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 of the MacColl Institute 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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Researchers in chronic illness management

GHRI

Affiliate researchers

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Recent publications on chronic illness management

2008

Coleman K, Mattke S, Perrault PJ, Wagner EH. Untangling practice redesign from disease management: how do we best care for the chronically ill? Annu Rev Public Health. 2008 Oct 16. [Epub ahead of print]. PubMed

Tsang A, Von Korff M, Lee S, Alonso J, Karam E, Angermeyer MC, Borges GL, Bromet EJ, de Girolamo G, de Graaf R, Gureje O, Lepine JP, Haro JM, Levinson D, Oakley Browne MA, Posada-Villa J, Seedat S, Watanabe M. Common chronic pain conditions in developed and developing countries: gender and age differences and comorbidity with depression-anxiety disorders. J Pain. 2008;9(10):883-91. Epub 2008 Jul 7. PubMed

Von Korff M, Saunders K, Thomas Ray G, Boudreau D, Campbell C, Merrill J, Sullivan MD, Rutter CM, Silverberg MJ, Banta-Green C, Weisner C. De facto long-term opioid therapy for noncancer pain. Clin J Pain. 2008;24(6):521-7. PubMed

Katon WJ, Russo JE, Von Korff M, Lin EH, Ludman E, Ciechanowski PS. Long-term effects on medical costs of improving depression outcomes in patients with depression and diabetes. Diabetes Care. 2008 Jun;31(6):1155-9. Epub 2008 Mar 10. PubMed

Unützer J, Hantke M, Powers D, Higa L, Lin E, D Vannoy S, Thielke S, Fan MY. Care management for depression and osteoarthritis pain in older primary care patients: a pilot study. Int J Geriatr Psychiatry. 2008; [Epub ahead of print]. PubMed

Cherkin DC, Sherman KJ, Hogeboom CJ, Erro JH, Barlow WE, Deyo RA, Avins AL. Efficacy of acupuncture for chronic low back pain: protocol for a randomized controlled trial. Trials. 2008;9(1):10. PubMed

Saunders K, Merikangas K, Low NC, Von Korff M, Kessler RC. Impact of comorbidity on headache-related disability. Neurology. 2008;70(7):538-47. PubMed

Von Korff M, Dunn KM. Chronic pain reconsidered. Pain. 2008;138(2):267-76. Epub 2008 Jan 28. PubMed

Young BA, Lin E, Von Korff M, Simon G, Ciechanowski P, Ludman EJ, Everson-Stewart S, Kinder L, Oliver M, Boyko EJ, Katon WJ. Diabetes complications severity index and risk of mortality, hospitalization, and healthcare utilization. Am J Manag Care. 2008;14(1):15-23. PubMed

2007

Batik O, Phelan EA, Walwick JA, Wang G, LoGerfo JP. Translating a community-based motivational support program to increase physical activity among older adults with diabetes at community clinics: a pilot study of Physical Activity for a Lifetime of Success (PALS). Prev Chronic Dis. 2008;5(1):A18. Epub 2007 Dec 15. PubMed

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Our major research interests

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