Working Together: Improving Outcomes in Chronic Disease Management
Working Together: Improving Outcomes in Chronic Disease Management
By Melissa Plantz
The challenges and costs of managing chronic diseases and conditions are both complex and expensive. Chronic diseases can be managed, but not cured and many patients suffer from more than one chronic condition. The Center for Managing Chronic Disease states that 1.7 million people in the United States die from a chronic disease – that is 70% of the total number of U.S. deaths each year.
Chronic diseases are the leading cause of premature deaths around the world. However, with proper management and collaborative care, patients can improve their quality of life.
Working together pharmacists and physicians can coordinate care for the following chronic diseases and conditions:
The Challenges of Managing Chronic Disease
The challenges found in managing chronic diseases and conditions are problematic for both patients and providers. Patients living with a condition or multiple conditions may lack support from family as there is an increase in “baby boomer” patients. Some of these patients are elderly and either have no family or family that lives too far away to be helpful on a regular basis.
Patients must manage fatigue and emotional distress. The severity of the condition can lead to major depression if left untreated. Patients can become frustrated and further depressed if the chronic disease limits normal activities once enjoyed. This only adds to the patient’s multiple chronic conditions and unfortunately, more medication as well.
Providers trying to manage chronic disease in their patients also face a wide range of challenges. The first being many patients have multiple chronic diseases and the provider may only specialize in one of these. For example, a breast cancer patient may also suffer from hypertension, depression, and are beginning to show the signs of an early stage of arthritis.
When this is the case, the patient is forced to see multiple specialists, typically in different locations, and receive different medications from each provider. When the number of prescription medications in a regimen increase, the risk of drug interactions can be higher. Without proper communication between providers, a deadly combination could be prescribed.
The Costs of Managing Chronic Disease
The prescription drug medications prescribed may have an exuberant price tag depending on the drug and the disease it manages. Even with insurance, some medications are extremely high in price and when faced with multiple medications in a regimen, a patient may be unable to pay for them all.
This is a form of non-adherence and is not intentional. Cost is a key factor in adherence and compliance. Chronic disease management is seeing an overall growth in Medicare spending due to the fact the “baby boomer” generation is aging.
Coordinating care between physician and pharmacist will optimize patients’ chronic disease management. Pharmacists working closely in the collaborative care environment can follow and monitor all prescription medications prescribed and confirm any drug interactions before they occur.
In a special report by the CDC, the following is said about pharmacists in collaborative care reducing costs, “One way to measure the cost-efficiencies of pharmacist-delivered CDTM is to consider the calculated return on investment (ROI), which reflects the value of the service based on the cost of delivering the service. The data collected from CDTM demonstrated an ROI of as high as 12:1 and an average between 3:1 and 5:1.”
The savings were due in part from pharmacists being able to manage medications which in turn reduced hospital admissions, avoidance of inappropriate medications, and emergency room and physician visits.
By Melissa Plantz
The challenges and costs of managing chronic diseases and conditions are both complex and expensive. Chronic diseases can be managed, but not cured and many patients suffer from more than one chronic condition. The Center for Managing Chronic Disease states that 1.7 million people in the United States die from a chronic disease – that is 70% of the total number of U.S. deaths each year.
Chronic diseases are the leading cause of premature deaths around the world. However, with proper management and collaborative care, patients can improve their quality of life.
Working together pharmacists and physicians can coordinate care for the following chronic diseases and conditions:
- Alzheimer’s
- ALS (Lou Gehrigs disease)
- Breast cancer
- Cystic fibrosis
- Chronic obstructive pulmonary disease (COPD)
- Heart disease
- And more
The Challenges of Managing Chronic Disease
The challenges found in managing chronic diseases and conditions are problematic for both patients and providers. Patients living with a condition or multiple conditions may lack support from family as there is an increase in “baby boomer” patients. Some of these patients are elderly and either have no family or family that lives too far away to be helpful on a regular basis.
Patients must manage fatigue and emotional distress. The severity of the condition can lead to major depression if left untreated. Patients can become frustrated and further depressed if the chronic disease limits normal activities once enjoyed. This only adds to the patient’s multiple chronic conditions and unfortunately, more medication as well.
Providers trying to manage chronic disease in their patients also face a wide range of challenges. The first being many patients have multiple chronic diseases and the provider may only specialize in one of these. For example, a breast cancer patient may also suffer from hypertension, depression, and are beginning to show the signs of an early stage of arthritis.
When this is the case, the patient is forced to see multiple specialists, typically in different locations, and receive different medications from each provider. When the number of prescription medications in a regimen increase, the risk of drug interactions can be higher. Without proper communication between providers, a deadly combination could be prescribed.
The Costs of Managing Chronic Disease
The prescription drug medications prescribed may have an exuberant price tag depending on the drug and the disease it manages. Even with insurance, some medications are extremely high in price and when faced with multiple medications in a regimen, a patient may be unable to pay for them all.
This is a form of non-adherence and is not intentional. Cost is a key factor in adherence and compliance. Chronic disease management is seeing an overall growth in Medicare spending due to the fact the “baby boomer” generation is aging.
Coordinating care between physician and pharmacist will optimize patients’ chronic disease management. Pharmacists working closely in the collaborative care environment can follow and monitor all prescription medications prescribed and confirm any drug interactions before they occur.
In a special report by the CDC, the following is said about pharmacists in collaborative care reducing costs, “One way to measure the cost-efficiencies of pharmacist-delivered CDTM is to consider the calculated return on investment (ROI), which reflects the value of the service based on the cost of delivering the service. The data collected from CDTM demonstrated an ROI of as high as 12:1 and an average between 3:1 and 5:1.”
The savings were due in part from pharmacists being able to manage medications which in turn reduced hospital admissions, avoidance of inappropriate medications, and emergency room and physician visits.