Disease Management Program

Disease Management Program (DMPs) It is structuralized program that is serving assistance through managing and picking up the wellbeing of people, who suffer the consequences of chronic diseases. It also goes along with the general improvement of these people's medical treatment in the long run. The definition of Disease management programs sometimes refers to "structured treatment program" and its key purpose is to reduce the symptoms of the specific disease to then keep patient's health stable. DMPs are also useful to avoid growing development of the chronic disease and additionally to prevent possible effects of the disease. Through Disease Management Program reduction of the serious illness symptoms occur and the health of patient is stabilized. Furthermore, DMPs are establishing and controlling the plan of afflictions management where the activities of how to deal with it in everyday life are presented. DMPs are offering certified and skilled specialists who provide patients with facilities and services that are dedicated and specified for problems that patient deals with - specialists help, single and exclusive plan of treatment, physiotherapy and rehabilitation are provided ( J.B Couch 1998 p. 85).

DMPs is offered for people who suffer from

Examples of disease:

• diabetes
• asthma
• heart failure
• hypertension
• clinic depression

Establishment

Beginning of DPM starts in 1997 when Zitter explained six elements of success for disease management ( D. Huber 2005 p. 10):

1. Having an understanding of course of disease
2. Threating people like they can take benefits from this innovation
3. Concentrating on preclude and resolution # Rising devotion of patients throughout deepening their knowledge about the topic
4. Guaranteeing 24h healthcare
5. Creating organic system of data management

On the other hand, in 2002 Gillespie create 7 criteria to select candidates to DPMs program:

1. Access to the treatment procedures and guiding principles in the same time with appropriateness and effectiveness of healthcare.
2. Commonly known problems in the treatment that are thoroughly recognized in the medical and scientific literature.
3. Numerous ranges of practices and a variety of drug addiction treatment methods.
4. The pool of patients with specific disease for whom treatment could be developed.
5. Avoidable severe events that are often connected with chronic illness, e.g. visit to an emergency department or urgent care.
6. Results that can be explained and measured in consistent and neutral ways and that can be adapted by submission of appropriate treatment e.g. decreased number of emergency department visits of hospitalizations.
7. The possibility of saving costs in the short term (less than 2 years)

DMAA - The Disease Management Association of America

It is also worth to emphasize the role of The Disease Management Association of America, now DMAA(also: the Care Continuum Alliance). It is organization which represents disease management society and nonprofit trade association. The organization's mission is to improve disease management by standardizing definitions, program components and performance measurements, and also to promote first-class principles for DMPs, in addition, educating payers, suppliers, accreditation bodies and legislators on the significance of disease management in making progress of the health of individuals and the whole population (D. Huber 2005 p. 10).

Techniques

The main techniques of DMPs that occurred in the scientific literature are ( E. Cohen, T. G. Cesta 2004 p. 38-41):

1. establishing a multidisciplinary group,
2. preparing an evaluation of outcomes to catalogue and measure them, and
3. introducing of using the knowledge management technologies.

These three fundamental techniques are practiced with a population health concentrate on improving overall health and well-being. Counted in the DMAA description Disease management components is considered to be the combined practice models that mainly consist of doctors and all maintenance service providers. The particular group needs to work with compete plan of care, and every single part of discipline (doctors, pharmacists, nurses, social employees,and many others professionals who are experts in taking an concentration of human health are supposed to cooperate with each other in team. Interactions and communication between work team is the major of the success of every program.

Examples of Disease Management Program

• Diabetes management program: Diabetes management programs are aimed at helping patients to better manage their diabetes by providing education and support. Education may include learning about the complications of diabetes, how to keep blood sugar levels under control, and how to make healthy lifestyle choices. Support may include assistance in monitoring glucose levels, assistance in setting goals, and access to resources such as support groups and dietitians.
• Asthma management program: Asthma management programs are designed to help people with asthma control their symptoms, reduce flare-ups, and improve overall health. These programs typically involve education on asthma triggers, how to use asthma medications, and how to recognize and respond to early warning signs of an attack. They may also include access to resources such as support groups and breathing exercises.
• Heart Failure Management Program: Heart failure management programs are designed to help people with heart failure manage their condition. These programs typically involve education on the causes and symptoms of heart failure, how to follow a heart-healthy lifestyle, and how to recognize and respond to early warning signs of an attack. They may also include access to resources such as support groups and dietitians.

Limitations of Disease Management Program

Despite the fact that Disease Management Programs offer a variety of benefits, there are certain limitations which are worth considering. The following are some of the major limitations of DMPs:

• Cost: The cost associated with implementing a DMP can be very high, as it requires a significant investment in staff, resources, and technology.
• Accessibility: Not all patients have access to DMPs, as they are often only available to those with private insurance or who can afford the associated costs.
• Effectiveness: While DMPs can be effective in managing chronic conditions, some studies have shown that they can be less effective than other interventions, such as lifestyle changes.
• Complexity: DMPs can be complex to set up and manage, requiring the involvement of a range of health professionals.
• Compliance: There is a risk that patients may not comply with their DMP, which can reduce its effectiveness.

Other approaches related to Disease Management Program

Other approaches related to Disease Management Program include:

• Telemedicine: Telemedicine is a way of providing care to patients over a distance using technology. This could include video conferencing, remote monitoring, or mobile health apps.
• Self-management: Self-management involves providing patients with the tools and resources they need to take ownership of their care. This could include patient education, lifestyle modifications, and other forms of support.
• Coordinated Care: Coordinated care involves ensuring that all providers involved in a patient’s care are communicating and collaborating effectively. This could include creating a care plan, or coordinating specialists and other providers.
• Risk Stratification: Risk stratification involves assessing a patient’s risk of developing a certain disease or condition, and then tailoring treatment accordingly. This could include using predictive analytics or other data-driven approaches.

In conclusion, Disease Management Programs are just one approach to managing chronic diseases. Other approaches such as telemedicine, self-management, coordinated care, and risk stratification can all be used to improve patient outcomes.

Disease Management Program — recommended articles

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References

• Cohen E., Cesta T.G. (1993) Nursing Case Management: From Essentials to Advanced Practice Applications Elsevier Health Sciences, New York.
• Couch J.B. (1998) The Health Care Professional’s Guide to Disease Management: Patient-centered Care for the 21st Century Jones & Bartlett Learning, Maryland, p. 85-87
• Huber D. (2005) Disease Management: A guide for case managers Elsevier Health Sciences, Iowa, p. 3-12.
• Lavery L.A., Wunderlich R.P., Tredwell J.L. (2005) Disease management for the diabetic foot: Effectiveness of a diabetic foot prevention program to reduce amputations and hospitalizations, Elsevier.
• Libersky J. (2014) Using Lessons from Disease Management and Care Management in Building Integrated Care Programs, Technical Assistence Brief.
• Rice K.L., Dewan N., Bloomfield H.E., Grill J., Schult T.M., Nelson D.B., Kumari S., Thomas M., Geist L.J., Beaner C., Caldwell M., Niewoehner D.E. (2010) Disease Management Program for Chronic Obstructive Pulmonary Disease, American Journal of Respiratory and Critical Care Medicine, Volume 182.
• Salzman B., Collins L., Hajjar E.R., (2012) Chronic Disease Management Elsevier, Volume 39 No. 2.
• Singht D. (2008) How can chronic disease management programmes operate across care settings and providers? World Health Organization, Denmark.

Author: Karolina Kaproń