cases where the patients are severely ill and require significant care, caregivers can often experience significant strain in their own lives, and maintaining contact with them allows medical staff to intervene if the problems arise from that strain.

Frequently evaluating and adapting a chronic care management regimen is important to maintaining the quality of the regimen. Chronic diseases can change over time, and the medial team must be prepared to make relevant treatment changes to keep the disease from further progressing. While routine tests such as blood work, heart monitoring, and imaging scans can help keep the medical team up to date about the patient’s condition, good communication skills between everyone involved is also very important.