Chronic illness management

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. That's because modern medicine tends to focus on detecting and treating acute problems, leaving fewer resources for the needs of chronically ill patients, 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 nearly 100 million Americans, of whom 41 million have their daily activities limited in some way because of their condition, and 12 million cannot live independently. Society's need for better chronic care is growing, and many managed care and integrated delivery systems are trying to correct the many deficiencies in current management of chronic diseases.

"Meeting the complex needs of patients with chronic illness or impairment is the single greatest challenge facing organized medical practice," says Ed Wagner, MD, MPH, senior investigator at Group Health Research Institute (GHRI) and director (emeritus) of the MacColl Center for Healthcare Innovation.

Fortunately, Group Health is leading the way in developing, implementing, and promoting better models of care for chronic illness. Group Health's defined population, computerized databases, and integrated delivery system make it a great place to experiment with new approaches. In fact, projects now underway at GHRI hold tremendous promise for discovering and disseminating knowledge about health care services for chronic illness.

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GHRI researchers in chronic illness management

Affiliate researchers

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Recent publications on chronic illness management

2010

Dublin S, Glazer NL, Smith NL, Psaty BM, Lumley T, Wiggins KL, Page RL, Heckbert SR. Diabetes mellitus, glycemic control, and risk of atrial fibrillation. J Gen Intern Med. 2010 Aug;25(8):853-8. Epub 2010 Apr 20. PubMed

Dunn KM, Saunders KW, Rutter CM, Banta-Green CJ, Merrill JO, Sullivan MD, Weisner CM, Silverberg MJ, Campbell CI, Psaty BM, Von Korff M. Opioid prescriptions for chronic pain and overdose: a cohort study. Ann Intern Med. 2010;152(2):85-92. PubMed

Lin EH, Rutter CM, Katon W, Heckbert SR, Ciechanowski P, Oliver MM, Ludman EJ, Young BA, Williams LH, McCulloch DK, Von Korff M. Depression and advanced complications of diabetes: a prospective cohort study. Diabetes Care. 2010 Feb;33(2):264-9. Epub 2009 Nov 23. PubMed

Reid RJ, Coleman K, Johnson EA, Fishman PA, Hsu C, Soman MP, Trescott CE, Erikson M, Larson EB. The Group Health medical home at year two: cost savings, higher patient satisfaction, and less burnout for providers. Health Aff (Millwood). 2010;29(5):835-43. PubMed

Spangler L, Reid RJ, Inge R, Newton KM, Hujoel P, Chaudhari M, Genco RJ, Barlow WE. Cross-sectional study of periodontal care and glycosylated hemoglobin in an insured population. Diabetes Care. 2010 Aug;33(8):1753-8. Epub 2010 May 26. PubMed

2009

Coleman K, Austin BT, Brach C, Wagner EH. Evidence on the Chronic Care Model in the new millennium. Health Aff (Millwood). 2009;28(1):75-85. PubMed

Gensichen J, Von Korff M, Rutter CM, Seelig MD, Ludman EJ, Lin EH, Ciechanowski P, Young BA, Wagner EH, Katon WJ. Physician support for diabetes patients and clinical outcomes. BMC Public Health. 2009;9:367. PubMed

Reid RJ, Fishman PA, Yu O, Ross TR, Tufano JT, Soman MP, Larson EB. Patient-centered medical home demonstration: a prospective, quasi-experimental, before and after evaluation. Am J Manag Care. 2009;15(9):e71-87. PubMed

2008

Green BB, Cook AJ, Ralston JD, Fishman PA, Catz SL, Carlson J, Carrell D, Tyll L, Larson EB, Thompson RS. Effectiveness of home blood pressure monitoring, Web communication, and pharmacist care on hypertension control: a randomized controlled trial. JAMA. 2008;299(24):2857-67. PubMed

Heckbert SR, Li G, Cummings SR, Smith NL, Psaty BM. Use of alendronate and risk of incident atrial fibrillation in women. Arch Intern Med. 2008;168(8):826-31. PubMed

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Our major research interests

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