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Disease Management for Chronic Obstructive Pulmonary Disease

Disease Management for Chronic Obstructive Pulmonary Disease

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This bibliography of disease management and educational interventions focuses on a relatively new disease target for such programs, chronic obstructive pulmonary disease (COPD). In 2000, an estimated 10 million Americans were diagnosed with COPD and another 14 million were undiagnosed. The high mortality and cost associated with COPD, as well as a lack of awareness regarding the disease, are incentives to apply disease management strategies. Further education of health care providers and the public could improve the detection and treatment of COPD.
This bibliography of disease management and educational interventions focuses on a relatively new disease target for such programs, chronic obstructive pulmonary disease (COPD). In 2000, an estimated 10 million Americans were diagnosed with COPD and another 14 million were undiagnosed. The high mortality and cost associated with COPD, as well as a lack of awareness regarding the disease, are incentives to apply disease management strategies. Further education of health care providers and the public could improve the detection and treatment of COPD.

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Categories:Types, Research
Published by: National Pharmaceutical Council on Oct 20, 2008
Copyright:Traditional Copyright: All rights reserved

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05/14/2014

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DiseaseManagementfor
ChronicObstructivePulmonary Disease
 
DISCLAIMER:The information contained in this annotated bibliography was obtained from the publications listed.The NationalPharmaceutical Council (NPC) has worked to ensure that the annotations accurately reflect the information contained in the publications, but cannot guarantee the accuracy of the annotations or the publications.There are articles available on the treatment of chronic obstructive pulmonary disease that are not included in this bibliography, which may include relevant informa-tion not covered herein.The inclusion of any publication in this bibliography does not constitute an endorsement of that publicationby NPC or an endorsement of the services, programs, treatments, or other information contained in such publication.This bibliography is designed for informational purposes only, and should not be construed as professional advice on any specificset of facts and circumstances.This bibliography is not intended to be a comprehensive source of disease management servicesor programs in the treatment of chronic obstructive pulmonary disease, or a substitute for informed medical advice.If medicaladvice or other expert assistance is required, readers are urged to consult a qualified health care provider or other professional.NPC is not responsible for any claims or losses that may arise from any errors or omissions in the information contained in thisbibliography or in the listed publications, whether caused by NPC or originating in any of the listed publications, or any reliancethereon, whether in a clinical or other setting. ©September 2003 National Pharmaceutical Council, Inc.
 
Introduction
 The Centers for Medicare and Medicaid Services and theDisease Management Association of America define diseasemanagement as a system of coordinated health careinterventions and communications for populations withconditions in which patient self-care efforts are substantial.
1,2
Disease management supports the clinician-patientrelationship and plan of care, and emphasizes prevention of disease-related exacerbations and complications usingevidence-based guidelines and patient empowermenttools.
1,2
Disease management also evaluates clinical,humanistic, and economic outcomes on an ongoing basiswith the goal of improving overall health.
1-3
 The specific goalsof disease management include:
3
Improving patient self-care through patient education,monitoring, and communication with members of thehealth care team.
Improving physician performance through feedback and/or reports on patient progress in compliance withprotocols.
Improving communication and coordination of servicesamong patient, physician, disease managementorganization, and other providers.
Improving access to services, including preventionservices and prescription drugs as needed. The following functions are the main components of disease management:
2,3
Identification of patient populations.
Use of evidence-based practice guidelines.
Support of adherence to evidence-based medicalpractice guidelines by providing practice guidelines tophysicians and other providers, reporting on thepatient’s progress in compliance with protocols, andproviding support services to assist the physician inmonitoring the patient.
Provision of services designed to enhance patient self-management and adherence to the patient’s treatment plan.
Routine reporting and feedback to the health careproviders and to the patient.
Communication and collaboration among providers andbetween the patient and the patient’s providers.
Collection and analysis of process and outcomemeasures along with a system to make necessarychanges based on the findings of those measures.Disease management programs are used widely for manychronic diseases, but the most common diseases includeasthma, congestive heart failure, and diabetes mellitus.Considerations in selecting a disease for diseasemanagement often include:
2,3
 Availability of treatment guidelines with consensusabout what constitutes appropriate and effective care.
Presence of generally recognized problems in therapythat are well documented in the medical literature.
Large practice variation and a range of drug treatmentmodalities.
Large number of patients with the disease whosetherapy could be improved.
Preventable acute events that often are associated withthe chronic disease (e.g., emergency department orurgent care visits).
Outcomes that can be defined and measured instandardized and objective ways and that can bemodified by application of appropriate therapy (e.g.,decreased number of emergency department visits orhospitalizations).
 The potential for costs savings within a short period(e.g., less than three years). Three major not-for-profit organizations whose mission isto promote quality health care have recognized thecontribution of disease management activities to qualityhealth care by establishing disease management certificationor accreditation programs. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), anindependent, not-for-profit organization and the nation’spredominant standards-setting and accrediting body inhealth care, offers disease-specific care program certification.Program certification is based on an assessment of compliance with consensus-based national standards,effective use of established clinical practice guidelines tomanage and optimize care, and activities for performancemeasurement and improvement.
4
 The National Committee for Quality Assurance (NCQA)recently began accrediting disease management programson the basis of standards that are patient oriented,practitioner oriented, or both. It also offers organizationscertification for program design (e.g., content development),systems (e.g., clinical information and other supportsystems), or patient contact (i.e., for nurse call centers andother organizations without comprehensive activities).
5
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Disease Management for ChronicObstructive Pulmonary Disease

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