The impact of comorbid chronic conditions on diabetes care.
John D. Piette,Eve A. Kerr +1 more
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TLDR
The increasing prevalence of multimorbidity among older diabetic adults is at least in part an unintended consequence of success in improving diabetes treatment quality and may miss opportunities to improve patients’ functioning, quality of life, and mortality risk.Abstract:
Effective diabetes management often presents enormous challenges. Not surprisingly, clinicians and patients alike can be overwhelmed by the need to address comorbid chronic conditions in addition to patients’ diabetes-specific treatment goals. Ignoring concurrent disease management, however, can lead to ineffective control of diabetes-specific risk factors and may miss opportunities to improve patients’ functioning, quality of life, and mortality risk.
Other chronic conditions are common among people with diabetes and account for much of the morbidity these patients face. According to the Medical Expenditure Panel Survey, most adults with diabetes have at least one comorbid chronic disease (1) and as many as 40% have at least three (2,3). The increasing prevalence of multimorbidity among older diabetic adults is at least in part an unintended consequence of our success in improving diabetes treatment quality. Improvements in HbA1c (A1C) monitoring and glycemic control have been documented in several large systems of care (4–7). More widespread use of treatments such as ACE inhibitors and aspirin have decreased patients’ risk of cardiovascular death (8–10). Diabetic patients are living longer, and like all Americans, this increases their chance of acquiring one of the many chronic diseases associated with aging.
Other more troubling trends have conspired to increase the impact of multimorbidity on diabetes management. In many health care systems, providers see patients during brief office visits and are overwhelmed by the number of health maintenance activities recommended by guidelines and quality monitoring agencies (11,12). When diabetic patients have multiple chronic conditions, screening, counseling, and treatment needs can far exceed the time available for patient-provider visits. Health problems that used to be treated in inpatient settings are increasingly managed within outpatient care, further straining providers’ resources for addressing diabetes-specific management goals (13). With inadequate health system support and …read more
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Defining Comorbidity: Implications for Understanding Health and Health Services
TL;DR: It is shown that the value of a given construct lies in its ability to explain a particular phenomenon of interest within the domains of clinical care, epidemiology, or health services planning and financing.
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Diabetes in Older Adults
M. Sue Kirkman,Vanessa J. Briscoe,Nathaniel G. Clark,Hermes Florez,Linda B. Haas,Jeffrey B. Halter,Elbert S. Huang,Mary T. Korytkowski,Medha Munshi,Peggy Soule Odegard,Richard E. Pratley,Carrie S. Swift +11 more
TL;DR: The American Diabetes Association (ADA) convened a Consensus Development Conference on Diabetes and Older Adults (defined as those aged ≥ 65 years) in February 2012 as discussed by the authors, where a series of scientific presentations by experts in the field were independently developed.
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Designing health care for the most common chronic condition--multimorbidity.
TL;DR: To ensure safe and effective care for adults with multiple chronic conditions, particularly the millions of baby boomers entering their years of declining health and increasing health service use, health care must shift its current focus on managing innumerable individual diseases.
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Future of multimorbidity research: how should understanding of multimorbidity inform health system design?
Cynthia M. Boyd,Martin Fortin +1 more
TL;DR: The objective of this paper is to review the implications of multimorbidity for the design of health system and to understand the research needs for this population of patients with multiple chronic conditions.
References
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Book
SF-36 health survey: Manual and interpretation guide
TL;DR: TheSF-36 is a generic health status measure which has gained popularity as a measure of outcome in a wide variety of patient groups and social and the contribution of baseline health, sociodemographic and work-related factors to the SF-36 Health Survey: manual and interpretation guide is tested.
Journal ArticleDOI
Improving Chronic Illness Care: Translating Evidence Into Action
TL;DR: The CCM is described, its use in intensive quality improvement activities with more than 100 health care organizations, and insights gained in the process are described, to guide quality improvement.
Journal ArticleDOI
Improving Primary Care for Patients With Chronic Illness
TL;DR: The chronic care model is a guide to higher-quality chronic illness management within primary care and predicts that improvement in its 6 interrelated components can produce system reform in which informed, activated patients interact with prepared, proactive practice teams.
Journal ArticleDOI
Improving primary care for patients with chronic illness: the chronic care model, Part 2
TL;DR: Research evidence shows to what extent the chronic care model can improve the management of chronic conditions and reduce health care costs and obstacles hinder its widespread adoption.