Chronic Illness Management

Research overview

What do diabetes, back pain, depression, and heart disease have in common? They're among a host of chronic health problems and disabilities that have traditionally received too little attention from health care systems — until serious complications develop. Modern medicine tends to focus on detecting and treating acute problems, leaving fewer resources for the needs of patients with chronic illnesses, which may be less urgent but are equally important.

Our population is aging rapidly, and people with chronic conditions are living longer. Chronic conditions now affect more than 145 million Americans. About half of Americans over 65 — our nation’s fastest-growing segment — have at least 2 chronic conditions. As our need for improved chronic care grows, health care delivery systems are trying to correct the many deficiencies in current management of chronic diseases.

For over 2 decades, KPWHRI scientists have been developing, implementing, and promoting better models of care for chronic illness. Much of this work is led by the institute's Center for Accelerating Care Transformation (ACT Center), which is widely recognized for its refinement and dissemination of the Chronic Care Model. The ACT Center continues to work with providers nationwide to develop strategies and tools for health care systems seeking to improve chronic illness care.

Such resources are then shared globally through active engagement with international organizations developing guidance and care recommendations. Providers worldwide continue to adapt materials such as the ACT Center’s Patient Assessment of Chronic Illness Care and Patient-Centered Medical Home Assessment surveys.

Recent publications on Chronic Illness Management

Tsuang D, Leverenz JB, Lopez OL, Hamilton RL, Bennett DA, Schneider JA, Buchman AS, Larson EB, Crane PK, Kaye JA, Kramer P, Woltjer R, Trojanowski JQ, Weintraub D, Chen-Plotkin AS, Irwin DJ, Rick J, Schellenberg GD, Watson GS, Kukull W, Nelson PT, Jicha GA, Neltner JH, Galasko D, Masliah E, Quinn JF, Chung KA, Yearout D, Mata IF, Wan JY, Edwards KL, Montine TJ, Zabetian CP. APOE ß4 increases risk for dementia in pure synucleinopathies. JAMA Neurol. 2013;70(2):223-8. doi: 10.1001/jamaneurol.2013.600. PubMed

Thacker EL, McKnight B, Psaty BM, Longstreth WT Jr, Dublin S, Jensen PN, Newton KM, Smith NL, Siscovick DS, Heckbert SR. Association of body mass index, diabetes, hypertension, and blood pressure levels with risk of permanent atrial fibrillation. J Gen Intern Med. 2013 Feb;28(2):247-53. doi: 10.1007/s11606-012-2220-4. Epub 2012 Sep 13. PubMed

Davydow DS, Katon WJ, Lin EH, Ciechanowski P, Ludman E, Oliver M, Von Korff M. Depression and risk of hospitalizations for ambulatory care-sensitive conditions in patients with diabetes. J Gen Intern Med. 2013 Jul;28(7):921-9.doi: 10.1007/s11606-013-2336-1. Epub 2013 Jan 17. PubMed

Arterburn DE, Bogart A, Sherwood NE, Sidney S, Coleman KJ, Haneuse S, O'Connor PJ, Theis MK, Campos GM, McCulloch D, Selby J. A multisite study of long-term remission and relapse of type 2 diabetes mellitus following gastric bypass. Obes Surg. 2013 Jan;23(1):93-102. doi: 10.1007/s11695-012-0802-1. Epub 2012 Nov 18. PubMed

Elena JW, Steplowski E, Yu K, Hartge P, Tobias GS, Brotzman MJ, Chanock SJ, Stolzenberg-Solomon RZ, Arslan AA, Bueno-de-Mesquita HB, Helzlsouer K, Jacobs EJ, LaCroix A, Petersen G, Zheng W, Albanes D, Allen NE, Amundadottir L, Bao Y, Boeing H, Boutron-Ruault MC, Buring JE, Gaziano JM, Giovannucci EL, Duell EJ, Hallmans G, Howard BV, Hunter DJ, Hutchinson A, Jacobs KB, Kooperberg C, Kraft P, Mendelsohn JB, Michaud DS, Palli D, Phillips LS, Overvad K, Patel AV, Sansbury L, Shu XO, Simon MS, Slimani N, Trichopoulos D, Visvanathan K, Virtamo J, Wolpin BM, Zeleniuch-Jacquotte A, Fuchs CS, Hoover RN, Gross M. Diabetes and risk of pancreatic cancer: a pooled analysis from the Pancreatic Cancer Cohort Consortium. Cancer Causes Control. 2013 Jan;24(1):13-25. doi: 10.1007/s10552-012-0078-8. Epub 2012 Oct 31. PubMed